When Clara sold her home and moved to live with one of her sons and his wife, she was decently healthy (despite cataracts, low blood pressure and incontinence)—and loved to dress up on Sunday mornings. She donned one of her felted cloche hats, pinned this week’s brooch on her jacket, and spritzed herself with her signature scent, White Diamonds.
Little did she realize, however, her perfume triggered migraines in her daughter-in-law Brenda.
When Clara traveled, Brenda tried to air out her suite and freshen up her mattress – which quickly grew musty with perfume and the faint smell of urine – by pulling it out into the sun. Yet, it wasn’t long before scented products designed to cover up smalls made Brenda sick to her stomach—which led her to find new living arrangements for Clara.
Stories like these are common: Olfactory (smell) sensitivities are both psychological and physiological. While they can be manageable at times, they may also lead to intense reactions that become a barrier to caregiving.
Considering that most seniors would prefer to age in place, resolving the problem is a worthy challenge. It begins with acknowledging and addressing the complex factors of olfactory discomfort.
Scent and memory
First, the sense of smell is closely linked to memory. The olfactory nerve is directly connected to the “lizard” part of the brain called the limbic system, and it has the power to evoke strong emotional reactions such as psychosocial well-being. The luxurious scent of White Diamonds, for example, can evoke everything from a sense of elegance and beauty to memories of happier days when Clara puts it on.
However, one person’s “scent” is another person’s “odor.” Perfumes and artificial scents can trigger physiological responses in some people—a reason why certain workspaces may be designated scent-free. Some people can experience strong reactions to body odors or other strong natural smells. These responses may be psychological, social or cultural, but that doesn’t make them any less legitimate as a stimulus. One person may associate a waft of urine as an expected part of caregiving, while another may experience it as a signal of contamination. For others, it’s a part of a complex psychological response to burnout.
Layla Myers, a certified nursing assistant in a nursing home, expected the smells that came with her patients. Because she loved the people for whom she cared, she could usually ignore unpleasant bodily odors and discharges. Yet, over her years as a CNA, the disinfectant used at her facility began to arouse frustration and despair, and she still associates the smell – which she describes as “Pepto Bismol mixed with hand sanitizer” – with the mismanagement and impossible working conditions she experienced there.
The brain links smell to memories both as a warning system and as a coping mechanism.
Physical causes of smell
Odor has a physical property, of course. It’s a chemical reaction between a gas from a substance and receptors that communicate with our brains. Our brains classify these gasses as either noxious or tolerable. Cleaners, perfume, urine and bowel discharges often top the list of malodorous stimuli.
And that so-called “old people” smell? This distinct smell – technically called “nonenal” – emerges as a body changes how it degrades omega-7 unsaturated fatty acids. A grassy or greasy odor whose specific catalysts are unknown, the smell may be from a hormonal imbalance or a change in metabolism, or even caused by pharmaceuticals or diet. Some caregivers and seniors may not notice, while others do, but as the maturing body produces stronger smells – stinkier bowel movements in response to diet, that nonenal odor and urine from incontinence – a caregiver’s natural response may be to try to mask them—with everything from Poo-Pouri to Febreeze.
Both seniors and caregivers can suffer from perfume sensitivities, and many may have something known as hyperosmia, a condition where odors are more easily detected, which may be caused by elevated estrogen levels (such as pregnant women) and/or the appetite-stimulating ghrelin hormones.
Recognizing that smell may evoke or trigger reactions means acknowledging the reaction and finding solutions. A parent or partner’s blood pressure medicine, for example, may create a body odor while also preserving their health. Meat or processed foods may result in disagreeable smells, but may reduce joy, health or quality of life if eliminated from an older adult’s diet.
As you deal with the olfactory challenges that come with caregiving, try one or more of these practical solutions to help you manage the problem:
- Use cleaning soda, distilled vinegar and bamboo charcoal (which can be renewed in the sun), along with hydrogen peroxide, to neutralize odors safely and environmentally.
- Remember that the sun is a disinfectant. Hanging laundry on the line outside and bringing mattresses, cushions and rugs out for a few hours can “bleach” out the smell.
- Fresh air from outside helps, so open windows during good weather.
- OxiClean, Borax, OdoBan or other cleaning enzyme additives may help with laundry.
- Seal up adult undergarments in a sealed container like this one by Ubbi.
- Environmentally sound disposal bags reduce your waste footprint. Try compostable diaper bags or wax-coated paper bags.
- Essential oil diffusers help mask odors. Choose a scent that both you and your loved one find pleasing. Change the oil if you begin to associate it with negative emotions.
- Incontinence pads on seats and mattresses absorb accidents.
- When smells trigger emotions or memories, it’s helpful to go into a well-ventilated area, turn on a fan, crack the windows, and employ mindfulness or grounding techniques, such as journaling and meditation.