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I've been on what seems like a very long journey with my mother. She's had COPD for a number of years and gone through several exacerbations. Each one has been more difficult than the last. I've spent a lot of money on a lot of things to help her quit smoking. She's allergic to the patches, hates the gum, tried and quit the vaping, can't use medications because of her current medications. I even shelled out $$ for hypnosis. She said she thought it was working, but just needed a little more. She had one last scheduled session before her last COPD exacerbation coupled with AFib.


They told her in the hospital that she has no choice. She is now a non-smoker. She is on 3LUs of oxygen 24/7 probably for the rest of her life. She is supposed to do nebulizer treatments of albuterol and ipatropium 3-4 times a day, inhaler twice a day, and her 16 other daily medications for heart, BP and other problems. Smoking at this point = death and I've told her this repeatedly. She can smoke or she can live.


Today, she lost a friend. I know that she is grieving and its understandable. I've been delicate in approaching it. Unfortunately, she's used this as a reason for not being compliant with her treatments/meds. I called her at 8:30am, she had not done her first treatment. By 3:30, when I called her again, she still had not done the first of the three minimum daily treatments. She also spent 1.5 hours off the oxygen when she came back from an appointment.


Then I saw it. I have cameras in her apartment at the request of her doctors. If they were not there, she would have to go into a facility. This was the compromise so that I could check on her to make sure she's doing what she's supposed to be doing with respect to her treatments, meds and the like. Otherwise she would need a full time companion to watch her for these things. So here's what I saw. After my phone call at 3:30 she sat down in a chair with her back to the camera. Took off the canula, and went out to the patio balcony. Her tubing for the oxygen concentrator is ample in length (25ft) and will go to the patio. I've seen her out there with the oxygen on before on multiple occasions. So I know there is NO reason to take off the canula to go outside. I believe she went out to smoke. There is no camera outside. When she returned 5-7 minutes later, she put the canula back on and sat in the chair before returning to her recliner to do her breathing first breathing treatment.


As much time, effort, energy and money that I have put into making sure she is as healthy as she can be, safe, and as independent as possible, I am feeling a bit angry right now after seeing this. I get that she is sad. But all it takes is one to start the habit again. I'm kind of feeling a bit betrayed that she doesn't seem to care that she's gambling with her life. It seems like I care more than she does about whether she lives. I know she doesn't want to die but it just doesn't seem to sink in that she's going to die if she continues to smoke, sooner rather than later. Should I be this angry over her smoking? Should I giver her a pass as long as its just this one time because she's grieving over her friend? Is it a waste of time to even bring it up with her? Chances are she'll just lie, and even if she doesn't she's just going to make excuses. Am I completely off base here in feeling this way? At the pace of her decline in health over the past seven years, she will be lucky to make it 70. I mean it seems like she's possibly already at end stage COPD at this point. I don't think she'll survive another exacerbation. At the same time, I'm reaching a point of frustration where if she doesn't care enough to help keep herself alive, why should I fight the inevitable?

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You can't care about her more than she does.

What you are feeling is completely normal when you try to care more than she does.

Realizing that she is free to make bad choices and she will pay the ultimate consequence may help you feel less angry.

Prepare yourself for her passing sooner then later, she has very serious illnesses for her age and if she had cigarettes to do it today she has probably had them all along.

I would let my mom do whatever she wanted at this stage of things, but that's me.
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Many years ago I had an uncle who smoked even after having his larynx removed. The old time cigarettes without a filter! He knew he was dying and had smoked forever. I understood how he felt so it didn’t bother me as much. The damage had already been done and there was zero chance of improvement for him.

He figured at that point, who cares? He was going to die anyway. Your mom may feel the same if she is indeed in the last stages of COPD.

I understand that it bothers you. Especially since it’s your mom. I bet she feels guilty about hurting you but she’s struggling with a very strong addiction and like many habits, it takes time to break.

My dad was able to quit cold turkey but the majority of people don’t do it the first go round. Very often it takes many, many attempts before successfully quitting, if ever.

She did just lose a friend and she may have automatically reached for what she finds to be comforting.

Personally, I’d give her a free pass after losing a good friend. You may feel differently and feel that she has to learn to cope with her grief in other ways besides having a cigarette. Not sure if there is a right or wrong answer here. That’s a tough call. One thing is for sure, you love your mom. That’s pretty clear or you wouldn’t be concerned.

Just encourage her, without judgment if that’s possible. It’s got to be her choice. She can’t quit for you and may never be able to.

I spent many years as a child confused because back then there were no narcotic support group for families. I lived with the secret of my oldest brother (now deceased) being a drug addict. (heroin)

I loved him as a brother. I despised his actions. There was no attention brought to the opioid crisis like there is now. So I felt shame even though I did nothing wrong.

My other brothers abandoned him. As an adult I took care of him until it nearly destroyed me emotionally. I was always terrified of finding him overdosed. I had seen him overdose when I was a little girl and had never forgotten it.

I finally said I couldn’t do it anymore. I wasn’t even sure I could go see him in hospice as he was dying from hepatitis c but my mother wanted to see her son before he died. So I took her. I looked at his very frail body and only saw one thing, my brother that I dearly loved suffering with something bigger than he was.

He wasn’t a bad kid. His best friend asked him to try drugs with him. Neither of them knew anything about addiction. They got hooked. They were only 13 years old. Breaks my heart.

My family tried for so long to get him to quit. It wasn’t his choice. He thought he could handle it.

On the drive to see him in hospice I asked God to take my anger away. Because like you, angry at your mom for cigarettes, I was furious about him doing drugs. I had no idea I was capable of non judgmental, unconditional love. I was the last one with him and there wasn’t any anger in me at all. He didn’t make it to 70 either. It hurts, I know.

He kept hanging on in hospice. My brother could never apologize to me for hurting me. Three nurses came up to me, telling me that he told them he was so sorry for hurting me. I accepted that and smiled. I didn’t require him saying it directly to me. I think I learned more about myself then, then I did my brother.

I asked the nurse if he would be able to leave hospice. The nurse assured me he was dying but holding onto hear something. I said, what? She said, I don’t know but when he does he will go very quickly. Those hospice nurses are amazing. He was in a coma towards the end.

I touched his frail knee and told that it was okay to let go. I said I love you for the last time and I told him I forgave him and I meant every word I said. As I drove out of the hospice parking lot the nurse called me and said he was gone. I’m so glad that my final days with him were filled with love for my brother with no anger. Follow your heart.
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Thank you, everyone for your kind and supportive advice. You are right. This is her choice and it’s better for me to just resign myself to the fact that she is going to do what she wants to do. If it kills her faster, there’s nothing I can do about it. I’ve done what I can do get her to do the things she needs to be healthy. She’s making the choice. Thanks, again.
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Gabby, you’re very welcome. You are a caring person and that is what your mom needs most. Just knowing that you care will be enough for her.

If she decides she needs additional help, she’ll ask for it. Then you can assist her in a way that works for both of you.
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You can be angry about the time, effort and money you've wasted, if it helps.

And you can be annoyed about the broken promises.

But then once you've done that, the important thing is not to go on wasting your time effort and money, and not to foster unrealistic expectations about her promises, and instead to think about what, for your mother, constitutes good quality of life.

She's a lifelong smoker, and she has not given up, and she doesn't want to give up. Now that she is on oxygen - yelp! - there are certain cast iron reasons why most of the time she cannot smoke unless she literally wants to go out with a bang; but if a cigarette genuinely makes her feel better, relieved, relaxed... what benefit will it deliver to her if she is prevented from smoking? Longer, more active life? Nope. Too late.

You can improve not only her but your own quality of life by gracefully surrendering this particular battle and refusing to comment further on what she does. Before you take her to task over this latest escapade, for example, pause and ask yourself whether you're telling her anything that you don't know she already knows.

You will also save yourself from having to listen to a load of boswelox excuses and evasions, and goodness won't that be a relief?

Her choice. You don't have to like it, mind; but neither do you have to fight it when, as you rightly point out, she'd rather not.
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Oh my gosh! Fantastic attitude. I need to print out your answer in bold print and remind myself of several things you said every time I think about reasoning with unreasonable people.

Sometimes I think that I can make people see something they haven’t seen before, or encourage them to give it just one more try to quit smoking, drinking, drugs, food, etc., only to feel like a fool when they have proven over and over they are not interested or unable to change. People need to start taking mental health issues as seriously as physical issues. There shouldn’t be a stigma attached.

Some people don’t even get enough rest. My cousin works 80 hours a week! He beat cancer years ago but just had a heart attack. Got his attention, for sure. I begged him to slow down and work fewer hours. He’s extremely goal oriented and accomplished his goals but unfortunately it cost him heart trouble.

We also have to question ourselves as to what our motives are. Is it to benefit the person, ourselves or both?

We can’t be embarrassed to reach out when we need it. All of us struggle in one way or another at some point in our lives. No one is born knowing all the answers.
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I hope you can put the anger aside and move on it. Not good for you to be feeling that way. I'm fairly certain that nothing you say will change the situation. So, I guess it's time to come to terms with her addiction.

Maybe acknowledge that you think she might be smoking again. But not in an angry way, just matter of fact. Say it's her choice, and she knows how bad it is for her, but that she's the only one that can make her stop.

Very frustrating, but there's only so much a person can do. I guess make sure that other things are done to keep her safe and comfortable but if she makes bad choices, that's on her, NOT you.
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It is so very hard to love someone & watch them make decisions that are against their best interests. You have done so much in providing care & support for your mom to stay at home. You are awesome & she very lucky to have you!!! She in all likelihood is not going to stop smoking. You need to have a calm, honest conversation about her safety re: oxygen use, smoking, flames, live ashes, etc. Thank goodness she knew to leave the oxygen inside when she went on the balcony to smoke.

My grandfather with emphysema, on oxygen, would light his cigarettes & smoke with his cannula in! My grandmother on the other side of the family, same diagnosis, would put her cannula on her forehead & light her cigarettes at the gas stovetop!!!
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Longears,

Wow, talk about where there’s a will, there’s a way. Come to think of it, I know a few people who would probably do that too. Tough addiction to break. Very creative ways to be able to smoke, huh?
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Smoking/nicotine treats mental illness symptoms. Your mom feels sad, I'm sure. I wouldn't waste any time or energy being mad at her but maybe you can look for other ways to help her cope with her feelings. And in general, I just don't think there's much any of us can do about another adult's choices in life. I went through this with my dad, where I was taking him for COPD doctor appointments, teaching him to use inhaler, and he wouldn't stop smoking or use inhaler properly and then would complain that he couldn't walk without being out of breath.

The nicotine gum just made him smoke even more. All the "talking to's" and lectures by myself and docs did nothing to get him to quit. In the end, others do what they want and sometimes a moment of comfort -- however bad for them-- is what they want.
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My grandfather, long passed, chewed tobacco. He once asked a visitor for a cigarette. He tore off paper and filter and shoved in mouth to chew.

You know, I am to the point, that you and medical professionals can tell them whatever. They will not change. For some it's smoking, or booze, or weight or what have you. They will pass sooner. I know a terrible thing to read, but there, you have it. It does not make your role any easier. I know and know well.
I am sorry for the stress it does cause you, though. Take care of you.
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AnnReid Jan 2019
Mine too. He was an engineer on a freight train, and he could chew and spit while he doing worked, so it was his drug of choice.
He was an amazingly handsome man, but my memories of him are always of his horribly disfigured mouth, missing and discolored teeth, and labored voice and breathing.
Addiction is surely among the toughest ills to overcome.
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It's not wrong to feel angry, and it's a waste of time to say anything about your mother's smoking addiction. When I was in the hospital having complications with my pregnancy 34 years ago, smoking was permitted in the common rooms. I'll never forget the man who had a tracheotomy.........and was smoking through the hole in his throat! If that doesn't say it ALL, then nothing does! Some people make the choice to continue smoking until death since they've already received a 'death sentence' with the COPD or lung cancer diagnosis. I watched my aunt & uncle do that very thing. You can't 'make' somebody want to change..........they have to want it for THEMSELVES.

Stop monitoring your mom's every move, that's my suggestion. Allow her to live her life as she sees fit, so you can live yours!!!

Best of luck!
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Are you mad at her for other diseases she is suffering from? Addiction is a disease. I imagine addicts wish they had easier lives or different diseases to deal with.

The icing on the cake for people dealing with an addiction is the message that it's completely under their control and they just have insufficient willpower. It's their fault they are ill. "No one's making you smoke, drink, or gamble. You are doing this to yourself ."

There are chemicals in our brains. They move us towards and away from behaviors. Some people get extra "feel good" chemicals from actions like drinking, smoking or other addictions. It's kind of like an allergy. They can withstand the pressure to use for so long. There are steps they can take to try to control the urges. But it's like running upstairs holding your breath. You can do it for awhile but eventually your body will force you to breathe. If you haven't experienced this, count your blessings.

If you could look at her nicotine addiction as more of an illness and less of a character flaw, you might find a kinder way forward.
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