care & love
Walk through the doors of any long-term care facility, and you'll likely be greeted by the soft hum of conversation, the gentle clink of dinnerware, or the warm smile of a staff member. These spaces are meant to feel like home—a place where residents receive care, companionship, and dignity. But for many, there's an unspoken visitor lingering in the air: a faint, persistent odor that's easy to overlook at first, yet impossible to ignore once noticed. It's the hidden problem of long-term care facilities: odor. Not the sharp, fleeting smell of a freshly cleaned room or the comforting aroma of baking cookies, but the kind that seeps into carpets, clings to bedding, and settles in the back of your throat—a silent signal that something isn't quite right.
Odors in care facilities are often dismissed as "just part of the job," a byproduct of aging, illness, or the hard work of daily care. But for residents, staff, and visitors, they're far more than that. They're a barrier to dignity, a source of embarrassment, and a quiet stressor that erodes the quality of life. In this article, we'll pull back the curtain on these hidden odor problems—exploring where they come from, how they impact those who live and work in these spaces, and what can be done to banish them for good.
To tackle odor, we first need to understand its roots. Unlike the obvious smells of a busy kitchen or a freshly painted room, the odors in long-term care facilities are often subtle and multifaceted, stemming from a mix of biological, environmental, and operational factors. Let's break them down.
The most common source of odor in care facilities is simple biology. Many residents struggle with incontinence—a condition that affects up to 70% of long-term care residents, according to the National Center for Assisted Living. Even with prompt cleanup, urine and fecal matter leave behind volatile organic compounds (VOCs) that create that distinct, sharp smell. Spills from meals, medication residues, and even sweat can also contribute, especially when they linger on skin, clothing, or bedding.
Take Maria, a certified nursing assistant (CNA) with 15 years of experience in a mid-sized facility in Ohio. "You get used to the routine: changing briefs, wiping down surfaces, using spray," she says. "But some days, no matter how fast you move, the odor sticks. A resident might have an accident during dinner, and by the time you get to them, the smell has already spread. It's not their fault, but it's hard not to see how it affects them." For residents like Mr. Thompson, an 82-year-old former teacher who now uses a wheelchair, these moments are humiliating. "I used to love having visitors," he says quietly. "Now I worry they'll notice. I've canceled lunch with my granddaughter twice this month because I felt self-conscious."
Surprisingly, one of the biggest culprits isn't always obvious: the nursing bed . These essential pieces of equipment—where residents spend 8–12 hours a day—are breeding grounds for odor if not properly maintained. Traditional nursing beds, with their metal rails, creviced mattresses, and under-bed storage, can trap moisture, food crumbs, and even pet hair (for facilities that allow therapy animals). Over time, these hidden pockets become havens for bacteria and mold, which release musty, unpleasant smells.
"We had a resident once who kept complaining about a 'stale' smell in her room," Maria recalls. "We cleaned the carpets, washed the curtains, even repainted the walls—but the smell stayed. Finally, we lifted her mattress, and there it was: a crumbled sandwich from weeks ago, stuck between the mattress and the bed frame. She'd dropped it while eating in bed, and it had slid right through the gaps."
Modern electric nursing beds —with their adjustable heights, split frames, and motorized controls—offer many benefits for resident comfort and staff safety. But they also introduce new hiding spots: motor housings, cable management channels, and even the hinges that allow the bed to recline. "Electric beds are easier on our backs, no doubt," Maria says. "But they're trickier to clean. You can't just flip the mattress; you have to disconnect the motor, wipe down every nook, and make sure no moisture gets into the electronics. If you skip a step, that's where mold starts."
Another hidden source? Shared equipment like patient lifts . These devices are lifesavers for staff, allowing safe transfers of residents between beds, chairs, and bathrooms. But if not sanitized properly after each use, they can carry odors (and germs) from one resident to the next. "A lift sling might brush against a resident's soiled clothing during a transfer," explains Dr. Lisa Chen, a geriatrician who consults with facilities on infection control. "If that sling isn't washed or disinfected immediately, the next resident using it will be exposed to those odors—and potentially bacteria. It's a domino effect."
Even with meticulous cleaning, poor ventilation can turn minor odors into major problems. Many older facilities have outdated HVAC systems that struggle to circulate fresh air, especially in private rooms. Stagnant air traps VOCs, allowing them to build up over time. Add in humid climates or overcrowded rooms, and you've got a recipe for persistent smell.
"In the summer, our third-floor wing becomes a sauna," Maria says. "The AC can't keep up, so we open windows—but then we get pollen and dust. It's a lose-lose. The humidity makes the odors worse, too. A spill that would dry in an hour in winter takes half the day in July, and by then, the smell has set in."
Odors aren't just unpleasant—they have real emotional and psychological consequences. For residents, they chip away at dignity and independence. "Imagine feeling like your body is betraying you, and then having that betrayal announced to the world through smell," says Dr. Chen. "Residents withdraw from social activities, stop participating in group meals, and even avoid eye contact with staff. Over time, this isolation can lead to depression and a decline in physical health."
Staff aren't immune, either. CNAs and nurses report higher stress levels in facilities with persistent odors, citing feelings of inadequacy or frustration. "You want to provide the best care, but when odors linger, you start to question yourself," Maria admits. "Did I clean well enough? Am I letting the residents down? It wears on you." High staff turnover—a critical issue in long-term care—can even be exacerbated by these stressors.
Key Impact: A 2023 survey by the American Health Care Association found that 68% of long-term care residents who reported frequent exposure to odors also reported feelings of "low self-worth," compared to 22% of residents in odor-free environments.
The good news? Odors are not inevitable. With the right mix of technology, training, and empathy, facilities can create spaces that smell as welcoming as they feel. Let's explore the most effective strategies.
The first step is to upgrade and maintain nursing beds with odor prevention in mind. When shopping for new beds, look for features like seamless mattress covers (no crevices for crumbs), removable and washable rail pads, and under-bed storage with airtight lids. For existing beds, implement a strict cleaning schedule: vacuum under the mattress weekly, wipe down rails and frames with antibacterial cleaner daily, and inspect for hidden debris monthly.
Electric nursing beds can be a boon here, too—if chosen wisely. Opt for models with smooth, non-porous surfaces (like powder-coated steel) that resist moisture and are easy to wipe down. Some newer models even come with built-in UV light sanitizers for the mattress or antimicrobial coatings on high-touch areas. "We switched to a brand with 'easy-clean' frames last year," Maria says. "The difference is night and day. No more scrubbing between hinges—just a quick wipe with a cloth, and we're done."
When it comes to biological odors, speed is everything. The faster an accident is cleaned, the less time VOCs have to spread. That's where incontinence care robots come in. These compact, mobile devices are designed to quickly and thoroughly clean residents after incontinence episodes, using warm water, air drying, and even deodorizing mist. Unlike manual cleanup, which can take 10–15 minutes (and often leaves behind moisture), robots can complete the process in 2–3 minutes, reducing odor-causing bacteria by up to 99%, according to manufacturer data.
At Maria's facility, two incontinence care robots were introduced last spring. "They're a game-changer," she says. "Instead of rushing to grab wipes, gloves, and spray, I wheel the robot to the resident, and it does the work. It's gentler on their skin, too—no harsh rubbing. And because it dries them completely, there's no leftover moisture to breed smells. Mr. Thompson even jokes that the robot is his 'secret weapon' now. He's had visitors every week since we got them."
For patient lifts , the solution is simple but critical: strict sanitization protocols. All slings, harnesses, and lift frames should be wiped down with a hospital-grade disinfectant after every use. Disposable slings (though more costly) can also reduce cross-contamination. Some facilities now color-code slings by resident room or care unit to prevent mix-ups. "We keep a log by each lift," Maria explains. "Every time you use it, you note the resident, clean it, and initial the log. It takes an extra 30 seconds, but it's worth it. No more 'mystery smells' following the lift around."
Improving ventilation is another key step. Simple fixes like opening windows during cooler hours, using portable air purifiers with HEPA and carbon filters, and scheduling HVAC maintenance twice a year can make a big difference. Some facilities are even investing in energy-efficient heat recovery ventilators (HRVs), which exchange stale indoor air with fresh outdoor air without losing heat—a win for both odor control and utility bills.
At the end of the day, technology can only do so much. Staff training is essential—and it should go beyond "how to clean." CNAs and nurses need to be taught to recognize the emotional impact of odors, to check in with residents who might be embarrassed, and to prioritize speed and thoroughness during cleanup. "We hold monthly 'odor rounds' now," Maria says. "A team of CNAs, nurses, and even residents walks the facility together, sniffing for problem areas. It's not about pointing fingers—it's about solving problems as a team. And when a resident mentions a smell, we take it seriously. That trust means everything."
| Feature | Traditional Nursing Beds | Modern Electric Nursing Beds |
|---|---|---|
| Odor Traps | Metal rails with crevices; non-seamless mattresses; hard-to-reach under-bed areas | Smooth, non-porous surfaces; seamless mattress covers; removable/washable components |
| Cleaning Difficulty | High—requires disassembly to reach hidden areas | Low—easy-to-wipe frames; some models with built-in sanitizers |
| Resident Comfort | Basic support; limited adjustability | Customizable positions (elevate head/legs); pressure-relief mattresses |
| Staff Impact | More physical strain; longer cleaning times | Reduced strain (motorized adjustments); faster cleaning |
Odors in long-term care facilities are hidden, but they don't have to be permanent. By addressing the root causes—from nursing bed design to patient lift sanitization—and embracing solutions like incontinence care robots , facilities can create spaces that smell as good as they feel. More importantly, they can restore dignity to residents, reduce stress for staff, and turn "just a part of the job" into a thing of the past.
As Mr. Thompson puts it: "It's not just about the smell. It's about feeling like myself again. When I don't have to worry about odors, I can focus on what matters—laughing with my granddaughter, joining the book club, living." And for Maria and her colleagues? "It's why we do this job: to help people live their best lives. Odor-free facilities? That's just part of the promise we make to them."