by Carolyn Lukert, MBA, CGCM,
PAC Consultant and Mentor
Dear PAC Consultant,
My wife is 72 and she was diagnosed with Alzheimers disease two years ago. She lives at home with me, and so far, I think I am doing a good job supporting her. I am very curious about something, though. One of the major changes I have noticed is with my wife’s ability to smell certain things. It’s strange in that she hasn’t actually lost her sense of smell, but she seems to not care about some really strong odors. For example: She is beginning to have a lot of bathroom accidents. So, her clothes often have the smell of number one, and even number two, if you know what I mean. Turns out, she takes off her soiled pants, hangs them on a chair, and then forgets to put them in the wash. Then, she puts them back on again. And when I point it out to her, she gets quite angry. She says the pants are just fine, and refuses to take them off. Well, there is no way we are going outside of the house with her smelling like that because it is just so embarrassing! And, everyone is going to think I am not taking good care of her. I hope you are not going to tell me to just ignore it because, if that is your answer, we will never leave our house again. And, I will have to invest in some type of heavy-duty odor repellant, as my sense of smell is working just fine, and it is making my life miserable. Please help!
Nosey in Naples
Let me just say that you are coming in loud and clear! You want an answer to this stinky dilemma! And I can’t say that I blame you. All kidding aside, our sense of smell is one that can bring us great pleasure as well as extreme disgust. Smell helps us to sniff out danger (pardon the pun), as well as trigger fond memories, relieve anxiety, and even help with pain management. And, we have the power to impact others around us in a big way when we are either the carrier or the cause of pleasant or unpleasant smells.
So, let’s break this down so we can understand what is happening, and then we’ll work on some strategies for supporting a person who is experiencing these types of changes.
The ability to smell is actually quite a complex process that involves several parts of the brain. When those parts of the brain are impacted (as they will be with many dementia-causing diseases), the processing of smell is affected. So, while your wife may actually be able to smell an odor, it doesn’t trigger the same meaning as it would if she didn’t have dementia. This can be the case for many odors – not just for number one and number two, as you put it. And, it is something over which she has no control.
I am wondering – have you noticed your wife doing any of the following:
- Wanting to scrape off visibly spoiled parts of food, and simply eat the rest – even though it is clearly spoiled?
- Resisting getting clean even though body odor is clearly evident to you?
- Using strong smelling chemicals – like bleach and other cleaners – and not taking proper precautions?
- Ignoring or not reacting in an appropriately urgent way to the smell of smoke/burning?
While some of these are simply distasteful, others can have potentially devastating consequences. Check out this video clip (advance to time stamp 4:35 for the specific section on the sense of smell).
So, understanding this, what are the chances that a person living with dementia is going to be able to change his/her response to those odors? And further, what distress might we actually cause by trying to make her understand and do something different? Lastly, what might be a better response to accommodate our loved one’s changing brain and reduce distress for all parties involved?
I am wondering if any of the thoughts below might be worthy of exploration (just pick one to start):
- Strategically gather her soiled clothing and get them in the laundry so they aren’t left to be re-worn over and over. This can be tricky and might require some stealth moves, but it seems like it might be worth it.
- If she has favorite outfits that frequently get soiled, perhaps getting multiples of those outfits, and trading out the soiled for clean without her noticing.
- If she isn’t using incontinence products, I am wondering if it is time to begin the process of introducing this concept.
- Consider adding to your care team (home care assistance, for example) to assist in supporting your wife’s changing needs, including helping with the conversations, techniques, and skills in all of the ideas listed above.
- Polish your techniques and skills for getting your wife’s cooperation in removing clothing that needs to be cleaned, and for assisting her with self-care.
As always, we are here to help. Simply email our consulting line email@example.com if you’d like to explore any of these thoughts in more detail, and to get help with finding associated resources.
I hope this helps to clarify what is happening, and that some of these ideas will result in a sweeter smelling situation for both you and your wife. Thanks again for reaching out.