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To all of you suggesting fabreeze, air fresheners and essential oils please be mindful that you are in a facility with other people. For me, being around fabreeze sends me to urgent care. Scented products can trigger her neighbors who have allergies or asthma. Go after the odor, stop trying to cover it up. Work with the facility and make it THEIR responsibility to make sure the odor issue is fixed. After all, they should be the experts at handling these things.
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Memory Care checks them once an hour here....and takes them to the bathroom. Regular assisted living is nowhere near as vigorous. My mother peed in the elevator once in AL......thats when she finally agreed to wear Depends regularly. I was glad nobody else was in there with us to witness her embarrassment. Sigh. You just can't get rid of the odor of urine entirely, I'm afraid. It will help a lot when your mom is on a regular schedule of Depends changes, and when her old clothes are replaced with new ones. I'd also lay down Extrasorbs on her cloth covered seating for protection.
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https://advancedtissue.com/2015/06/preventing-pressure-ulcers-in-incontinent-patients/
you might like to view the information there even if no pressure sores at present. It explains why regular changing and washing plus barrier cream are important, 

For the room odour check out
https://www.amazon.co.uk/Purifying-Eliminator-Absorber-Closets-Charcoal/dp/B004BOH6BM

Bicarbonate of soda is also excellent - you can get some talcs with that in it - neat bicarbonate can cause skin irritation but mixed it is great for the skin and odours.
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Im not sure what to call it...

I have this little thing that plugs in and emits a mist from a reservoir containing a mix of water and essential oils. A sort of mini humidifier. It can be set to produce a steady streaming mist or periodic puffs. It does need to be regularly refilled but on the periodic puff setting it does last 24 hours. The mist is not hot even when set on the steady stream so burning ones hands/fingers isn’t really a threat.

Still - I imagine that if mom is sitting around in soiled briefs no amount of scented products will adequately freshen the air. I’d start there.
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Isthisrealyreal Sep 2019
Diffuser rainmom?
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I would plan a day that she can be kept out of her room for most of the day, have someone go into her room and saturate anything cloth or porous plastic/vinyl with straight white vinegar. Vinegar kills the enzymes that cause the odor. Make sure that you get the floor under the places that she sits or sleeps. It will be strong, but it goes away as it dries. I would close her door and put a few fans with the window open.

What does the facility recommend for getting her to change her depends more frequently?

I had to sit face to face with my dad and tell him that I know that he can't help it and I know that he would be embarrassed, so lets deal with this by wearing briefs, changing them when they are wet. He was mad, but once he realized that he was more comfortable it wasn't a problem.

Oh, if her cloths get saturated with urine, a regular wash may not get rid of all the odor. Check her closet, it may be time to take them home and do a vinegar and baking soda soak or replace items.

I don't recommend covering the odor, it doesn't really work, it smells like covered up odor. White vinegar is amazing, it will even get the stains out and it is cheaper than any other options(3.50 a gallon), non toxic, and can be stored in her room. I would keep a gallon and a spray bottle handy to spritz any spots as they occur.

Best of luck, that is a tough one.

You can also use kitty litter under her chair and bed as an odor absorber.
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Thank you all. My mother's AL also provides memory care. She is gradually evolving in that direction. Like me, or me like her, she does not like to be told. Still needs some sense of control. I get it. My expectations need to be adjusted I think. I will speak to the head nurse regarding my concerns.
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JudinWA Sep 2019
Hi WVson1. I think your best statement is the realization that your "expectations need to be adjusted". That is though one to do. Having worked with families of Seniors in all types of health and care situations for 40+years as an RN that statement really resonates with me. Often it really starts with the primary caregiver, in this case it sounds like you, being willing to adjust their views, expectations and overall ability to address and cope with a parents' changing needs. Then the next step becomes what is it that Mom really needs--to be in control. How does one address the issue and allow Mom to be in control? So many different ways to go about this. For the situation of being incontinent, short of moving her to Memory care, as you do not seem ready, take time to really evaluate all her actions and behaviors related to elimination. Times, awareness or lack there-of, actions or little behaviors that she may do that signify that she is going to eliminate, looking for something. When does she take off clothing, or doesn't she at all? be ready to "sneak in" or substitute clean clothes for soiled at time of eliminating,

How often in a day are you able to come, or can you set aside 2-3 days to be there a lot of the time to learn her behaviors with regards to elimination (not just show up and she is soiled again.) the overall goal would be a little pre-emption to be able to gently replace soiled for clean.

Is she still sing the toilet some of the time? if so what time of the day? When she has her pants down, step and and gently replace with clean. Or if she takes off clothing at night, put new clean clothes out without her really being aware, and replace soiled, including briefs.

But with the goal of getting her to think she is in charge, not you. After all she has been in charge of this activity for most of her life.

Maybe she simply does not like the style of briefs you have chosen, but does not understand that. I have one family that calls their Mother's briefs her "party pants". She has always liked to dress up, and always wore nice underclothing. there are some nice looking briefs available (albeit a little more expensive). but by changing the type of brief and tapping into Mom's love of nice clothing, they're able to address the issue. So maybe there is some way to look at the whole process differently. As you said changing, not lowering, your expectations based on Mom's lifelong habits.

All the best. It is not easy. eliminating odors is another problem, and there are a lot of good suggestions here. I would avoid scents that simply cover up, and go with ones that eliminate. And I agree with the animal lovers, housepet odor eliminators are often the best and the least expensive overall.

Finally, the basic problem may come down to the fact that you are her child. And have never been in charge of personal care for your parent. Often, by having facility staff provide care, your Mom will be more receptive. This removes you fro the loop, and from being the "bad guy". Staff are particularly trained, especially those with Memory Care training, to deal with this and other particular issues arising with Dementia. Adding increased caregiver hours will cost though, and that is another consideration.
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People who have dementia often are not able to manage their own hygiene and toileting issues. And, AL staff often have limits to how much they will handle. I'd meet with staff to see if there are any options, because, it sounds like she needs frequent checks on her BM status and more regular and prompt cleanups. It's not likely your mother will cooperate with this, since she has refused so far. I'd explore a higher level of care without delay. Her sitting in dirty diapers is likely to have negative side affects from skin infections, UTIs, etc. I'd also keep in mind that a regular AL may not have the training or experience to work with a person who has dementia, like those in a memory care unit would do. If she's being cleaned properly, there would not be a bad odor.
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I second FreqFlyer's advice on scented items and plug-ins.   And I think it's easy to conclude that the scents are real and that there are no added ingredients, but that's not always true.  

The only real scented items I buy are from either of two herbal suppliers.  One grows her own herbs, is very particular and once discontinued a wonderful, soothing amber essence body cream b/c her herbal and natural ingredients supplier became unavailable.  The other also grows her own herbs and is still expanding her product line.

I buy my facial and skin creams only from these suppliers.

Another thought is to use essential oils to create natural fragrances.
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I think all cushions should be checked. Mattresses too. Your mom bathes, so it isn’t her. The AL facility is supposed to help keep her clean so I would check areas where waste leaked.
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Be careful with plug into an outlet item scented item. When the oil runs out, you quickly need to remove the product from the outlet or it could become a fire hazard if left unchecked for months..

Also read the ingredients used in these plug-ins. Some plug-ins the scented smell can cause diarrhea in infants. So I wonder if the same can be said for the elderly? I know these items are not good around pets.
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Bed Bath and Beyond sells a product by Yankee Candle that plugs into an outlet and slowly releases scent. Nothing dangerous about it. May not completely solve the issue but might help some.
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worriedinCali Sep 2019
Bath and body works sells those too, there are a variety of plug in diffusers and scents. One bottle of scent (I forget what they are called) lasts a good month. I buy them when they are on sale 5/$23 and use a 20% off or $10 off a $35 purchase coupon.

They are safe BUT you don’t want them to fall out on to a wood surface, it will ruin it. Learned that the hardway!
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Try a bowls of vinegar. Worked for me.
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Katsmihur Sep 2019
Baking soda absorbs room odors.
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WVson1, regarding the odor control, I agree with GardenArtist about the Fabreeze. For odor control, check out the organic section of the stores, as those sprays are more user friendly, more plant base. A product called Mrs. Myers makes some nice scents. I use all of her products. I love the Iowa Pine scent but your Mom may or may not like it.

As for her chair, you can check out the pet stores for cleaning products that can be used on furniture. These stores also carry items that you can place in the room to absorb ordors.

As others had mentioned, sadly you can't convince a person with dementia to make changes. Is your Mom in the Memory Care section of the Assisted Living?
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You are indeed a good son.
I do think, though that you may be placing the bar a little too high in terms of your expectations for your mother.
Does she change her own garments? If not, the help staff should have a pretty reasonable schedule for her toileting needs.
You indicate that she “does not realize” that her personal garments “need to be changed”, but that is the absolute fact, SHE DOES NOT REALIZE, and CANNOT realize, and most likely will NEVER REALIZE that she needs fresh underwear, because she has dementia.
You cannot “convince” her, because she has very likely lost the capacity to be convinced. Given her sensory and cognitive limitations, (“She is oblivious to all of this”) she cannot be expected to understand and act on what you are expecting of her.
If the AL care givers are not expecting more of you, try to understand and accept the fact that they are probably focused on preventing skin break down, and not as much focused on your concern about odor.
There are room fragrances and deodorizers that contain only natural ingredients, and they can used to dissipate or conceal the odors that seem objectionable to you.

Hope this helps!
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If the smell in her room is overpowering it is likely that more than the chair has become saturated with urine and nothing short of a deep clean with appropriate chemicals is going to remove the smell.

It sounds as though your mother is in an AL that is more appropriate for people who are mostly independent and whose need for assistance is minimal. Bottom line is that she isn't receiving the care she needs, unfortunately administrators will often promise much more than the facility has appropriate staff to handle. Her dementia is only going to get worse and with it will come physical decline, I think now is the time to look for a higher level of care.
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Perhaps you're not aware, but Febreeze contains toxins, the reason why I never have and never will use it.    Many people are unaware of this.

Try baking soda instead; it absorbs odors, as do newspapers and coffee grounds, although I wouldn't normally suggest leaving coffee grounds in an area where someone with dementia is staying.    You could try putting them in a bottle, or large container like those for herbs and seasonings.    Leave the top off but the perforated internal cover so the odors can be absorbed by the coffee grounds.

A scented candle, if not overpoweringly chemical in smell, might help, but consider the danger of leaving it anywhere where your mother might be able to access it.

Lemon is also a possibility.  Some friends who also use organic only treatments use lemon as a cleanser.  It can interact with some metals though.  I cleaned my sink with it and it turned the metal base around the drain to a rusty color, which I haven't been able to eliminate.

I don't have any other suggestions but you might raise this with one of the staff and see if there are other substances that could be used.   Hospitals and nursing homes probably see this often, and I suspect there are some more powerful treatments that they have.   

Don't use bleach though; the odor is overwhelming.
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Riverdale Sep 2019
I doubt an AL facility will allow a candle in the room. It's a great solution for odors but too great a risk in that setting.
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