Old People Smell

When I was a little kid, 5 to 10 years old, my friends and I talked about how the 'old people smelled'.  They smelled 'different' and some people actually smelt bad.  The old man smell was different from the old lady smell, too.  As old people were sometimes hugging us when we were trying to walk by we often got up and close with these smells we didn't particularly like.  I don't see it as much today but I've seen a kid with his body pulled up against an old person trying to kiss his cheek and the kid squirming like all hell  get out to get get his nose as far away as possible.  It still happens.
Turning 60 I recalled all this.  Now none of my friends or family have any bad 'old people smell'.  I've many friends in their 70's and 80's and Dad is 93. I visit with Dad and the friends he had in the home where he stayed didn't have that smell either.  Truthfully though, my own sense of smell has diminished.  As a kid I swear  I could smell chocolate clean across the city.
As a physician I've given some thought to old people smell.  It's possibly genetic in some associated with pheromes and endocrinological factors we don't see. Clearly babies have a fairly universal 'clean baby smell' which is pleasant to the nose of most. According to evolutionary biologists, this is thought to be part of their survival mechanism. If a baby smelt like they do when they need to be changed all the time, someone in the tribe, likely the old man or woman would 'forget " them outside the tent in the winter.  As for needing 'changing', that's a modern sanitary problem. In hunter gatherer sociieties, the kids crawled on the floor and man's best friend, the dog, cleaned them up, without any costly need for pampers.  As a consequence babies survived and so did the species, partly thanks to dogs.
Young people have youthful pheromes which contribute to mating and reproduction.  In old people these decrease.  Estrogen levels and testosterone levels influence personal odor.
But these are really minor contributors.  If they were major I'd notice the difference in my friends who range from their 20's to 90's and frankly I don't.
I can smell 'illness' though and for years my first indication of 'illness' was my olfactory diagnostic capacity.  All manner of contagion smells.  Just consider halitosis, the bad breath, it's decay and infection of the gums and caries.  A dental visit can change a horrible smelling mouth to a mouth that smells as fresh as a baby's bum, after a dog's licked it, of course.
When I was a child, there wasn't universal health care and there was a greater likelihood of chronic illness and acute illness in the old people.  Old people when I was growing up, because of the poverity in those days as well as the stigma and superstitions associated with physical disease, considered it much as we do with psychiatric disease.  So they avoided doctors, hospitals and often died from readily treatable conditions because of neglect.  No doubt some of the people I 'smelt' as a child were dying of cancer or treatable or untreatable infectious disease.  Advanced cancer smells not so much because of the cancer but because it can affect bodily mechanisms.  A fungating breast cancer I treated once smelt terribly badly but it was because the tissue was so tender the person couldn't wash. Often skin diseases are like an open wound which not only can't be washed because of pain but may weep and crust.
Mostly sick old people smell because of pain. A local world reknowned rheumatologist and arthritis specialist , Dr. Andrew Chalmers, has compassionately remarked after some of his elderly patients have been noted to smell , "It's because washing is painful for them, getting in and out of a tub, lifting their arms to shower. It's the pain that causes the smell."
And that's really the truth of it for most.  As people get older they have increasing difficulty with cleanliness.  My parents home in their late 80's had an 'old person's home' smell simply because Mom with her arthritis couldn't keep up with the cleaning and vacuuming. There was a 'musty' smell in the house.
We further often forget that water isn't something that is 'free' for many. When I worked in the north on Indian reserves, the water was supplied by a single tap outside in the middle of the community. People had to carry buckets and the paths to their houses in a three block radius were icy or clogged with snow.  It takes water to wash and old people had increasingl difficulty getting to that tap.  Naturally people used their water for drinking and cooking first.  Dr. Jack Hildes, who established Canada's famous Northern Medical Unit made such simple fundamental observations when someone commented on the 'old people smell'.  "Would you carry dozens of pails of water to your house weekly to wash your clothes at 60 below zero?" Dr. Hildes had a way of making his points memorable.
And that's another principal cause of smell, clothing.  The cost alone of laundry is prohibitive for many on a fixed pension.  Dad's blind and doesn't realize he sometimes gets soup on his shirt.  Were it not for family too he'd wear the same shirt more than once because he forgets to put his clothes in a laundry.  As old people can often lose their sense of smell, just like their sight or hearing, they often don't realize, without family, friends or caregivers, that they are wearing soiled clothes.  As a kid I remember we most disliked the old men who smoked cigars and cigarettes because their clothes reeked of the old stale smoke. The smoking old ladies , to put a twist on that modern phrase, were worse because they'd try to cover up everything with gallons of cheap perfume. The smell that resulted was like the inside of some cars that have that sad and overwhelmed old air freshener hanging from the mirror.
Nobody I know in my personal friendship network has 'old people smell', despite their age. But my personal friendship network is mostly middle class or better, Canadian, with good health care, indoor plumbing, lots of fresh water, soap and accessible laundry facilities.
When my grandfather came to visit from the north when I was a little boy he always smelt of wood smoke.  That's how they heated their home in northern Manitoba. I loved that smell and I loved my grandfather. My grandmother died in our home, my mom taking care of her till one day she didn't awake in her room.  I was a little afraid of her gnarled fingers from the ravages of arthritis but remember her smelling of lilacs and lavender.  I think it was the soap she used.
I just thought it important to close with these thoughts, that sometimes, old people smell, is something really special and sacred.