Disposal, Laundry and Odour Control

Principles

• Deal with it quickly. Odour and germs increase with time.
• Seal it. Closed bags and lidded bins contain smell and germs.
• Separate it. Keep soiled items apart from clean ones and from food areas.
• Protect hands. Wear gloves and wash hands after.
• Clean the source. Odour mostly comes from urine and stool left on skin, fabric, mattresses and floors, not from the room itself.
• Dignity. Handle everything discreetly. Never comment or show disgust; see dignity in intimate care: words, privacy and consent.

Disposing of used products

What goes where - Used pull-ups, briefs, pads, underpads and wipes are sanitary waste. They should not be flushed down the toilet, even if labelled flushable, since they block pipes and septic tanks. - Solid stool should be emptied into the toilet and flushed before disposing of the product, as far as practical, with gloves; roll the soiled brief and tape it closed. - Gloves and gauze go with the sanitary waste.

Step by step 1. Put on gloves. 2. Fold the used product inwards, with the soiled surface inside, roll it up and fasten it with its own tabs or a piece of tape. 3. Place it in a small bag (a sealable bag, a thick plastic bag or an opaque disposal bag) and tie or seal it. Double-bag if heavily soiled or if there is infection or leakage. 4. Put it in a lidded bin in the room or bathroom, lined with a bag. A foot-pedal bin avoids touching. 5. Empty the bin at least daily, more often in hot weather, and tie the bag before carrying it. 6. Wash hands, and clean the bin lid and rim regularly with a disinfectant cleaner.

Municipal rules in India. Under the national solid waste management rules, households are expected to segregate waste, and sanitary waste (such as diapers, pads and wipes) should be wrapped securely and kept apart from wet kitchen waste and recyclable dry waste, to be handed over to the waste collector as directed; many cities ask residents to mark such packets (for example, with a red dot or a label) so that workers know how to handle them. Rules and collection systems vary, so check with your municipal body, housing society or waste collector. Do not burn diapers, which releases harmful fumes. Do not throw loose items into open drains, gardens or the street. Do not leave bags where animals can tear them.

Home-care medical waste: if your parent has a catheter, dressings with blood, or an infection, ask the nurse or doctor how to dispose of this waste, since rules may differ.

Apartments: use tied, double-bagged packets and a closed container to reach the collection point, and avoid leaving bags in the lift lobby. Talk to the society management, or use a private collector if needed, discreetly. See lifts and apartment living for seniors.

Household staff and helpers: give clear, respectful instructions on handling and provide gloves; do not expect untrained helpers to handle heavy soiling without guidance; see training a new attendant: first week.

Handling soiled clothes and bedding

Immediately - Wear gloves. Do not shake or wring out soiled items, which spreads germs and smell. - Remove solids into the toilet. - Place items in a bucket or basin with a lid, or a ventilated laundry bag, until washing. Do not store wet soiled linen in a sealed plastic bag for days, which breeds smell and mould. Wash the same day if possible. - Keep soiled laundry away from the kitchen, food and clean linen.

Pre-rinse and wash 1. Rinse in cold water first, which removes urine and stool without setting stains or odour. Hot water at this stage can set protein stains and make smell worse. 2. Soak heavily soiled items in cold water with a little detergent or an enzyme-based laundry soak for a short time, as the fabric label allows. 3. Wash in a machine or by hand with detergent. Use hot water (about 60 degrees Celsius) where fabrics allow, since heat helps kill germs; use a longer cycle and an extra rinse. For fabrics that cannot take heat, use a disinfectant laundry additive, as the label directs, or wash in cooler water and dry in sunlight. 4. Avoid fabric softener on washable underpads and absorbent items, since it reduces absorbency; see washable underpads: washing, drying and lifespan. 5. Bleach: chlorine bleach can disinfect white cotton items if the label allows, but do not mix with other cleaners (especially ammonia or acids); oxygen-based boosters are gentler. 6. Dry in strong sunlight where possible, which freshens and helps kill germs. In the monsoon, use a ventilated room, fans, a dehumidifier or a dryer; do not leave damp items stacked; see pest, damp and mould at home. 7. Wash separately from other family clothes when practical, or at least from delicate items, and clean the washing machine drum occasionally with a hot cycle. 8. Wash hands after loading, unloading and hanging.

Mattress, cushions and chairs - Blot up fresh urine with absorbent cloths or paper, pressing, not rubbing. - Clean with a cloth and cool water with a little detergent or an enzyme cleaner, avoiding soaking. - Dry thoroughly in sun and airflow. - Protect with waterproof covers; see mattress protectors for incontinence and underpads: disposable and washable options. - For commodes and chairs, see commode chair cleaning and hygiene.

Controlling odour

### At the source (most important)

• Change products promptly, and use well-fitting, absorbent products with odour-locking cores; see pull-ups or briefs: choosing the right product.
• Clean the skin well at each change, with water or gentle wipes, and dry thoroughly; see wipes and perineal hygiene done gently.
• Keep skin healthy, since damaged or fungal skin smells; see incontinence-associated skin damage: prevention and care.
• Drink enough: concentrated urine smells stronger; see hydration for older adults.
• Treat infections: strong, foul-smelling urine with other symptoms needs a doctor; see urinary tract infections in older adults: atypical signs.
• Watch diet and medicines that alter urine odour, such as some foods and vitamins; do not stop medicines.
• Oral and body hygiene, since mouth and body odours are often blamed on urine; see oral care for frail older adults and denture hygiene.

### In bins, bags and the room

• Use lidded bins, emptied daily, and wash them with disinfectant and sunlight weekly.
• Use tied bags and place them outside promptly.
• Ventilate: open windows when outdoor air is clean; use exhaust fans and cross-ventilation; see temperature and ventilation at home.
• Clean floors and surfaces with a mild disinfectant or a vinegar solution, and wash bedding often.
• Absorbers: a small bowl of baking soda, activated charcoal bags or dry coffee grounds can absorb odour; place out of reach of confused people.
• Enzymatic cleaners break down urine and stool residue on hard surfaces, fabrics and mattresses; test on a hidden patch.
• Air purifier with an activated carbon filter can help in a closed room; see air purifiers: choosing one for an older adult's room.
• Avoid strong perfumes, incense, sprays and air fresheners. They mask rather than remove odour, and can irritate older lungs, trigger asthma and cause headaches; see indoor air quality for older lungs: dust, smoke and damp. Do not use camphor, phenyl or strong chemicals in the person's room. If oxygen is in use, no flames, incense or candles; see using an oxygen concentrator safely at home.
• Clean the toilet and commode daily.

### Persistent smell

If a smell lingers despite cleaning, check the mattress and underlay, cushions, the floor and skirting, the bin, drains, the washing machine and the person's skin. A damp patch under a mattress or old stains may need deep cleaning. Replace stained, smelly pads and cushions. Seek advice if the smell comes from the person despite hygiene: wounds, infections, fungal rashes and some illnesses cause odour.

Protecting carers and the household

• Hand hygiene before and after: soap and water for at least 20 seconds, or alcohol hand rub when hands are not visibly soiled.
• Gloves for any contact, changed between tasks, and aprons if heavy soiling.
• Cover cuts on your hands with waterproof dressings.
• Do not share towels, cloths or razors.
• Clean surfaces that have been touched, such as the bed rails and bathroom taps.
• Keep food preparation separate from soiled laundry and bins.
• Do not eat or drink while handling soiled items.
• Infection: if your parent has diarrhoea, a contagious skin condition (such as scabies), a resistant infection or a respiratory infection, ask the doctor for specific hygiene and laundry instructions. See infection control for home caregivers.

When to ask a professional

Ask a nurse about safe handling of waste and laundry if your parent has infection, a catheter, wounds or diarrhoea. Ask the doctor about persistent strong odour from the urine, skin or wounds. Ask your housing society or municipal office about sanitary waste collection. Seek urgent help for fever with confusion, spreading skin redness, blood in urine or stool, or no urine for many hours; call 112 for emergencies.