How do I remove or reduce the smell of stale urine in Mother's home?

You already tried everything I was going to suggest. I don't have it quite as bad but I have found that the pet urine removers work pretty well when you know exactly where the urine is (like a chair). I have probably had the most luck with Nature's Miracle. I did have one particularly bad spill on a sofa that took several months of treatments.

I also put about a quarter cup of vinegar in with her laundry when it is stinky.

Have you tried leaving uncovered bowls of vinegar around? I did that when I bought a smoker's house and it helped get that smell out.

Also, we now put a pee pad down before Mom sits anywhere even though she wears depends. That has saved us many times.

Oh my....it sounds like there are quite a few issues going on with your mom. Is her doctor aware of what's going on with her catheter? Is it malfunctioning or is not able to properly handle it? I'd be concerned that she is not able to properly handle her hygiene anymore. Have you noticed other decline? I wouldn't let the air freshners distract you. My LO bought them by the case and had as many as 12 in one room at one time, but, she was developing dementia and later it was quite evident that is what was going on. I'd have her evaluated by her doctor to rule out infections or other causes and figure out how you can get her help. It may be that she needs more supervision or she may need an aid to help her with it.

I'd also be concerned with her being able to properly care for any pets. You can't tolerate unsanitary conditions for yourself and your pets if things are just fine cognitively, imo. Are you the Durable POA, Healthcare POA, etc.? I'd see what could be done to help her at this point.

And regarding the smell, if things are going to continue, then the smell would just continue as well, no matter how well you clean it.   It may need a professional cleaning.  Maybe, others will have some pointers on that. I'd be more concerned with the reasons for the smell. 

I would also look into a professional cleaning service, one that does after fire type cleaning. And not to promote anything here, but one of my friends started selling "essential oils", and brought a defuser over, and used it in my very large, smoke filled home for an hour or two. I swear it was even noticible in my bedroom .. Yes I bought one!! You can get them on Amazon much cheaper, and it worked here for the smoking my mom does!

Thanks for the input!!
Nature's Miracle IS the product I used, but when the source of the smell is still coming in regularly and sneaky-peeing, I'd have to clean carpet every week--not doable.
I'm not POA, DPOA or MPOA, since I am just a dumb girl :) She does not share with me the details of her dr visits. She's just declining in general.

Mother does her own laundry. I do not know how to gently approach the situation of her clothes smelling. She has a family around her--my brothers kids, who are all adults themselves. The smell bothers my SIL b/c it seeps out and into her part of the house. I KNOW it bugs her, but she would never say a word.
Mom's catheter is fine, she just had it checked. (Sadly, she pretty much always has a UTI, which makes the smell worse.) Even with it, she leaks, or she doesn't change the bag often/well enough. That and the wet pads in the trash and those filthy birds are the primary source of smells.
I am going up next week to "Spring clean". I'm also going to push brother to put down the hardwood floors too. This carpet is 18 years old and just looks nasty now.
It's a slippery slope, talking to my brother. He is frustrated with mother, but also VERY sensitive to anything approaching criticism of his care of her.
My daughter uses the essential oil diffuser and it IS amazing--I may try that. The overpowering scent of the room fresheners make me sick. Mother used to burn candles, but that was a huge fire hazard.
As far as a professional cleaner, she would NEVER EVER allow anyone into her place--also, she is a little hoarder and maneuvering into the small spaces she has left for herself--impossible for more than one person to be in any room.
I am going to deep clean next week and force brother to clean the birds somehow (they are filthy, and not hand-trained, so you can't touch them) and power wash the cage. AND I will open all the windows for the hours that I am there.
That's probably all I can do. I am the only sib (besides brother) who gives her time of day, and I feel the responsibility fall heavy on my shoulders. It doesn't seem to bug her, and realistically, maybe I should just put Vicks Vaporub up my nose when I go there and let it be. I guess I am projecting my own sense of "clean" on her. She's happy enough--any suggestions about any change just upset her. We're NOT close enough that I can tell her she smells bad. That her place stinks. That the birds are a health hazard.
At least now the weather is warm and I can open a window when I am there!

Midkid, yes time to get new carpeting, especially since what comes out is dark and gross. Could be a sign of mold building up under the carpet and into the carpet padding, that might shake your brother's thinking and make him quickly redo that flooring. He doesn't need to put in anything expensive, cheap wood looking products are around, make sure it has a poly coating for easy cleanup.

My late parents house had "that smell" so anything taken out of the house would have "that smell". I have Dad's old books and after 6 months they still smell the same as when I brought them home. Even the bookcases I kept smell, no matter how much I clean them.  Hmmm, since wood needs moisture every now and then, I will experiment using body lotion :)

It's amazing how certain smells will transfer to the wood forever. I have an vintage wooden clothes closet piece of furniture that a good friend sold to me. She was a heavy smoker, and 20 years later the furniture still smells of smoke.

I agree that the first thing is to talk to your brother, but i totally understand your comment that "It's a slippery slope, talking to my brother. He is frustrated with mother, but also VERY sensitive to anything approaching criticism of his care of her. " All those responding, can you suggest to MIDkid58 how to do this???
THere were 4 siblings in my family, and although we all got along, words between us must have been careful words. Im not good at words so during our monthly conference calls , i kept quiet. BUT i had second medical POA, so i took my dad to ALL appts.
I immediately emailed all siblings with the results and conversations. Its only fair. YOU and YOUR BROTHER both love her, but i see that one issue is your brother is sensitive. Any POA feels this.. So all the advice is good, but MidKid58 needs help with the wording of how to talk to her brother.SHowing she thinks he is"doing a good job, but is there anyway I can help with mom that helps you."...eventually as he trusts and believes in you, he may take suggestions from you. You have to win his confidence that you love your mom too, and that you think he's doing a good job too and aren't planning to take his authority away..you just want to help him. SO can anyone think of words that will help her with her brother...to me that's the issue i am seeing needs to be addressed.....until then, she will have to try those temporary suggestions.....HELP her with how to open up to her brother in a caring way where he feels safe with his sister's suggestions....

Get rid of the carpet! Have it replaced with either tile or an engineered wood. You will never get rid of the smell and besides it is very unsanitary.

Having a UTI definitely adds to the odor factor. It is often extremely difficult for our elders to get rid of a UTI...even with RX medication. Sorry, I don't have all the answers, but it appears that you are doing absolutely everything possible and doing it well. This is a tough situation. With my clients, I used to wipe down their mattress top almost every day, using a cleaning cloth saturated with white vinegar. That made a big difference, but neither of them had a UTI at the time. One change that would help - though not 100% - would be to entirely get rid of the artificial air fresheners. Those things are extremely toxic to humans, too. Then introduce the essential oils in the diffusers (you'll probably need more than one diffuser, one for each room might be good). I'll be thinking about you and your family and sending you all pink light, which is love. Love can heal many things. Hugs!

Removing the carpeting is a sure bet. But, expensive pre-varnished hardwood and snap together laminate floorings still have space between boards for urine to drain into. Your brother might be more willing if you also suggest sheet vinyl flooring, a much less expensive option. Sheet vinyl cleans easily and does not retain any odor. Do a search to see the many options in sheet vinyl. I put sheet vinyl in my own mother's apartment. I also replaced her couch and chair with futons. I covered the futon mattress with a moisture proof mattress pad and have washable futon covers. These replacements have made cleaning up after my mom, and her elderly tomcat quite simple. FYI: the new "Slide" cat litter is an excellent product.

MidKid 58, your mom's lungs are going to suffer with all the air freshner. Here are some more thoughts for your situation. There are a lot of good products for neutralizing dog/cat urine odor with enzymes, you can use a blacklight to find the urine. Look through the products on Amazon under Pet Supplies. It is very difficult to clean all the urine from the carpet because soaks down into the padding. You/your family could probably replace the carpet yourselves. There are some new products that look like wood planks or ceramic, but are vinyl (Home Depot or Lowes). They snap together and are easy to install without adhesive. A friend installed a floor by herself and it turned out fine.

Several products to recommend. Go to the website of Planet Urine. There products are amazing. Also you can get Ozium room air odor absorbers on Amazon. It is used in hospitals and really works. That carpet pad has to go!! Why doesn't brother take out her trash and at least clean the bird cage and change their papers daily? My ex had parrots and yes birds can stink!
As far as laundry, there is a product called Zero Odor that is added to the laundry. I got it at Bed Bath and Beyond. Also FunkAway is another detergent online. Putting a pad down on her recliner too but likely the urine has soaked into the foam of the chair so probably need to toss and get a new chair. Hope some of this helps.

I haven't read through all the answers, so forgive me if I repeat anything.

First, I'm going to guess that the bags in the bathroom need to be replaced. My DH uses a plastic urinal and after about a month, they have to be dumped; you just can't clean them anymore and the smell is horrendous. Thankfully, he can get replacements from HomeHealthCare every month.
Next, after Hurricane Katrina, we discovered that coffee grinds smell much better than vinegar and you can leave a dish here and there - but really, this isn't your problem.
Locate where the smell is coming from and then try either Peroxide - you can get a spray bottle - and/or baking soda to absorb the smell. Baking Soda will also help to dry out any moisture. Again, after Katrina, I learned that Peroxide would remove the blood from our freezer and it took the smell with it! Win-win! I now use Lysol Power & Free Multi-Purpose Cleaner with Hydrogen Peroxide. Heaven in a spray bottle!!
Lastly, I purchased some "Cooling Mattress Pads" and they have a water-resistant lining on the bottom. Machine Washable & Dryable and I put one on our recliner and one on the sofa. It just saved my sofa yesterday when DH spilled his smoothie. Got them all at Walmarts.
Oh! And I now keep a non-slip bathmat in front of his seats. This has helped to prevent his falling from sliding on the floor when he tries to get up.

Use Kennel Odor Eliminator [KOE] available from Revival Animal Health & other Pet Stores- It is the best! Eliminates the odor w/out leaving a "fragrance" of anything except clean. Use inlaid linoleum [best because there's no grout to clean] or a non slippery tile on the floor. Hardwood shouldn't get wet! & will really stink "fake" hardwook will also be slippery & stink! Used both in Mom's house starting in 1994. House is now rented & floors look like new.

I found it necessary to treat my mother's cotton knit slacks with straight vinegar before laundering which leached out the urine, and then washed them in hot water through two laundry cycles. Later, I discovered that a small amount of bleach in the laundry worked as well so I dispensed with the vinegar treatment. This was rough on the slacks which I bought by the many dozen from Lands End during their sales. I protected the three places where Mom sat with pads, and ordered waterproof pads that were long enough to tuck into each side of her full-size bed. These cost about $100 each but lost their waterprotective quality after a number of washings, so they had to be replaced. These were on top of her fitted sheet, and I had a fitted waterproof mattress protector under the fitted sheet. Mom also resisted changing the pads frequently, so I had to keep after her. I ordered larger pads for daytime and even larger, longer pads for nighttime to help contain the urine. I dumped each used pad into a plastic bag and ran it out of the house to the outside trash as soon as it was used, even in rainstorms and in deep snow. I felt it all paid off when a visiting nurse looked at me as if I were lying that my mother was incontinent because she could not smell any urine. Initially, I hired caregivers for four hours a day to take care of Mom, cook, clean, take Mom shopping and accompany her to her medical appointments and the pharmacy. It was very much worth it until I could "retire" when Mom needed 24 hr care. Get those family members in line. You are going to need to share some of this work and expense.

There is a product that completely rids odors. I do not sell or have anything to do with this product. We found it at Brimfield Antique Market being sold for getting rid of odors in old furniture. They actually put ammonia on a cotton ball and then sprayed it with this product - no smell!!! Amazing product. It is called Odor-B-Gone and you can purchase it on line. Everything that has urine on it will have to be sprayed and the fact that she does not have the best hygiene - you will be using this product everyday. But to me it is well worth it. We had a little dog that was sick - that was our introduction to the product. Best of luck!!

Midkid58 - do NOT push for hardwood flooring. Urine will seep into the wood + smell too - total waste of money for hardwood. If there is a concrete foundation, the urine may well be seeping into the concrete. I had this in house I bought. Pull out carpet + we washed down the concrete with bleach + disinfectant (it's been long time so not sure of products). Then we let it air out for 3 weeks before anything else was put on floor.

Best alternative flooring - is old fashioned vinyl. inexpensive + easier to wash.

you can also set out dishes of ammonia overnight to absorb some of the smells.

My moms house use to small the same we use lots of bleach wipes and bleach. My mom has an incontinance problem but wears pull ups. We use fabloso lavander scent in the toilets and commode. I would rinse her bag out with vinigar not as harsh as bleach. Other than that I cleaned the carpets took her out for the day to let them dry used fans to help dry it and with the help of all the bleach vinigar and fabloso it's kept it at bay. I also help clean my moms private parts and she's a big lady her folds to not allow odor

clothes washing - add baking soda to the laundry

I use TIde and Tide Rescue for Odors. Works well with urine soaked pads and clothes--better than vinegar I've found. I wash all every day. I think your problem resides in the behavioral changes and the dementia first, then the odor problems can be addressed with some success. Otherwise the smell will recur. I have experience with this in a urine smelling house where the resident actually lived in only one room. Even a good coat of paint did not take care of the smell until the floor boards were replaced in his bedroom.

Just one short comment, I would not replace carpeting with hardwood or engineered wood or even not with laminate. The best flooring that will be easiest to clean and look the nicest under the circumstances is sheet vinyl flooring and it comes in many beautiful colors and designs. You can get some that looks like tile or hardwood. Hardwood will be damaged by urine and is costly to refinish. Liquid will also damage engineered wood and laminate when it seeps into the cracks. Tile is too hard and the grout will let liquid seep in and it's hard to keep the grout clean. Vinyl is your best bet AND the least expensive. Good luck!

Diluted bleach water is the best I've found. Even if it discolors something, it's best to clean with for removing odors. If you can saturate carpets and suraces, suck it up with a wet vac then dump that water down drain or outside. Repeat. Also hire professional cleaners, the type that clean up after floods, fire etc. Do that then keep up with bleach water.

I would recommend the sheet vinyl flooring as well. I'm planning to install it in moms room soon w/outdoor rubber carpets on top to reduce the risk of slip & falls. As to the speaking with brother, in my experience it's always a win if things can be the other persons idea. I am the youngest & female so I get the dumb girl attitude. We'll this dumb girl gets much accomplished in cooperation by leading them to the solution. Start by just praising SILs clean home & wondering how moms area could be cleaner. Go about what your doing but keep asking for ideas like "you have none". I have all legal control paperwork wise but it's a lot easier if everyone feels heard. I don't mind playing the games for peace. Hope that helps.

I use to do my late Mom's laundry while she was in long-term-care, and I found old fashioned 20-Mule Team Borax worked fine.

Try mixing up some bacteria and enzymes like you put in a septic tank or use a carpet cleaner bacteria enzyme cleaner and mix with water in a spray bottle and spray it. Lynzymen is best but most except ridex will work.

Thanks so MUCH for all the great answers, and honestly, just the support!! Having zero support from the sibs, it helps me to know that there are people out there who listen and take time to respond with helpful answers.

I have to laugh--after re-reading my OP, I wrote "cocktails" instead of "cockatiels". Two cocktails might help mom sleep :) Yes she has 2 stinky birds. The cage is cleaned maybe twice a year.
I have this conundrum with the floor. It REALLY needs replacing, through at least the hallway and her bedroom. BUT--brother was approached about putting down vinyl..he blew up and said "NOBODY is putting down a plastic floor in MY home". So I then asked about the wood floor. He actually HAS the flooring as he did his entire upper floor in it a few years back and bought enough to do mother's place. However, he refuses to allow anyone to help him and he won't do it until after mother dies. He's being a real jerk. Mother really wants/needs a new floor. He won't comply. It IS his house and she isn't paying rent and DOES take a load of his time as it is--so I can't blame him, but the floors all need upgrading. I am sure that the hallway is a big part of the culprit, smell wise. The stuff I clean out of it is beyond disgusting. And I am positive it has soaked through the subfloor by now.
I will approach him again---IF mother still feels she wants her floors done. Her walking is just a shuffle now, she cannot lift her feet an inch. Just moving from the kitchen floor (wood) to the carpeted area takes all her strength to push her walker.
I don't shop with her, brother does, but I will encourage him to get a detergent with oxy-clean in it, and perhaps he can broach the vinegar rinse with her. She often used Borax when we were kids--so maybe she'd try that. She has very little laundry each week, and it is the one thing she can do by herself, I don't want to take that from her.
I will talk to brother once again about replacing the floor. If he just stiff arms me, I will save the dirty water from the carpet and let him see it.

Mother has a cough, always. I am sure it's the birds, combined with no outside air ever getting in. I had not thought about the air fresheners--but that makes sense! She has 5 in a 600 sf apt. All going off every 15 minutes, night and day. That cannot be good.
I can't chuck her recliner, it's basically brand new and covered with so many blankets and such, I think I will just wash all the coverings and clean the one area I know she "leaked" onto.

I have appreciated the comments. Our family dynamic is weird, the boys have all the "power" the girls have none. I'm the annoying sister/daughter who sees potential problems and issues and brings them to the light. Nobody is ever happy with me. Oh well--Spring cleaning this week and a confrontation with brother loom.

How awful would it be if the already "popping" kitchen wood laminate floor suddenly popped a board? It's separating in several places and has chipped pretty badly. One board is almost out.....hmmm..you can't just replace ONE of those, you have to redo the whole room.

In honesty, Brother has more help than he could possibly use and we could get mom's whole apartment re-floored in 2 days IF he will allow it. I'd make sure the subfloor is painted with KILZ until the stains are covered.

One of the biggest factors in the smell issue is that she has a Jack'n'Jill bathroom--opens into both bedroom and small den. She leaves the doors propped open all the time. Otherwise she can't get in the bathroom. I will do some more research on cleaning the cath bags. Maybe she isn't doing that right---I just thank heavens she doesn't also own a cat.

Thanks again---I know my posts are super long, but I have no one to speak to about this!! Wish me luck with brother, he's my junior by 5 years, and I can wield the "older sister" thing on him if I am pushed hard enough!!

So many great suggestions here! I only have one to add, and that's to install a "diaper genie" type garbage can in the bathroom. If you can teach your mom to use it, all the better, but I've found if I just chuck any used briefs in the diaper genie and spray a natural odor remove in the top, it keeps the odor from lingering quite well. When my brother bought them for my parents' bathrooms I was sure they'd be insulted. They haven't even noticed they're anything but e tea tall trash cans with lids. They don't use them. They have a big plastic standard size open trash can under the sink, which is all they use themselves. I've taught some caregivers at the ALF to use the diaper genies, and whenever I'm over there, I pop in the bathroom, put on disposable gloves, and quickly transfer anything smelly into the diaper genies. It helps at least with my sanity. :)

Laundry-wise, I've honestly found that washing everything in HOT water, with oxyckean spray and regular laundry detergent, works the best. But I've been told enzyme additives are great too. I just can't vouch for them personally.

Overall I would urge you to try and accept your mom's current limitations. She may still be doing her own laundry and you may assume she would be very insulted if you took over that duty. I thought so too, but when I started taking over the job, my mom just made a little protest about it, like "You don't have to do that, I can do it myself" but soon she was grateful I was doing it for her and she could just enjoy her crosswords and TV. And now the laundry gets done often enough! (She used to leave it sitting for days ... which was not great considering they're both incontinent.)

I know that you've tried to help but have gotten nowhere. If your mother lives with your brother and he has POA, you still have some options. I know I might get beat up on but those filthy birds and your mother's habits have done a number on her. If you know her doctor, send him or her an e-mail or an actual paper letter informing them of the real situation. Mother and brother are probably hiding this from them. Let the doctors be the bad guys. Or you can call APS and let them deal with this mess. Take a step back and don't help out anymore.

Regarding the new Slide cat litter - I got my cat a new litter box and I use the Slide litter. He just loves it!

Midkid58 - Thanks for your detailed posts. I'm glad you have so many of us answering. I have few urinary suggestions, but brother can be sympathized with, and told what the results are, or could be, if nothing is done ( "I am sorry to have to mention this again, but ....Black water rug wash means the underpad is rotten and maybe there's black mold. It could soak into anything below the flooring for permanent damage. I don't know what the best solution is for you, but rotting carpet might be what's causing mom's chronic cough." )
Then let go of the topic. It is his responsibility.

As for the doctors, you are allowed to tell them what you observe. The doc can't tell you anything, but you could write him a letter, and make a copy for your brother. Give it to him after you mail the doc, then inform him of what you did. Good luck. You have a good heart.