Ethical question: Am I supporting Mom's personal choices or enabling her unhealthy behaviors? Or both?

What is overwhelming her? Just a thought but I have a number of health problems and it gets overwhelming. If she now is being told she has cancer could it be she just doesn’t want to handle it anymore? Have you tried to ask her?
If it bothers you, many groceries can be bought by instacart so she can buy what she wants , have them delivered and you don’t have to.
We all have bad habits. I’m not sure the food causes this and that are always founded. My mother is 92 and has eaten junk food , chips, pop, sweets etc her entire life, smoked for 40 years. Physically she walks better than me. I’ve tried to have a decent diet , never smoked, rarely drank and got a chronic disabling disease at 35. Go figure, lol!
But if she has cancer, especially if it’s advanced, let her do what she wants to do

My mom had a different set of things she refused to do for her health. When I look back on it, I think she felt if she had to be in this situation then somehow she deserved things on her terms. One might be that if your mom can get you do things with her then she will comply which creates a dependency on you. It is not realistic for you, while she has all the time in the day to fill. I think I thought I had to keep my mom alive as my responsibility. It actually created more tension between us. So you may have to make the choice of having more time with her by extending her life or allow her to choose. The latter may mean less time but a happier time between the two of you.

The person that I know who lived the longest (well over 100) occasionally smoked, drank, always consumed refined sugar, preferred white bread, loved sugar cereal, kept candy in the house, ate ice cream daily...

Some of the professed “healthiest eaters” I know died young - of natural causes.

We we can try to prolong our lives all we want, but we will all die. That is the only guarantee.

We might as well enjoy the journey.

My brother used the patch while in hospital. It worked for him. The nurse put it in him.

What about a patch now? Most people cannot quit cold turkey, especially long time smokers.

Some facilities have smoking areas for residents, rehab patients and visitors. I’ve seen it. Not saying smoking is good but people do smoke.

We all need a good laugh. This is a funny clip that I believe everyone can relate to. Here we have a bold bossy older woman who everyone thinks is hysterical but if you were here caregiver you would go crazy with all her demands. If Gladys was sick and dying would you give her her alcohol?

https://youtu.be/wGZccD6A_KQ

Your mother's choices have led to a situation where she is no longer able to shop for her own groceries and cigarettes. So, here you are in this very real quandary. If I were you, I would probably do everything in my power to help mom quit smoking. Why? Because in her condition, she is very likely going to be spending time in a hospital, rehab, or nursing home long term. All three of those types of facilities do not allow smoking. Better for mom to work toward quitting on her own terms than to have to go cold turkey, and you can help her achieve this. I hear you on the sweets, but seriously, quitting smoking by itself is hard enough. Tackle the sugar later. And yes, reward her for reaching mini-goals in that process. Those goals should be something fun and positive and can even promote self-care like going together with you or a grandchild to have her hair done, a manicure, a visit to a park, a pretty plant for the window sill or making cookies. I can tell that you are very busy, so delegate when you can.

You are doing the right thing.

You are treating her as you would want to be treated. (This is how I would want to be treated too).

We don’t make perfect choices for ourselves—but it is that freedom of choice and independence that drives our happiness.

If my kids someday force me to eat a gluten-free, vegan, sugar-free or fat free diet, contrary to my wishes, I would feel very happiness-free.

I also feel that that she should be allowed to choose which doctors appointments she wants. We all know that the doctors are self-referring, and most patients don’t need to go terribly often. We could spend our whole retirement in a waiting room if we went to every recommended appointment.

Tell your mother in very tough, firm manner - as long as she is in YOUR house, she is not allowed to smoke (take the cig's away and don't buy them); and she will eat what you serve (healthy); you will not get her "bad" food and there are certain house rules effective at once. And if she rants and raves, tell her to stop it at once or you will kick her out. In the meantime, start hunting where to put her and seek answers to financial questions. This is slowly killing you and destroying you - and I don't think you deserve that. Talk with the doctors about medication and possible help but do NOT give in to her. You are enabling her and destroying yourself.

My heart goes out to you.

It is not a matter of taking control from a parent but of exercising the choices/control that you have for/of yourself. It is always about ourselves and our choices and changes, not the choices or changes of others.

We all have restrictions on us in relationships and cannot expect any one other person to do exactly what we want. How we deal with that is our choice - we can get angry, have tantrums, manipulate and so on, or we can accept that others make their own decisions/choices and deal with that constructively.

Your mother is manipulating you to enable her to continue making her bad choices. You are feeling that pressure and also the pressure to "keep her happy." You are not responsible for her happiness.

The only person you can control is you. If you stop the enabling, you are not taking control from her, but exercising a different choice for yourself. How she responds to that is her business - her choice.

When my mother was developing vascular dementia she started making some bad choices. Mother had mental illness all her life, ranted and raved at me and other family members regularly, and generally was very difficult to get along with and always impossible to please. Years ago I realized I had to make my own call about what I thought was best and stick to it despite the flack, and that is what I did from then on. She often didn't like it, but I did what I thought was best anyway. She appointed me POA and I went against her wishes on major issues several times after that. Again, she didn't like it ,but in my view it was in her best interests and that was what I was to do as POA and a responsible daughter. It the long run these decisions proved to be best for her.

I have dealt with several loved ones with addictions. I would not encourage or facilitate their addictions as much as it was within my power to do or not do so. I would work on having a good healthy relationship with them, and respect their right to make their unhealthy choices, without involving me. Nor did I let them manipulate me. I drew those boundaries. I worked to provide a healthy enthronement/relationship as far as it was within my control. If we deny one thing, it is beneficial to provide for a healthy alternative - something they would enjoy. "Mother, no I won't do such and such, but I would be happy to do this and that with/for you."

I am happy to say that that most of my addicted family members are recovering.

Your mother is an addict - to cigarettes, and junk/sweet food. It is killing her. You might want to look up how to deal with addicts. . I wouldn't sidestep the issues, but calmly and firmly state your boundaries. She doesn't care for herself and has given up on herself. You care for her. You don't have to give up on her.

Not sure what you mean by mentally incompetent, but it sounds like you are in such a tough spot here. I don't have an answer for you, we all have to do the best we can to deal with this at the time. Sometimes day to day even. Just know that I feel for you, and hope things smooth out. For what it's worth (but it depends on her level of cognitive impairment), the sugar free snacks work out just fine and they don't know the difference! And when people get angry, cry and yell? It can be very stressful at the time, but eventually? They stop. Feelings can be so powerful, but most don't usually last forever.

Stopping smoking is a well, fill in the blank. It's so tough. Withdrawal, etc. And some people just aren't willing to go through that.

And, your money is yours. Use it how you see fit, whichever way that goes for your Mom.

Uncontrolled diabetes is an accident waiting to happen. Do not enable her nicotine addiction. Since she doesn't possess the wherewithal to buy the unhealthy items, YOU should not get them for her. "No, Mom, I'm broke."

Insanely difficult answer. Maybe you’re gonna have to tally up all these replies which ones are for and which ones are against and go with that. I’m sorry but you totally understand what you’re going through.

OK here’s my two cents. Do what’s right take care of her properly. Let her cry and be angry and such. Eventually she will start getting to feel better even though she may have her resentment towards you you’re gonna have to ride that out and as she sees her life improve hopefully she will be grateful.

I had a gentleman who really wanted things his way but as his health declined and his wife’s, he be-grudgingly gave over to me taking proper care of him. I did whatever I could to stay Doing the things he wanted to do, eating the things he wanted to eat, but ultimately he did leave it to my decision. And we broke the rules occasionally for good measure. The fun stuff had to become treats not the norm. Good luck my friend!!

I asked a similar question last year and I received a lot of "let her eat what she wants".  The problem is, in my own experience, once you see your parent go down that road once, reach 300+ lbs, then develop Diabetes, and now the degenerative neurological disease she has, it is hard to just let her eat sweets and junk food!  Cause in my head is that the same road took her where she is now...and I am having to pick up the aftermath of her behavior. 

Well, the road ends here for me, as of tomorrow she is going into a Skilled Nursing Facility...she wants to do whatever she wants...be my guest, but it won't be under my roof, in front of my child. 

It didn't matter that I tried to control the amount of sweets...she managed to get her other caregiver to get them for her...so yeah, they find a way. 

We can't be guilted into their self-destroying habits, we just step back and let it be.  There are fights that you just can't do alone!  Be strong and take care of yourself.

She sounds exactly like my grandmother and my Mom would take her grocery shopping and she would buy cakes and ice cream and was diabetic and took a shot of insulin at home that Mom and her sister monitored. They gave up and let her eat what she wanted. Her mind had gotten bad (behaviors) just like your mother’s to a degree. She was 86 and went to assisted living for 2 weeks before going to the hospital where she passed away. Mom and her sister let her eat what she wanted so she would at least have that right and control. I don’t know your Mom’s age but left her have her sweets and cigs since everything else is going south. I let my Dad do the same. He was 89 when he passed and ate his Little Debbie cakes and ice cream. I did not stop him. It was all he had left that he enjoyed.

It sounds like she is neglecting herself and refusing medical care. When refusing medical care, the first step is to explain the reason and what harm refusing would cause.

I do agree that you should not control her. You always let them make their own decisions. If you do not agree, all you need to do is explain the harm. I feel it is your choice on whether to buy her unhealthy products. If you feel it is immoral, I would just tell her that you feel bad for enabling bad habits and would prefer not to do it. Some home health agencies allow caregivers to purchase these items for clients and some do not, so there is no standard. It is a personal choice for you. There is a FDA approved electronic cigarettes that you can get from the doctor. It is safe and no chemicals. Just nicotine. Ask her if she wants to try that?

Good luck.

I feel your pain! My husband has been a type 2 diabetic for many years, and he seems to think just taking a bunch of pills will make everything OK. I have tried to get him to eat better, count carbs, read labels, etc. and it does no good. He is going to do what he wants. If I don't buy stuff he wants to eat at the store or fix meals he wants, he wants to go out to eat all the time.

Now, my situation is somewhat different in that my husband still goes to the grocery store and buys some of his own stuff. However, he still wants me to be the one buying the carby food and snacks, because he can somehow justify eating them now. Go figure.

He also spends all his leisure time parked in front of the TV. If I suggest he take a walk or go to the fitness center, he says he will think about it. Right. He will sometimes go if I say I'm going, but I'm tired of being his mother and having to be the one responsible for his behavior. He ought to be doing this on his own. Besides, I am the one who does all the housework, frequently babysit my grandchildren, etc., so I don't always feel like exercising. I get enough.

My adult children say to just let it go. He is an adult and is eating himself to an early grave. I'm tired of the whole situation, and we don't have the money for assisted living care or any other kind of expensive care. I just keep praying and try not to let it worry me too much.

In the end, adults who have all their faculties are responsible for their own choices. You should consult her GP, and if he or she says there isn't much you can do, then there probably isn't.

One option you can consider is to tell her you are not going to buy her junk food or cigarettes, and if she yells at you, she will see very little of you - only what is absolutely necessary. Nobody is required to endure abuse. If that is not something you want to do, then don't let guilt get to you. Everybody is doing the best they can in bad circumstances.

Hmmm .... I haven't read the comments except the one at the top. Start with compassion. Mom is acting crazy ... for a reason or reasons.

First, she has at least one addiction - nicotine. I would research or connect with a professional regarding how to remove cigarrettes and treat geriatric nicotine addiction safely from both the physical and mental health perspectives. Even sane adults have trouble quitting or find it impossible.

Is she suicidal? If someone were not geriatric I think that's how some of the these behaviors would be perceived. The psychiatric component, if there is one, I would suggest needs to be addressed by a professional. She is clearly intentionally or unintentionally very self-destructive.

What would a nursing home do? I suggest since you are basically running a hospital for one patient, that you do what a skilled and licensed nursing facility would do. I doubt any licensed healthcare facility would provide liquor, cigarrettes, roulette tables, not to mention sugary sweets for diabetics.

Within reason they would have to provide healthcare like insulin. Diet is a huge factor and you would do well to feed her and optimal diet.

She is manipulating you. That's ok, it goes on a lot in families. I would get counseling for you. You could easily get riddled with guilt and confusion, physically and mentally exhausted and then collapse, then who will take care of mom?

You are the responsible steward of your money. With regard to any purchases the buck stops with you. Only spend your money on what you can solidly affirm a yes to when you look at yourself in the mirror. Yes, you and your conscience really do matter!

As a Catholic, I would ask a Priest how best to be merciful to all concerned throughout all of this.

Finally, the physicians hipocratic oath, "first, do no harm."

God bless you!

While I understand what the majority are saying, I have a different opinion. Your Mother is an adult and these are the things she wants to do. I don't believe you are enabling her, you are fulfilling her requests. If you force her to say quit smoking by not buying her cigarettes she is going to go through a very negative withdrawal, be miserable and blame her misery on you.

My husband was in hospice care due his a failing liver from drinking. As soon as we left the hospital he wanted me to stop at the liquor store and I refused. He even try walking to the store one day when he was very very weak and I caught him and stopped him. He begged me every day to go out and buy him some and I told him no, I did not want to be the cause of his death.

He died 10 days later miserable because he didn't have his wine and beer. I blame myself even worse for denying him pleasure during his last days.

If if your mom wanted to quit smoking and start eating healthier she would have done so by now. She's not interested in changing at this point of her life and forcing could actually lead to more physical pain. If she dies sooner, that is on her and not you. Being a caregiver is hard enough as it is. Having to deal with daily fights will be even harder.

First of all, you need to find a Caregiver Support Group in your area and make attending the meetings a high priority. You cannot help your mother when you are overridden with guilt and constantly second-guessing yourself.
Additionally, I would encourage you to try and remember that you can't control everything. You seriously need to get to a place where you are okay with that. The journey of a caregiver and their care receiver always ends the same. It is an incredibly difficult road to travel, but if you can focus on what really matters, you will have wonderful memories, and no regrets. Take it easy on yourself and on your mom. The journey ends in death. My prayer for you is that you live in relationship with your mother so that you can say you have done your best.

FYI - I work in older adult ministries and I lead a caregiver support group. Believe me, you need to find a group to attend. Check local churches and community centers for groups and make a commitment to yourself to attend.

You stated that you offered a counselor and she refused. Would she see a nutritional counselor about her diabetes? Her doctor could refer her and some insurances cover it. I have to confess that I was diagnosed with Type 2 diabetes 2 years ago and did not accept the diagnosis well. I continued eating the wrong things - I'm a lifelong chocolate addict. I finally got so tired of being tired, depressed, overweight and sick feeling that I started paying better attention to my diet and began an exercise class at the Y that I enjoy. My family and friends have noticed that I have more energy and seem to feel better and do more. I lowered my A1C with diet, medication and exercise. With some concentrated support, she may be able to do the same. As far as the smoking - I don't know why anyone does that knowing it causes so many serious health problems. My own parents didn't quit until one had a heart attack and the other had cancer. Some people you just can't tell them anything I guess.

This is my own personal belief and may not be right for you. If making bad health choices makes her a happier person but shortens her life, then by all means make her happy. Even with health problems, including dementia, she still has the right to make choices about how she wants to live. Life is short, regardless, and why spend one's last time on Earth being miserable?

I wouldn't buy what she wants and shouldn't have (and neither of you can afford, especially the long-term effects from continuing these habits.) You can do this without discussing it with her, which is what leads her to misbehave. If you really want to, you could try at least once to explain why you will not get these items for her (using the various "excuses" given in the responses here - you have no money for these items and she doesn't either, these choices can lead you to NH/dialysis/amputation etc. You should also include in that conversation that she needs to take meds and check her blood for the diabetes, which also can lead to NH/dialysis/amputation - not done in a threatening manner, just informational. One time when she is "rational." If she won't comply with doctor orders, there isn't much you can do other than to stop enabling her "addictions."

The combination of she should not have these items (sweets and butts) AND you using your own funds to provide them should stop. Once in a while some healthier treat/sweet would be okay - kind of a reward for eating healthier. If she complains when groceries arrive, either by you delivering or store, plead ignorance, or say they didn't have what you wanted or you forgot or there wasn't enough money to cover the food, butts and treats, whatever works. She will likely put up a fuss when she doesn't see her "goodies", so just defer it saying "Maybe later I can get out and find it" (of course you won't, right???) and if she continues to fuss, go home. Being competent, she might eventually figure out why you are not "helping" her and maybe, just maybe she can get on board. This way you would not be enabling, but also not "controlling" her lifestyle choices. She still has the option to do all the wrong things for her health, she'll just have to find another "dealer." Clearly she doesn't sound like she could get out to buy these things, so someone else would have to be talked into getting what she wants.

As for appointments - mom was starting down the dementia path and would often balk at going or tell me she cancelled the appointment (almost 1.5 hour drive just to go one way from my place to hers, then additional time to get to doctor, wait and be seen. It was not an easy thing to do and having her cancel would irk me to no end! She is now in MC (into year 3) and will whine, complain, say no, etc when I come to pick her up. After a few excuses, I will just say 'comon mom, put your coat on and let's go, we're going to be late!' This is taking on the role reversal others mentioned. It is a bit different in that your mother is still 'competent' and can make her own decisions, but you are no longer a child, so mom shouldn't be ordering you around and getting angry when you don't comply.



I would have standing orders at the doctor office to consult with you both in making the appointments or canceling! You could specify they add the best "times" for you to bring her. Does this doc office provide portals? I created mom's and use it to check on things - it would list appointments and generally what they are for. One of those times mom said she cancelled, she actually hadn't (I called the office and confirmed - I was only about 10-15 m from her place.) Turns out she wrote it on her calendar, but didn't follow through.

There are some very good answers here. One specific idea might be to try cutting her a deal. I will no longer be buying you things that exacerbate your diabates, but if you go on insulin, I'll get you X treat once a week.

Something like that, basically trading small treats for compliance. Once she starts complying, she may start feeling better and a positive cycle could begin.

This sounds kind of terrible and infantilizing, but maybe deperate time call for desperate measures.

Smoking is a very tough addiction. Maybe you could get her on the patch? Rather than having her quit cold turkey.

I agree with those who urge you to get her evaluated for depression, and treated. If at all possible.

She sounds really stubborn. So sorry you're having to deal with this.

I empathize with you. I moved my dad in with me 9 months ago. After he lost his wife (my mom) 3 years ago he has steadily gone downhill, with one suicide attempt. He is depressed and anxious. He stays in his bed and gets out only for meals or trips to the bathroom. He will not do any of the exercises the PT recommended. He quit smoking almost a year ago but wishes he could start back. He has mild COPD so I do not offer to buy him any. He keeps up his behavior he will be bedridden or in a nursing home. His doctor said not to push him. Let him be. So that is what I have done. In his opinion, he has nothing to live for. I cook healthy meals for him but he has a sweet tooth. I do not deny him this one pleasure. He is 86 but it drives me crazy that he has lost the will to live. He refuses to see a psychiatrist. I'm lucky if I can get him out of the house for his regular doctor appointments. I guess I am saying let her enjoy the things that she looks forward to. Perhaps don't buy them for her but you could drive her to the store and let her buy what she wants. It's hell getting older for sure. I love my dad but hope he passes away peacefully in his sleep so he can be with Mom.

You are doing the right things in getting the appointments back on track. She needs her next appointment to be with a Neuropsychiatrist to treat what looks and sounds like clinical depression with addiction and/or early onset dementia. Yes, though, you are still enabling her in some ways (like the sweets); not only in ways that are continually self-harming to herself, but you as well. Her illness is controlling you. My heart goes out to you.

IMPORTANT-What looks like her unwillingness may actually be INABILITY... the brain is very susceptible to underlying, manifesting dementia in exactly the perfect storm that describe. As with most dementia, it will likely develope slowly and undetected. Make a list of normal behaviors 5 years ago and backwards, then a separate list of newly detected and experienced behaviors in contrast to her declining medical condition. Keep this with you at all times and especially appointments. You will see patterns if you're not already. You will need to give clinicians specific examples moving forward in order for them to clearly assess. You may have to make two appointments as talking in front of her will only allow for her to refute the situation.

If you are willing, then bear the burden of her shortlived anger. Once the excess sugar, salts, fats are not in her body, she probably will feel horrible...its very similar to a drug withdrawal and often also affects the dopamine receptor of the brain. You must, though, find out if this behavior is indicative of another progressive disease process on the rise. To help spur your awareness, look at signs and symptoms of Diabetes Type 3... the new American Diabetes Association guidelines. As with most dementias, it is not memory persay, that is initially (noticeably) affected, it is decision-making.

I know it feels like a difficult dilemma for you because you love your mom and want the best for her. She, however, does not want the best for herself. If she is, in fact, competent because she has been medically assessed, she is free to choose her course of self-destruction. You can tell her you love her and all the reasons you hope she will choose to work on her own behalf, but enabling her behaviors with purchases you know are potentially deadly is not an ethical quandary, it's an ethical abdication.

You know you would not feed peanuts to an allergic child just because they wanted them. The wisdom of adulthood is easy to find in this interaction but perhaps it seems more elusive when you are the child trying to guide your parent's choices. Enabling behavior is as addictive as unhealthy choices so this work is yours to do. Unfortunately, even if you do your own work well, your mom still may not survive her own choices, and she may not want to.

When my mom decided to discontinue her chemo treatments after having only two, I felt it was a mistake but I realized that it was her decision to make and not mine. I set about being as supportive of her, in spite of her decision, as I possibly could, rather than demanding that she make me happy by choosing my perspective for her own path. Sometimes the only thing you can do with competent adults is offer them unconditional love for who they are and stop demanding that they perform to your standards for acceptance. They are free to choose well or poorly.

I'm sorry for the heartbreaking relationship you have with your mom. You can continue to offer the support of enabling good care arrangements but, as my dad's doctor told me, you can only do for him what you are able to do AND what he will allow you to do. You'll have to work with the entire formula and not just the half you favor.

Best wishes on coming to terms with all of this.

When I started cooking for my mom I refused to give her sodas and other junk foods. She complained. She got over it when she started feeling a lot better. I know the smoking is a more difficult one, but I would not have ever in my life bought cigarettes for anyone for any reason. My son is an alcoholic and I certainly would never supply him with alcohol. For the cigarettes and sweets, your mom will find a way to get them if she's that stubborn, but you should not supply them. You should not do what you know is wrong. It messes with your well being.

Your mom sounds like one tough cookie! There is no one right answer. Even if you stopped purchasing the junk food and cigs, she still would not follow up with her doctors or take care of her medical needs, so her health will deteriorate no matter what. Given that fact, it's very important to discuss with her about her wishes for medical intervention when that time comes, especially because she is still mentally competent now. I know it's hard to talk about, but vitally important. Here is a link to some short videos about your choices and some tips about how to discuss this with your mother that I've put together. I hope they might help you a bit.
http://bit.ly/2IeYzMW

Hi...
You have some real good Answers here..truly!
I'm chiming in becuz I lost my fiance' @ age 57, from diabetes complications/kidney failure....here 1 day, dead the nxt. He ate horribly & smoked & drank & sweets...he was in full blown denial, many diabetics ARE.

what I noticed you saying was:
You didn't want to take away her ability to make decisions..
However, I see her doing that VERY thing to you?
You too, have decisions. & that's simply, put, " mom i'm not going to contribute to unmanaged diabetes"
& maybe point out she' noticeably not loving herself. & you Do love her.
Goodluck

Your mom cannot have cakes, pies and cookies. It will kill her.That is the bottom line. So, what ever you need to do, you must do. My ex husband was diabetic, and I remember what a challenge it was to keep him away from sugar. I would buy sugarless pies and cookies, but the the problem is there are a lot of calories and being overweight is bad for diabetes. Once I heard he was in dunkin donuts so I pulled up and waited for him to come out. When he saw me he just froze (lol) and I took the bag of donuts away from him and went back inside and bought the sugarless ones. It's hard to keep on top of it. They will fight you.