Monthly Archives: September 2013

What Causes That “Old-Person Smell”?

We know it when we smell it, though it can be hard to describe, and even harder to talk about. Sometimes we describe it as musty, sometimes as medicinal, sometimes — sadly — we just find it vaguely unpleasant. But what causes that “old-person smell”?

“There’s absolutely a particular smell we associate with aging, but there isn’t one specific cause,” says Eric Shapira, a physician and clinical gerontologist in Half Moon Bay, California, and author of A New Wrinkle: What I Learned from People Who Never Acted Their Age (iUniverse, 2009). “It’s a combination of many different things that are all associated with what happens to the body as we get older.”

Here are the ten main reasons experts say older people and their homes have that “old-person smell.”

1. Closed Quarters

If you’ve spent time with older adults, you’ve probably observed that their homes tend to be stuffy; open windows are not a common phenomenon.

“Most older people’s homes I go into have the heat on, the windows shut tight, the shades drawn, and the curtains pulled over the shades,” says Brenda Avadian, founder of The Caregivers Voice, a newsletter for caregivers. “There’s absolutely no fresh air.” Dislike of drafts is one primary reason older people’s homes are so stuffy, Avadian says. “Older people feel cold all the time because the body begins to lose temperature regulation. And when rooms are hot, stuffy, and airless, you get mold and bacteria growing, in addition to general stuffiness.”

Fear is another factor, experts say. “Many old people live in fear because they feel vulnerable; they know they can’t defend themselves,” says Brenda Thompson, patient care director for Tri-Country Home Nursing Services in Westbury, New York. “They start to think everyone’s watching them, and an open window is an invitation to a robbery. Also, they’re afraid if they open the window they’ll forget to close it again.”

2. The Cleaning Conundrum

As people age, they have a harder time keeping their homes clean — often for good reason, says Barbara Moscowitz, director of Geriatric Social Work at Massachusetts General Hospital. Because of the risk of dizziness and falling, older adults are often told by their doctors not to bend down, not to climb up on chairs or ladders, not to kneel or stoop. And how are you going to keep a house clean without being able to do those things?

“When our bodies are weaker, we can’t clean up after ourselves as well,” says Moscowitz. “Some people have the means to pay cleaners to come regularly, but many don’t, and they may hesitate to admit to family members that they can’t maintain their homes on their own.”

Dust, mold, mildew, and dander — the word for sloughed-off skin cells — accumulate and cause air to smell stale, while rotten food and accidents — pet and human — that haven’t been thoroughly cleaned up add to the “pee-yew” factor.

3. Laundry Limitations

We think nothing of throwing a load of clothes in the wash whenever we need to, but that changes as we get older, experts say. “You’re not moving as fast, so you probably don’t work up a sweat, and it’s a lot of work to do laundry. So you hang your shirt back up in the closet, figuring you can get one more day’s wear out of it,” says Barbara Moscowitz.

If an older person’s house has an unpleasant musty odor and you can’t tell where it’s coming from, open the closet, she suggests. Often you’ll find it filled with clothes in need of washing and shoes that could do with airing or replacing.

Of course, laundry issues related to incontinence are also common, experts say. Sadly, many older adults simply underestimate how much time it takes to get to the bathroom and don’t make it on time. And they may not notice a small amount of leakage, which can have a big smell.

4. Sensory Decline

One explanation for the “old person smell” is surprisingly simple: An older adult’s sense of smell isn’t as keen as a younger person’s, experts say. “By the time you’re in your seventies, you’ve lost 75 percent of your sense of smell,” says Brenda Thompson. “You don’t notice the odor, so you have no idea others are reacting to it.”

When someone seems to slack off on hygiene issues, from body odor to bad breath to unpleasant smells in the home, it may be lack of awareness rather than lack of concern that’s to blame. Loss of vision is another contributing factor, says Barbara Moscowitz. “If Grandma has a stain on her blouse or there’s a film of mold on the bathroom walls, it’s not that she doesn’t care; she doesn’t know it’s there,” says Moscowitz.

5. Dental Dilemma

As we age, the tissues of the mouth produce less saliva, which is why dry mouth is a common affliction of old age. “Saliva is our best defense against bad breath,” says geriatric dentist Randy Geller of Bellmore, New York. “It washes the mouth clear of food particles and bacteria.” Snoringand mouth breathing while sleeping are also more common as we age, drying out the tissues of the mouth even more.

In addition, overall mouth hygiene tends to decline because many older adults don’t brush their teeth as efficiently as they once did, Geller says. There’s even a term for the bad breath caused by gum (periodontal) disease: “perio-breath.” Dentures and bridge work — which are made of acrylic and can begin to retain germs and odors if not replaced after the recommended seven to ten years — can also lead to hygiene problems. Denture wearers are also more likely to a musty odor that comes from fungal infections of the mouth.

Diabetics can have an additional problem known as “ketone breath,” released when acetone compounds are metabolized in the stomach. Digestive issues, such as acid reflux and GERD, which are increasingly common as we age, contribute to bad breath through stomach odors coming up into the mouth.

6. Thirsty No More

Dehydration is startlingly common in older people, says geriatrician Eric Shapira, and it contributes to their smell in a number of ways. “As we age, our pituitaries stop sending the signal that tells us we’re dehydrated, so we stop feeling thirsty,” Shapira says. It’s common, he says, for older people to drink very little without realizing it. In addition, elderly people whose mobility is low may find it tiring to get up to use the bathroom, so they drink less by choice.

The problem is that dehydration affects the body’s ability to regulate itself in a number of ways. “If you’re not drinking enough water, everything becomes more concentrated, and those odors come out through the pores,” Shapira says. Dry skin sheds skin cells, which can have a musty odor. Any odors from food, such as garlic or onion, become stronger. Urine becomes concentrated, so even just a drop or two of leakage can have a strong smell. Then, in a chain reaction, being dehydrated contributes to feeling cold all the time, Shapira says, leading in turn to closing windows and overheating the house.

7. Bathing Issues

An aversion to taking baths often occurs late in life, experts say, particularly in men. The reason: Taking a bath or shower can seem like a lot of work, and they have fewer reasons to clean up. “You’re probably not getting yourself gussied up for a hot date anymore,” says Brenda Avadian, founder of The Caregiver’s Voice. “The motivation’s just not there like it used to be.”

For others, fear and frailty prevent them from bathing. “We see many older adults who can’t bathe as often as they want to,” says Moscowitz. “Taking a bath or shower can be dangerous if you’re frail, and it’s common for older adults to develop a fear of falling, because they know they won’t be able to get up.”

Even so, pride keeps many people from telling family members that they have issues with bathing. “So we have many older people who are just giving themselves sponge baths,” Moskowitz explains, “and that’s not enough.”

8. That Medicinal Smell

Older adults often take a lot of medications, which can cause a subtle chemical odor that we associate with aging. In particular, says Eric Shapira, any sulphur drug has a strong smell when excreted through the pores. More noticeable still can be the medicinal smell of certain ointments and creams popular with older adults. “Many older people use products like Ben-Gay for sore muscles, or patches for arthritic pain,” says Barbara Moscowitz. These products, made with menthol and other chemicals, can have a strong medicinal smell. Vicks Vapo-Rub, also made with menthol, remains popular for those with breathing difficulties, while those with skin conditions use a number of different creams and ointments, all of which have an odor.

9. Cleaning Without Really Cleaning

One of the odors we associate with aging is that chemical-laden antiseptic smell that assails you when you walk through the doors of some [nursing homes][1]. That astringent scent comes from ammonia and other antiseptic cleaners and air fresheners that facilities use to clean up accidents. The problem is, in many cases, they’re not doing a thorough deep cleaning, and then they use products to try to mask the smells, says Barbara Moscowitz. “What you get is that ammonia-antiseptic smell laden over the smell of urine and feces, which may have seeped into cracks between floor tiles or other places.”

10. Surrounded by Stuff

Old things give off the musty odor of age, and the elderly tend to live surrounded by old things, points out Brenda Thompson of Tri-Country Home Nursing. “All those old books and papers, old linens and clothes — they all harbor dust and dampness and give off a musty odor that can pervade the whole house. If you moved into that house in 1945, those books may have been there for 60 years. I’ve seen drapes that have been there that long, too.”

Yet getting older people to give things away is difficult, as many family members have found. “Some of it is that older people have a different sense of time,” Thompson says. A box of clothes can sit for weeks or even months waiting to be sorted.

And, of course, all those photo albums, books, linens, and clothes carry memories, so giving things away can be painful. “One day we’re going to be older too,” Thompson says, “so it’s important to understand these changes and be kind and compassionate, as we hope others will be to us.”

11 Easy Diabetes-Management Tips

11 Easy Diabetes-Management Tips

Diabetes Management in 10 Minutes or Less

6 Ways to Stop Diabetes From Making You Tired

WebMD Feature


Feeling fatigued? If you have diabetes, tiredness can be one of the symptoms.  

The first step toward feeling better is to talk to your doctor. Your doctor will check your overall health, including how well your diabetes is controlled and whether you have any other medical conditions that need attention.

It will help if you keep a diary for a week or two for your doctor. In it, write down:

  • Your blood sugar levels.
  • How stressed you feel. Some people feel burned out from the effort it takes tomanage diabetes every day.
  • How often and how much you exercise.
  • What you eat and when you eat it and how much you eat.
  • How much and how well you slept.  
  • If you wake up at night because you’re snoring, need to use the bathroom, or if anything else interrupts a full night’s sleep.  
  • How you feel when you wake up in the morning. Do you feel rested or tired?

Together, you and your doctor can make a plan to boost your energy level. Your plan may include:

1. Exercise. Move more, and you get more energy. People who take a brisk, daily 30-minute walk are less tired than idle people, says Cynthia Fritschi, PhD, RN, CDE, assistant professor in the biobehavioral health science department at the University of Illinois at Chicago College of Nursing. 

Choose an activity you like, whether it’s Zumba, tennis, walking, gardening, orswimming. Do it for at least 30 to 60 minutes a day. If you can’t spare that much time at once, sneak in shorter (10-minute) periods of exercise whenever you can. As long as it adds up to 30-60 minutes per day, that’s what counts.

Wear a pedometer so you know how many steps you’re taking each day. Try to add 500 steps a day until you reach at least 10,000 daily steps, says Geralyn Spollett, MSN, ANP, CDE, of the American Diabetes Association and Yale Diabetes Center.

2Watch your diet. To keep your blood sugar level steady, eat three healthy meals and a snack during the day. Include healthy carbohydrates from fruits and vegetables and whole grains, as well as lean protein from sources such as beans, tofu, fish, or skinless chicken breasts.

3. Avoid caffeine, especially late in the day. Caffeine can keep you awake and disrupt sleep. It can also make it harder to control your blood sugar, if you overdo it.  

4. Get enough B vitamins. B vitamins help nerve health. If you have nerve problems from diabetes, make sure you’re getting these nutrients from your diet (good sources are foods such as fish, poultry, fortified cereals, and eggs) or a supplement. It’s a good idea to tell your doctor about any supplements you take, including vitamins, so they can check that you’re getting the right amount.

5. Check on your snoring. Many people with diabetes briefly stop breathing several times at night. That’s called sleep apnea. Symptoms include snoring, feeling sleepy during the day, having trouble concentrating, and often waking up with aheadache or sore throat. Tell your doctor if you, or your bed partner, notice those things. Sleep apnea can be treated, and that could help you get better at night, which gives you more daytime energy.

6. Stay hydrated. You can become fatigued if you’re dehydrated. Drink at least 8-9 glasses of fluids a day.

6 Ways to Wreck Your Blood Sugar Level

Type 2 diabetes is a tough disease. It requires constant vigilance to keep your blood sugar level under control. 

It also requires avoiding some common mistakes, many of which are the product of long-held bad habits. 

Injuries that are minor in a healthy person can have severe consequences when you have diabetes, so good wound care is essential. Because of reduced circulation and problems with sensation (neuropathy), people with diabetes are at a much higher risk for complications from ordinary, everyday cuts and scrapes.

Read the Diabetes Wound Care Checklist: What’s in Your First Aid Kit? article > >

 Here are six mistakes that you can learn to avoid.

1. Not Knowing Your Disease

“You are your own doctor 99.9% of the time,” says Andrew Ahmann, MD, director of the Harold Schnitzer Diabetes Health Center at Oregon Health and Science University in Portland, OR.

By that he means that you are the one watching your diet, making sure you exercise, and taking your medication on schedule. Understanding how diabetes works will help you make better decisions about how to monitor and manage it. Classes on coping with diabetes are an excellent but underused resource.

“Not enough patients seek them out, and not enough doctors send their patients to them,” Ahmann says.

 That’s unfortunate, because not only do they offer essential information, but they are often support groups as well, bringing together people who have the same problems and giving them a place to meet and talk with each other.

2. Expecting Too Much Too Soon

One of the biggest hurdles in controlling your blood sugar is sticking to your eating and exercise habits. Many patients become frustrated and give up because they don’t see results right away, says endocrinologist Preethi Srikanthan, MD, assistant clinical professor of medicine at UCLA’s David Geffen School of Medicine.

“Most people expect something dramatic is going to happen right away,” she says. “But it has taken them a decade or two to get to this point, and it will take a while for them to even to get to that initial 5%-10% reduction in weight. …These are challenges that must be taken in small steps.”

Expecting too much change right away is a mistake. So is doing too much before you are ready, especially when it comes to exercise, Ahmann says. He advises starting off slowly and easing into the habit.

“If they do more than they can tolerate, they will often quit,” he says. “Or they will do too much and hurt themselves.”

Be sure to talk with your health care provider before starting a new exercise program, especially if you aren’t already active. He or she can help plan a routine that’s safe and effective, as well as set realistic goals.

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