House smells like wee

If she’s got a comfortable budget, then if the GP doesn’t come up with much - then can strongly recommend finding a local women’s health specialist physio. Vet them a bit, some are focussed on getting people back to running marathons post natal, but plenty do older women too.

They can be very good at working out the wider lifestyle picture (so pads, plus exercises, plus avoiding constipation and generally managing the situation).

As are continence nurses, but they’re harder to arrange privately.

I’d buy one of those purple flashlights on eBay or Amazon that show up urine and other bodily fluids. Under a fiver. Use it when it’s dark and you’ll see where puppies or humans etc have been having accidents so you can target those areas for a deep clean.

Did her test results come back?

I’ve had to start keeping a eye on the fridge contents as my mum has started going by use by date even if things have been open a week like the half pudding that she’d left in there which must have been well loaded with bacteria ( “ why are you throwing that half pudding out as it's dates not up yet”) ( yeah mum it says use within 24 hours of opening, not 8 days lol) and the over a week old half loaf she was still eating and wondering why she had sickness and diarrhoea….

Thebrains not what it used to be….

Perhaps get the cleaner in twice a week - at least to start with?

I’ve just read your updates and I hope your DM is better soon.

One thing I’ve just thought of is that constipation can cause some women to leak urine. I know that she’s had diarrhoea recently but that doesn’t necessarily rule out constipation. Just one more thing to possibly rule out

Is that a change since covid? I know they both had to go through the referral to a gynae for diagnosis but this was pre covid in both cases. If it can all be done at the GP that sounds a lot easier.

Gp can prescrbe estriol cream or rings for this.

Genito urinary symptoms of menopause

I would also buy bins for her with scented liners, get in touch with the council to see if she qualifies for an extra bin, clinical waste bags and a collection for continence products, when she sees the continence nurse they can arrange prescription pads and a continence products service

Good point OP about possible undiagnosed Neurodiversity. I thought of difficulty with Executive Functioning skills from the current and previous difficulties outlined.
I’m not suggesting a diagnosis of anything but just might explain some things. Cognitively she knows what to do and how to do it re cleaning, personal and food hygiene etc but can’t actually manage to put the two together.
Difficulty with Interoception might explain not knowing she needs to urinate. Just a thought.
Doesn’t really help your situation but might help to understand it. Sounds like you are doing everything you can in difficult circumstances.

Washing everything you can on a longish hot cycle and giving EVERYTHING a good clean/wipe over. My mother had the same issue including the denial and when her frailty got to the point I had to take over washing, dressing and housework the honk improved dramatically. But it's everywhere including in shoes.
nobodys mentioned vaginal atrophy so far I think, that can be the cause of the problem and why vaginal HRT can be such a useful thing to take.

it looks to me that you are setting expectations on your mother. It’s up to her how she lives, of course it’s not nice to live in a smelly house but it doesn’t sound like she has initiated any of these interventions and changes.

You can nudge and encourage but it might be wise to lower your expectations.

im sorry that this is not what you want to hear - but it’s rare to manage to change people.

With carpeting, check whether it is into the underlay. If it is, no amount of cleaning will sort it out. It is is just the carpet, get the pet urine enzyme stuff recommended at the top of the thread. Use that first, then have everything steam cleaned professionally. They will also be able to clean mattresses, chairs etc.

Wash bedding and clothing at 40° minimum on the longest available cycle and dry outside in the sun if possible. Detol do a laundry sanitiser if you want a bit extra.

A waterproof mattress protector is a necessity, but they can be a bit sweaty, so it can be trial and error. You can also get disposable mattress pads which would be useful for your current situation as it can save the non stop washing. Make sure you have at least three sets of everything.

Neutradol gel air fresheners are good. You can tuck them away out of reach and they are not overpowering.

There should be a mobility shop in your area, they can be an invaluable source of help, advice and equipment.

It may be worth thinking about a commode in the short term. If you do, you can get liners and put a thin layer of clay clumping cat litter in the bottom. It will soak up the urine and stop splash back.

You seem pragmatic, it's the best way to handle these situations in my experience.

It may not be a major intervention - she may need to see a gynaecologist. Two of my elderly relatives developed this in their 80s and in both cases it was a hormonal deficiency solved by inserting a small ring (diaphragm style) which releases a low dose of hormones. From memory once the consultant and diagnosed and prescribed, replacement rings could be provided and fitted by their GP practice once or twice per year.

They were both told that this hormonal deficiency is a common cause of incontinence issues in older women but it tends to be under diagnosed and under treated. Pelvic floor exercises and strengthening are advisable at any age but if its hormones the ring treatment is very low intervention.

Firstly I'm really sorry your going through this.
Would your mum consider moveing to a smaller property in the longterm .
Decanter to make cleaning easier ,getting rid of carpets replace with lino that's easier to clean if possible.
The mattress might have to be replaced.
Also you can buy kylie sheets on amazon these can be used on beds or chairs and if wet can be washed and reused.
I appreciated this is all very expensive.

Yas she has money would she be amenable to a daily carer? You can call them something else (PA?) if it would help her accept help. They can make sure she showers and changes clothes, wears Tena, check the food dates, keep on top of her clothes washing. Then a twice weekly cleaner to keep on top of the rest.

It will be helpful if she can accept GP help with the continence issues as will turn off the source of the problem, so to speak.

Agree in the meantime to put protectors onto stuff.

IMO once urine is soaked into furnishings you won’t get rid of it. Mum had an incontinent dog and despite the carpets being cleaned in hot weather the smell came back.

It’s good that you’ve put some boundaries in.

Could it be that the house is no longer suitable for her?

Have you had the discussion of moving to a retirement village when she’ll probably have a wet room making showering easier in the long run and there will be less rooms to clean and maintain?

On a chair it would helpful to have disposable bed pads so when sitting down would protect a chair. Waterproof mattress cover for the bed and disposable bed pad on top of the bed sheet to save stripping bed every day. I got my mums from Amazon. I found that incontinence pads where much better that pants. Mum used a pad with sainsburys incontinence pants instead of actual pants as you could just tear them at the side and didn't have to take them on or off. Used waterproof pants on top if going out.

(By "incontinence pads" I mean like puppy pads.)

You might want to start with a massive, thorough deep-clean from a good cleaning company.

Also get all the carpets cleaned (again using a professional). If they still smell, they'll need to be ripped out. Maybe replaced with hard flooring that's washable.

Get rid of as much stuff as you can (or as she will allow) out of her house. This includes unnecessary furniture, kitchen stuff, general junk.

If her bed smells, get rid of that too and get a new one. Use a waterproof mattress protector.

Disposable incontinence products would be better than washable. You can also talk about using disposable incontinence pads on the furniture too.

Wash everything on hot cycles and use Dettol laundry sanitiser.

If you can get a regular cleaner in 2-3 times per week, that would be much better than once a week.

I had stress incontinence after giving birth and this is really common.

i wore pads all the time.

other suggestions:

mattress protector for beds. The cheap ones break and rip very fast. If urine is in the mattress it is very very hard to get it out.

you can also buy pillow protectors. I’m not aware of duvet protectors but duvets can be washed in the bath.

Dettol laundry helps with urine smell.

(we had an old incontinent cat for many years).

most sofas if they have moveable cushions you can buy plastic protectors. We actually changed ours to a sofa with washable covers (had to wash them a few times).

You mentioned she's had recent stomach trouble. Have you had a look in her fridge? My parents in their 70s started ignoring expiry dates and as their appetites decreased with age their food storage practices weren't as good as they could be. Lots of saving this for later and then forgetting all about it..

that will really help op