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Posted October 17, 2007

Ask An Expert

Elderly Behavior: When a Loved One Smells Bad

Q. My husband and I own a home in which my 86-year-old mother-in-law lives on the first floor. A strange odor originating downstairs, similar to what we experienced at her own home for years, has begun to permeate our staircase and living room upstairs. You can even smell it outside of her windows.

Mother has always had poor cleanliness habits, even in her 60s, and has never been much of a housekeeper, yet she always becomes belligerent when we try to assist. Last night, we found proof that she may be incontinent, something I mentioned to my husband last year, but she denied it to my husband this morning. We can't make her wear adult diapers, and she refuses to see a doctor.

Believe me, Mother has her forgetful moments, but most of the time she doesn't miss a thing that goes by her. What can we do? She's not mentally or physically incompetent, so a nursing home seems out of the question, but she refuses to listen to her sister or us. And, she's too belligerent to allow anyone to stay or visit with her. This is driving me crazy and breaking my husband's heart.

Karen B., Hempstead, New York.

A. It's obvious from your words that you and your husband care a lot about your mother-in-law, despite the fact that this situation is "driving you crazy." I don't doubt that it is.

Obviously, this is a long-standing problem. What you smell is probably what some people call the "old person smell." It is the accumulation of body oils, perspiration and dead skin cells that accumulates when a person has less than ideal hygiene. Add that to old urine and poor housekeeping and you can get quite an odor.

I wish there were a way to resolve this problem without someone being the bad guy. Unfortunately, there isn't.

If properly prepared, sons and daughters of aging parents can accomplish just about anything. In this case, though, I do believe that you need to call in some reinforcements. As your mother-in-law won't go to the doctor, I imagine that it's been a long time since anyone did a real assessment of either her physical needs or her cognitive status. A professional geriatric care manager would be the ideal person to call in to do just this.

Without a thorough assessment it's impossible to know whether your mother-in-law might have psychiatric issues, or possibly some dementia that you haven't detected, or even a physical problem that should be medically addressed.

A geriatric care manager can come to your home and do a thorough assessment.

You might be amazed at the information a good interviewer will be able to extract. The care manager can then give you a complete report and help you find resources and develop a plan. The care manager will also usually be willing to be the "bad guy," which can be very helpful.

Any plan you come up with will require that either the care manager or your husband (or both) give your mother-in-law alternatives that she won't like.

You will all then have to stand firm as a group, because she is sure to test you. Exactly what these alternatives would be will depend on the results of a good assessment.

If you would like to consult with a geriatric care manager, you can find one near you at the website of the National Association of Professional Geriatric Care Managers. You should be able to talk with local care managers and find out how they have handled similar situations in the past. Then hire the one who appears to be the best "fit."


Bringing in a care manager will cost a bit. How much will depend on the care manager's rates and how involved you want him or her to be. However, the investment will be well worth it in both the short and the long term if you can get your mother-in-law the help she obviously needs.

This answer is provided by Molly Shomer, MSSW, LMSW, a family caregiving specialist and licensed geriatric care manager. Molly, a nationally recognized expert on eldercare issues, is the author of The Insider's Guide to Assisted Living. Her website is www.eldercareteam.com, and she can be reached at molly@eldercareteam.com.

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