By Şevval Önal — Nurse, graduate of Ege University Faculty of Nursing · Section: From the Experts · Last updated: 16 October 2026
Many family caregivers describe the same thing: "I wipe the room every day, but the moment I open the door that smell is there." The problem is usually not the cleaning but where the odor is hiding. The floor may be clean, but odor lingers in the mattress, in the curtain fabric and under the lid of the pad bin.
Why does a bedbound patient's room smell?
The odor in the room has four main sources, and each one calls for a different response.
| Source | Why it smells | First thing to do |
|---|---|---|
| Urine | Fresh urine has a faint smell. As it sits, the urea in it is broken down by bacteria and sharp-smelling ammonia is released | Change wet pads and sheets without delay |
| Sweat and bedding | A patient who always lies in the same position sweats at the back and hips; the moisture soaks into the mattress | Repositioning, cotton sheets, a mattress protector |
| Vomit | Stomach acid and undigested food soak into fabric | Remove the solids and wash the fabric straight away |
| Pad bin | Used pads release odor for hours in a closed room | Put pads in a tied bag and take them to a bin outside the room |
One more source is often missed: a pressure injury. A wound on the hip, heel or back can produce a strong, unusual odor, which may be a sign of infection or tissue breakdown. Do not try to clean this smell away; have the wound assessed promptly by a health professional.
How do you get urine odor out of a bed and mattress?
- Blot, don't rub. Press a dry towel or paper towel onto the stain. Rubbing pushes urine deeper into the mattress.
- Use cold or lukewarm water. Hot water can set the stain into the fabric.
- Wipe with vinegar and water. Mix one part white vinegar with one part water, dab it onto the stain with a sponge, then blot again with a dry towel. Test on a hidden spot first. Vinegar helps with odor; it is not a disinfectant. Never mix bleach with vinegar or any other acid; it releases toxic chlorine gas.
- Sprinkle baking soda. While the surface is slightly damp, sprinkle plenty of baking soda and leave it for a few hours; once it has dried, vacuum it up. Baking soda draws out the remaining moisture and odor. Skip this step if the powder bothers the patient's breathing.
- Dry it. If you can, dry the mattress with good airflow, near an open window or outdoors. A mattress that stays damp starts smelling again within a few days and can grow mold. If the liquid has gone deep into the mattress, surface cleaning may not be enough; wash the cover if it comes off, and consider professional cleaning if needed.
- Take precautions. Put a waterproof sheet on the mattress and a cotton sheet over it. If needed, place a disposable underpad under the hips. If a pressure-relieving mattress is used, make sure the sheet and underpad suit it; do not layer thick covers on top of each other.
For armchair and wheelchair cushions, follow the manufacturer's cleaning and drying instructions. Wash removable covers as their care label says. Check the instructions before wetting a pressure-relieving cushion or putting it in the sun, and do not use a cushion again until it is completely dry.
How do you get rid of vomit odor?
The longer vomit sits, the more stomach acid soaks into fabric and the smell can last for days, so clean it up without waiting.
- Check the patient first. If they are awake and can sit safely, help them sit up and lean slightly forward. If they cannot sit and nothing prevents it, turn them safely onto their side. If they lose consciousness, are clearly confused or struggle to breathe, call your local emergency number straight away and follow the instructions. A patient who is unresponsive but breathing normally is placed in the recovery position; if they are not breathing normally, start basic life support as the emergency operator directs. Once the patient is safe, put on gloves for the cleanup; vomiting can be caused by an infectious stomach bug.
- Lift the solids with a piece of cardboard or a paper towel and throw it away; do not rub.
- After removing the solids, clean the surface with a cleaner suited to the material. If you suspect an infectious stomach bug, use a disinfectant that works against it on hard surfaces, following its label. For fabrics and upholstery, follow the manufacturer's washing and cleaning instructions. Once cleaning and any needed disinfection are done, an odor eliminator can be used for the odor that remains.
- Wash sheets and pajamas separately from other laundry, at 60 °C (140 °F) if the care label allows.
- After taking off your gloves, wash your hands with soap and water for at least 20 seconds. If the patient is fully awake and can safely rinse and spit, help them rinse their mouth with water. Do not give water by mouth to a patient with reduced alertness or swallowing problems; follow the care team's advice for mouth care.
If the patient is vomiting repeatedly, cannot keep fluids down, or you see blood or pieces that look like coffee grounds in the vomit, the smell is a secondary concern; see a doctor straight away.
What is "old person smell", and is it real?
It is real, but its proper name is "age-related skin odor" and it has nothing to do with cleanliness. A study published in 2001 showed that after the age of 40 a compound called 2-nonenal increases on the skin, and that this is linked to the faintly greasy, grassy smell associated with older people (Haze et al., "2-Nonenal Newly Found in Human Body Odor Tends to Increase with Aging", Journal of Investigative Dermatology, 2001). The smell comes from the skin's natural oils and transfers to pillowcases, pajamas and the headrest of an armchair.
A few simple things help: change pillowcases and pajamas often, wipe the skin daily with lukewarm water, and refresh the room air even in winter. Avoid talking about "the smell" within the patient's hearing; it is a matter of dignity, and older people can be very sensitive about it.
How do you keep the room air fresh?
- Ventilation: If it is safe and the outside air is clean, open the window at least two or three times a day for 10–15 minutes, more often if the weather allows. Cover the patient first and make sure the draught does not blow directly onto them.
- Bin: Do not leave the pad bin in the room. Use a pedal bin with a lid and empty it at least once a day.
- Textiles: Think about curtains and rugs; odor lingers longest in them. If possible, avoid rugs around the bed, and wash the curtains as soon as they start holding the smell.
- Odor control: A fragranced room spray adds another smell on top of the bad one and can bother a sensitive patient. Once the source is cleaned and soiled items are out of the room, a fragrance-free odor eliminator can be used as a supporting step for the odor that remains. Keep it out of the patient's reach and use only a little; never apply it directly to the patient, to an open wound or to surfaces its instructions do not list.
When is odor a sign of illness?
In home care, odor is sometimes the first warning. If you notice any of the following, tell the doctor or the home health care team before you try to get rid of the smell.
| What you notice | What it may be |
|---|---|
| Urine smells stronger than usual, is cloudy or bloody; there is a fever | Urinary tract infection |
| The patient has suddenly become drowsy or confused, or struggles to recognize you | In older people, sudden confusion has many possible causes, including a urinary tract infection, dehydration or medication effects |
| Redness, discharge or a heavy smell at the hip, heel or back | A pressure injury or wound infection |
| A fruity or acetone-like smell on the breath | In diabetes, high blood sugar with ketones (risk of ketoacidosis); urgent if there is vomiting, abdominal pain or fast breathing |
| Vomiting keeps coming back; the patient cannot keep fluids down | Risk of dehydration |
This table does not make a diagnosis; it only shows when you need to ask for help. A doctor makes the diagnosis.
A short daily checklist
- ☐ Are the pad and the waterproof sheet dry?
- ☐ Has the pad bin left the room?
- ☐ Has the room been aired at least twice?
- ☐ Has the patient been repositioned as the care plan says; any redness, moisture or wound on the skin?
- ☐ Is fluid intake in line with the care plan (any fluid restriction and swallowing safety considered)?
If you are curious about the hospital and care home side: How to get rid of hospital and care home odor
Frequently asked questions
Why does a bedbound patient's room smell? Usually because of urine left sitting, a damp mattress and a pad bin kept in the room. As urine sits, bacteria turn its urea into ammonia.
Can urine odor be removed from a mattress? Yes, in most cases it fades; if the liquid went deep, it may not go away completely and professional cleaning or a new mattress may be needed. Blot without rubbing, wipe with vinegar and water, sprinkle baking soda, leave it, and dry the mattress thoroughly.
How long does vomit odor take to go away? Often the same day, if it is cleaned straight away and the fabric is washed and dried; in a mattress or upholstery it can linger longer. Vomit that has soaked into fabric and dried can smell for days, so act without waiting.
Is "old person smell" a sign of poor hygiene? No. It comes from a compound called 2-nonenal that increases on the skin with age. Changing pillowcases and pajamas often reduces it.
Can a fragranced room spray be used in a patient's room? It is not recommended. It masks the smell and can bother a patient with nausea; a small amount of a fragrance-free product is preferred.
What should I do if the smell of urine changes? A change in smell does not on its own mean infection. If there is fever, burning or blood in the urine, contact the care team; if alertness changes suddenly, call for emergency help.