My mother who has dementia and smokes caused a small fire on our front porch, luckily I caught it before it really took off but didn't sleep much because she gets up all night long to smoke. Suffers from sundowners too
Lauri 1: A quick and hopefully workable solution to start with the problem of dementia and safety may go something like this. "Mom, I know you love all of your kids, and we love you. (I do not know how many in the family), so because of that, we see the need for you to do no more smoking." "It is dangerous for your good health, and dangerous to your personal safety as well as the safety of others around you.( for what ever reason you choose to use, such as forgetfulness, or sleepiness . Saying "We all find we have to make changes as the years pile on, and I hope someone cares enough for me when I start to need a helpful hand, such as some of us feel you need some encouragement to make some changes to help you be more safe and healthy at this time." "So to keep it simple mom, we insist that you break free of the smoking." "If other issues come to our attention that you are needing extra help for your safety and the safety of others, we will be insisting that added care will be necessary. I and the family love you dearly, but feel the responsibility to be more careful about your health and safety. " (Then just do it, if she drives to buy cigerettes, you may need to take away the keys or get doctor to inform her not to drive anymore. Then comply with his suggestion. Your mother's health and welfare along with others around her are the main important factor. She will not like losing personal control over unsafe habits, but that will just be the way the cookie crumbles, when issues arise for everyone's safety. Take care and do what has to be done. Love to you. joylee
My understanding is that her smoking was the major issue with fear of the house being burned down. I had no idea that NH would allow smoking. They don't allow it in the NH where my cousin's husband is. Since the original question is not on this thread, I could not go back and review what was said exactly. It seems that the issue is that she almost set the house on fire.
All of the assisted living places that I know of have smoking sections and residents can go out and smoke when they please. I think they have one at the Secure Memory Care unit that I visit too, though, I'm not positive they are allowed out without supervision. Their outside area is in a secure area though.
When did this thread become about smoking? The OP asked when it was time for nh care. Nursing homes have smoking areas outside. The OP CAN tske her mom out for a smoke when she visits. The staff might even do it when she's not there. Her mom will be fine. They'll make it work. And just for the record, I'm a non-smoker.
Scary, but I dont want to assume any details since house fires are often caused by people without dementia too. Importantly, is she mild/moderate/severe? Her moods? Consider if she honestly thought a butt was out or if she was sitting next to a roaring fire without noticing. I feel for you with the concern all night. Agree with folks who suggest aides come to you, at least as a stopgap for you. Moving quickly is usually traumatic for someone who is already disoriented, slowed, and forgetful with dementia. Moving is not necessarily better when it's severe dementia either, they may not be able to say how scared they are. A lot depends on acceptance based on if they thought they'd ever go to a NH or always thought stay home. Please install smoke detectors through the house and porch/anywhere she smokes before another sun sets. We also used baby monitors to alert us. We'd still wake up but not getting out of bed to check let us fall back asleep quickly when it was nothing. It's time to get help when you can't keep them or yourself. But NH don't necessarily provide more or better care or make things easier; the time you spend with her can no longer be when she's feeling best, or for a few minutes at a time throughout the day, but only when you visit, and you certainly can't fold laundry while you chit chat, etc. Even NH staff won't have visuals at all time on her, and other patients mean she may wait a while for help. I witness plenty of unanswered call lights, but most people w/dementia don't remember how to turn the light on in the first place, so they have to sit/wait for the aide to come for something else. Also, if in-home help they get to know her, and you know the care she receives. We had security/nanny cams (they knew about them, but quickly forgot) that let us check in online remotely and/or review when something required it. In a NH you're out of luck to know if all the caregivers are kind and gentle with her, meds on time, or not changing her appropriately, etc. which can lead to UTIs, ERs, etc. Nutshell, grandpa went NH in his final months because he became too physical - a big strong man. There was no choice with kids in the house. Finally when we couldn't keep grandma in the house even when we were home we tried a home for her, but she just left that too looking for us and got ornery, so she came back with an aide 6 hrs/night to give some relief, and we made sure she had an ID bracelet, informed our neighbors and police to call us right away. Thankfully a team of reasonably-priced caregivers saved the day. Hope some of those ideas help, at least til you know for sure which way to go/when.
Well I don't know if someone can blame smoking on a person getting dementia and good luck with taking away her cigarettes. If you are buying them, you must stop. And get ready for some terrible spells when she goes thru the withdrawl. Talk to her doctor to either get her an aid to stop smoking (and not the e-cigarette-they have chemicals also if you think about it) and/or to have the doctor sign a paper indicating she needs more supervision than you can supply on your own. good luck.
Safety is the issue here, & it should come first both for her and for you. She will need a smoking cessation method prescribed by her physician, because the tobacco by now has become a lifelong addition. It is impossible for some people to break. She will probably need a memory care unit, because any type of move will cause more confusion. Look around to see what is available, and then visit. Spend time finding how what the place looks and smells like. Does it smell like cooked food? Dos it smell like urine? Is the air stale or fresh? Is it clean and free of clutter? Are the staff warm and friendly? Visit during meal time. What kind of security is in place to prevent her from walking our into the street? Remember, safety first!
Knowing when to put your parent in a nh is one of the hardest determinations to make. The fact that you're struggling with this proves what a good daughter you are, and that your heart is in the right place. That will protect your mom, and it will ensure that you make the right decision when the time comes. I went through this process so I speak from experience. I struggled because my mother's only problem was mid stage Alzheimer's. Physically, she was fine. I had admissions ppl tell me my mother doesn't need nursing home care, just "supervision." That's a common error. If you can't live and take care of yourself without "supervision," that's a justifiable reason for nursing home care. Most nursing homes have a "secure dementia unit" for people like our mothers.
Like I said, I struggled with this, too, before placing my mother in a nursing home last November. Here's what I've found that it boils down to. If her needs cannot be completely be provided for at home, without a major upheaval, it's time for nursing home care. So, if you can afford to have really good aides come in to care for her, and you can keep your job, then no need for nursing home care. If her needs or condition exceeds what an aide is able to handle, it's probably time for a nursing home. For example, my mother hallucinated, and would get up at night, afraid and angry, demanding to know why the aide was there. That scared away even the good ones. I couldn't keep anyone and I was not able to handle her needs to my satisfaction myself. I would have had to quit my job and spend my health and frankly, I wasn't equipped. My mother had also gotten to the point where she hated her home. In retrospect, I think her world had become too large for her, if that makes any sense. Her private room at the nursing home is about what she can handle and she is now a lot more content, but that's our situation. Everyone's different. If you have found that you've had to quit your jib, spend your health, and neglect the rest of your family, and still there are problems, then it's probably time for a team of professionals to take over. Good luck. And if you decide to look into nursing homes, tour them first, pay attention to how the environment makes you feel, and follow your gut.
First, I agree with what others have said, but my specific point to you is one that I had a LOT of trouble letting sink into my brain and heart when I took over POA for both my parents. It is this: YOU are now the parent. You must figure out how to reverse roles with your Mom and make all your decisions on what keeps her safe and healthy. SO...unless your mom is still driving herself to the store to buy her own cigarettes, you must remove them or somehow limit them to supervised use only. With dementia, your mother's brain is damaged and her executive decision making ability is making her function like a child....SO YOU become the parent. If dementia is making things unsafe in the home, your choices are hire caregivers to be with her when you cannot; look for a memory care facility or look for other placement...like a small group home situation where they accept dementia as a diagnosis, but resident are not ever unsupervised. This means, if you do not have POA already, with control of her finances, you must get that control via POA or guardianship. It means, also, that, depending on her total money situation, you need to consider that you may eventually be needing to qualify her for Medicaid or VA Aid and Attendance, if her husband was a war time veteran....and in getting ready for that, you look for placement in facilities that are licensed for accepting those types of residents when the money runs down low enough. If you do not have an eldercare attorney already, it's worth a few hundred to have a couple meetings with one to set up all her paperwork properly and learn how to get started on these applications. Our attorney has staff who helped me with all these applications and helped me understand how to spend the money properly that Mom had left when we were getting Dad qualified. If you plan ahead of time, it saves a lot of time and money and potentially penalty time being added. If Mom is up and around easily, memory care will be better for her than a nursing home, because she will be up and dressed each day, eating and living in a family atmosphere....and not just relegated to her assigned room and a dining room for meals etc. All activities are geared toward those with memory issues, rather than those who are just plain old, in memory care or a small group home.
I think if she is cognizant enough to understand consequences as put forth by you, then it is reasonable to say to her that if she continues to smoke you cannot have her in your home. I hope, having said that, that you too do not smoke! There is a childish aspect to early stage dementia and she would see that as lacking in parity, probably failing to understand that not only is it a health issue but a danger issue. Anyway, if you are unable to get a reasonable night's sleep, or attend to your own needs or those of your family, then it may be time. Personally, I could not have a smoker in my home, no matter who they are or where they smoked. I would not be willing to live with it. My dad, who has no dementia but smokes a pipe non stop, is not respectful of our rules about smoking only outside. My parents would tell us, not ask us, when they'd be coming to stay for a three or four week visit every winter (we live on a golf course in Fla. so perfect free vacation for them). My dad lied about smoking in the bathroom in the opposite wing of our home. Just lied and thought what? I couldn't smell it? We put up with a lot, including my somewhat demented, angry and bipolar mother's tirades and selfish behavior, but the smoking was the final straw. I had to tell them that since they didn't respect our rules in our own home they could no longer plan their trips to stay here. A lot went into that and built up to the point where there was no other option suffice to say. They pulled out the we-are-the-parents card refusing to accept I am a middle aged grandmother, not a teenaged rebellious child! Ah, well. Its one thing if your parents don't have funds and you do what you have to do as best you can. But you still only are obligated to make sure they are warm and safe.
Many who smoke say smoking makes them feel calmer, which is true. Actually it is the process of inhaling deeply and strong exhaling that creates the calmness.... one can get the same result using a soda straw cut to the length of the cigarette. It's the addictive nicotine that keeps the person going back to cigarettes.
Then there is the smoke which contain Carbon Monoxide, Formaldehyde, Lead, Tar, Acetone [stuff found in nail polish remover], Ammonia, Arsenic, and many other chemicals.
Some have suggested to others to use the e-cigarette, but from what I have read one is just substituting harmful chemicals for another group of harmful chemicals. Plus anyone with dementia might do damage trying to re-charge the e-cigarette, using power sources not approved by the manufacturer to recharge a lithium-ion battery can result in an explosion and fire.
Lauri1, I hope you can get your Mom is quit smoking as it will be hard to find a nursing home that will allow smoking, it will be a huge challenge. Example, our large regional hospital system here in my area bans smoking anywhere in the building and on the grounds which also includes the parking lot.
I agree with the majority of people here in that your mother needs more supervision than one person can give. When the safety of the person with dementia or the safety of the caregiver becomes an issue it's time for outside help.
A memory care unit sounds like a good start unless she has physical issues that require a nursing home.
Please consider this option before a fire ends life for both of you. We'd love to hear an update from you when you can get back to us. Take care, Carol
Secondhand and third hand smoke is far more dangerous than actually smoking. The third hand smoke comes from the walls, carpeting, etc. When one could smoke on airplanes, my husband was invited by Boeing to inspect the back of the aircraft's fuselage on a plane that had crashed. It was gummed up with nicotine and prevented the engines from running properly. Smoking is THE worst addiction one can have because of the 4000+ chemicals being absorbed by the body. I worked on the project to get smoking banned from aircraft so my husband was not exposed. (He still got dementia because smoking was not banned in the cockpit and the captain ruled). Now it is!
Interesting thing on the smoking piece. When mom last saw the vascular doctor he asked her how long she smoked. She never smoked a day in her life, but her brothers and best friend smoked like chimneys and he said well your lack of blood flow and general circulation mimics those patients of mine that have smoked. He said you were around enough smoke in your life it appears to affected your health pretty profoundly. And said of course diet and exercise, or lack thereof, didn't help, but he seemed genuinely surprised she never did.
First thing is take away the cigarettes! Smoking ruins brain cells, and is probably the most dangerous habit one can have with dementia because of the fire potential. Keep yourselves safe first, and if she cannot stop smoking (how is she getting the cigarettes?), then do what you must do.
Your situation is very trying and I would suggest if financially possible hiring a night aide to sit with your mother while you sleep. Nursing homes are very confining for wanderers and smokers. Just know not every aide will be a fit so if one doesn't work ask for another. Be sure to lock away money and checks (blank and returned) as a safety measure. It would still be less expensive to keep her home. You could even consider contacting your church or temple to locate someone privately. Retire aides need a little extra income and since there is no heavy lifting they may be a possibility. Life is a challenge.
Sounds like it's time to me.....She needs more supervision. The smoking is going to a big issue for nursing homes. If they allow it at all it would be outside. Good luck.
Like I said, I struggled with this, too, before placing my mother in a nursing home last November. Here's what I've found that it boils down to. If her needs cannot be completely be provided for at home, without a major upheaval, it's time for nursing home care. So, if you can afford to have really good aides come in to care for her, and you can keep your job, then no need for nursing home care. If her needs or condition exceeds what an aide is able to handle, it's probably time for a nursing home. For example, my mother hallucinated, and would get up at night, afraid and angry, demanding to know why the aide was there. That scared away even the good ones. I couldn't keep anyone and I was not able to handle her needs to my satisfaction myself. I would have had to quit my job and spend my health and frankly, I wasn't equipped. My mother had also gotten to the point where she hated her home. In retrospect, I think her world had become too large for her, if that makes any sense. Her private room at the nursing home is about what she can handle and she is now a lot more content, but that's our situation. Everyone's different. If you have found that you've had to quit your jib, spend your health, and neglect the rest of your family, and still there are problems, then it's probably time for a team of professionals to take over. Good luck. And if you decide to look into nursing homes, tour them first, pay attention to how the environment makes you feel, and follow your gut.
Then there is the smoke which contain Carbon Monoxide, Formaldehyde, Lead, Tar, Acetone [stuff found in nail polish remover], Ammonia, Arsenic, and many other chemicals.
Some have suggested to others to use the e-cigarette, but from what I have read one is just substituting harmful chemicals for another group of harmful chemicals. Plus anyone with dementia might do damage trying to re-charge the e-cigarette, using power sources not approved by the manufacturer to recharge a lithium-ion battery can result in an explosion and fire.
Lauri1, I hope you can get your Mom is quit smoking as it will be hard to find a nursing home that will allow smoking, it will be a huge challenge. Example, our large regional hospital system here in my area bans smoking anywhere in the building and on the grounds which also includes the parking lot.
A memory care unit sounds like a good start unless she has physical issues that require a nursing home.
Please consider this option before a fire ends life for both of you. We'd love to hear an update from you when you can get back to us.
Take care,
Carol