A Place for Mom's Family

My mother was diagnosed with Vascular Dementia about 2 years ago - shortly after my father (who also suffered from vascular dementia & a host of other ailments) passed away.  For several months she was okay living at home by herself - or so we thought until she started calling me 2 or 3 times a day, asking the same question and then started having panic attacks.    To make a very long story shorter . . . ..  about 18 months ago, my husband (semi-retired) and I decided - in order to allow her to stay in her home -  to move down here into that home which had already been deeded to me with a life estate for her.  As an only child, I felt it was my responsibility to look out for her and care for her.  So, I found a position in a nearby town and for a little over a year my husband stayed at home and made some cosmetic changes to the home - careful to leave her room and bath intact so she would feel more comfortable and not confused, as she might be later on in the disease. She loved the changes and said she'd wanted to do that for years, but my Dad objected to spending the money.

Despite the other smaller issues we have and are just dealing with as kindly and gently as we can - I want to speak mainly about the Smoking Issue!  My mother has been a smoker for 60 years (she is 82), but agreed to our condition that for us to move in to help care for her, she would have to only smoke outside and she was more than willing to do that.  As we started making the cosmetic changes to the house we discovered that she was not a careful smoker (furniture strategically placed to cover burn marks in the carpet - we have since replaced).   As her disease has progressed (much more rapidly than expected), she has gotten much more careless - even while smoking outside. And, in case you are thinking "year round? poor dear!" - we live in Texas and the temp is very moderate year-round and we have a wonderful sheltered porch for her to do so.  At any rate we find burn holes in her robes and clothing and the cushion of the patio chair she sits in and once she caught a wastebasket on fire, and well, I could go on and on.  So, we now limit her smoking to when one of us is around to supervise her doing so.   To say she is mad as a hornet is an understatement.

So, we have to hide the cigarettes and only give them to her when we are there.  My husband has gone back to work - in retail, so his hours vary and some times she can smoke in the mornings and sometimes she cannot smoke for 8 hours.  But, she doesn't remember why.  So now she calls me 2-3 times a day to find out why there are no cigarettes there and of course that launchs us into a daily argument about whether or not she has a "right" to smoke.  We stress the safety issue repeatedly - but she thinks we are ridiculous - evidence to the contrary, however.  Eventully she'll come around to saying "well, I think it's ridiculous that I can't smoke when I want to, but okay, I'll agree to your RULES."   But, when we get home, we find evidence that she has been looking everywhere for cigarettes.  One day she got a neighbor to take her to buy cigarettes and then she hid them and I only found them two days later by accident in her closet, along with an ashtray with a half smoked cigarette in it.  I explained to the neighbor to please not take her again, and he understood and agreed not to.  But, the next day - same thing, same behavior - in fact a few days later she set off on foot to a local convenience store down a very busy road to get some cigarettes - she appeared to be confused as to where she was, when fortunately the same neighbor saw her and gave her a ride home.

To say we are at our wits end is also an understatement.  So, does anyone have any suggestions?  Trust me when I say it is a true safety issue - we've long since given up on believing she would ever actually quit smoking - despite the health issues related to it.  We think we've reached a compromise and do not know what to do except to stick to our guns.  But, we end up in turmoil over it at least once a day.  The stress of this is really getting to me and I find my patience running very thin at times.  What do they do about the safety issue of smoking at an assisted living facility or a nursing home - especially for those patients who also suffer dementia?

Thanks for listening to me and for any suggestions you may have.  Sorry this is so long but I didn't know how to explain without going into detail

 Linda - truly sad and extremely tired!

Hi, I can see your frustration. Is it financially possible to get her a companion or sitter to be with her while you are away from home. It will put your mind at ease and give your mom something she has loved for alot of years. She will eventually forget she smokes but until then she will need some close watching.

For companions or sitters you can use an agency or a less expensive way would be to hire one of your own, through advertising at hospitals or nursing facilities for trained staff. Also the more she deteriorates she will have someone else she is familiar with to care for her.

Hope this helps some. Keep up the good work!!!!

Hi, Linda -

If you decide to look for a caregiver, call A Place for Mom. At A Place for Mom we have professional Eldercare Advisors standing by to help you. Once you're connected with your own personal eldercare advisor, he or she can provide senior housing or care options and information. There are two ways you can be connected to an advisor: call our toll-free number at 877-MOM-DAD9 (666-3239) or visit our website and fill out a brief assessment form (www.aplaceformom.com). Our assistance is free to families as we are reimbursed for our services by many senior care providers around the country.

We are happy to help!  Hugs to you - Linda

Hi Linda!

I am sorry to hear of all your stress and frustrations.  It is not easy to deal with the many challanges that come with caring for a parent with dementia.  To answer one of your questions, do nursing homes and assisted livings places allow smoking?  I am in the midwest and most of them do not allow smoking.  Some have a smoking room but most of them do not allow it at all let alone in your own room.  They are concerned about the safety and health of the residents.  I have worked with a families that have a parent with dementia that smoke and I have help them find communities that allow suppervised smoking.  One lady I was helping said her mom really wanted to move to an assisted living where her friend was living but it was non smoking inside and out of the building.  They tried a laser treatment and so far she is doing great not smoking.  I have also had some families use a patch. 

I this information is somewhat helpful!

Linda Knutson,

Eldercare Advisor

This is often a difficult situation when it comes to smoking.  I think that you will find that smoking is a physical addiction and to attempt to have someone who has smoked all of these years and who no longer has the coping mechinisms to quit for long periods of time or cold turkey would be extremely difficult, at best.  You may want to contact her doctor about getting her on some type of smoking cessation program to eleviate the symptoms while you are away.  After she has been smoke/nicotine free for a short time the dementia make take over and help her to deal with the habitual symtoms that follow.  You definitly need to do something sooner than later while you still have a home to come home to.  As a former smoker,  I know that it is more dsifficult for some than others and there is no pat answer as to how to get mom to quit.  There are some medications that contain Wellbutrin that will help with the smoking and also contain a mild anit-depressant that helps with the transition.  Contact her doctor and best of luck  You will not regret all of the things that you are doing and will be blessed for it many times over.  What  goes around does come around, and when the time comes for you to need help it will be there. 

DIane