Quad heart bypass. Bi-Lat femoral arterial bioassay-stil smokes. Cardiologist says "don't fight this battle". He wants a cigarette about every two hours. Non-insulin diabetes but run sigh blood sugars. Candy demands, ice cream demands, green grapes, oranges, etc. "don't worry, just give them whatever they want". He's 83 - is this the way to play this? The alternative is constant arguing-trying to re-direct, offer alternatives. Help!

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Yup. That is how we play this. Give him what he wants.

This is your husband we are discussing, right, and he lives at home with you?

In my mother's nursing home I saw residents being wheeled to the patio to smoke, with large fireproof aprons covering them. Look up ~fireproof smoking aprons~ on Google. There are also similar lap blankets that could be used to help protect furniture. It makes sense to decrease the fire hazards as much as you can. But smoking is not a battle worth fighting at this point.

How high do his blood sugars run? What was his last a1C number? If his numbers get dangerously worse, perhaps he could start taking insulin. Or just live with the consequences of the high numbers. He wants an orange? That is just not a battle worth fighting. Give him an orange. Let him peel it himself, to spread the experience out. My husband's geriatrician told him to stop taking his blood sugar readings when he developed dementia, and to eat what he wanted. She monitored his a1C about every 3 months and told us she would let us know if it became dangerously high. It never happened.

The time you have left with your dear husband is limited, no matter what life-style changes he does or doesn't make. Constant conflict is bad for his quality of life, and yours, too! Try to enjoy each other. Cherish all the good moments.
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If you like reading, She, I suggest "Being Mortal: Medicine and What Matters in the End," by Atul Gawande. It has some good insights about Quality of Life decisions near the end of a life span.
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He may be terribly bored. I guess you could try introducing to him to FreeCell or something, on one of the simpler handheld devices? That might substitute a new addiction and take his mind off the others - it sounds as if he's looking for stimuli.

But other than that, and oh my goodness the fire risk must make life a bit exciting, what's good enough for a cardiologist...

I think perhaps the way to look at it is, what are you trying to achieve? What are you hoping for for your father? And I have to agree that there is very little point in trying to get him to adopt healthier lifestyle choices if it's only going to make him miserable and you unpopular.
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My MiL lived with us and was a HEAVY smoker, I was sooo worried about it but she wouldn't stop/ told everyone she was not going to stop, but she was terminal copd. One day she woke up having delirium and didn't WANT to smoke, we knew then that something had changed, she never asked to smoke again and 14 days later she passed.
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So, he can have his cigarettes, but can you take charge of the lighter? Since you won't be nurse ratchet, answering his request to light up will always be met kindly, with no judgment, no comment.

The apron is a great safety feature.

About his fears....check with the doctor that he has meds for that anxiety.

So sorry that you are going through this. If you have a social worker, counselor, or therapist on board, this support can help you decide when he needs care that you won't be able to provide, and they will discuss the many options with you.

As well as caregivers here, can help you talk this out. Keep coming back!
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I would be worried about the cigarette lighter too.(cigarettes too as far as possible fires w ashes etc)

and smoking... and eating sugary foods, I guess if he wont listen. then it'd be hard to stop him especially if he is demanding. if the cigarettes and sugary foods causes his health to suffer, you shouldn't feel to blame. constant arguing is hard on both of you.

you say you offer alternative foods, but maybe you just have to accept he wont change? when you dig in your heels with dementia, they just push back even more.
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Thank you all for your encouragement and reassurances. I so often feel that I am not doing enough to keep husband safe at home and there is no hope of placing him in memory care unless I can eventually get him enrolled in Medicaid. I do like the idea of a fireproof apron too. Every day/week is a new behavior or the repetition of one I thought was gone. Last night he needed the bedroom door closed because he was sure that someone would sneak in and stab him. He was truly afraid. Thank you all again.
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My mother was in her mid 80's and the Dr. kept pushing her to eat more potassium rich foods. Just have her eat 12 almonds a day. We tried for a few weeks and she just wasn't interested. Finally bought her Hershey's dark chocolate kisses with Almonds and we could at least tell the Dr. she was having a few almonds a day. Maybe not the way the Dr. wanted but Mom was happy.
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I'd like to second the recommendation for Atul Gawandi's Being Mortal. It helped me realize where the important battles were and to gracefully let go of the others. That was a valuable lesson. The bottom line is my loved one has a death sentence. Rigid diets and rules will not change that. If my goal is to make his remaining time pleasant and comfortable, my efforts make a difference. If my goal is to extend his days by a month, two, more, my efforts are for me and are selfish. I prefer him peacefully content and as happy as he can be, for however long he has.

I know She will make the decision best for the man she is caring for, that special individual who is himself and not the same as any other man. I am sure she is wise enough to look at safety issues as well. In the end we each do what we honestly believe is the best for our loved ones.
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Dear She1934,

It's so hard. After my father's stroke, he stopped smoking completely. I think it added to his unhappiness. I tried to make this up with food, but that was short lived. It is hard when people get into their 80s and 90s. I just don't know how aggressive us caretakers should be in reinforcing healthy eating and living. Those are life long habits and they are hard to break.

I know its hard to know what is right sometimes. I hope I made my dad a little happy to let him have his way.
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