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New here. Mom has smoked since early teens and now 75. Smoking directly and indirectly affected her health and after two awful cases of pneumonia finally was officially dx with COPD/emphazema and macular degeneration (legally blind in one eye), as well as very limited mobility (hip problem) and variety of other health issues because of refusal to see a doctor due to smoking throughout her life. She can barely make it from the front door to the car. Her health is in steep decline. She never drove freeways before and now has two specialists require an over 30 min drive and lengthy appointments. I'm the primary caregiver (another post for another day). She continues to smoke even though all of this. Recently due to making a ton of commitments on my end -- both financially as she is in huge debt and taking her appointments, shopping, chores, etc. you know the drill -- asked her to make a commitment to stop smoking. She didn't. So I'm the bad guy and judgemental according to my sisters and should mind my own business even though they aren't committing to help. I basically told my sister it is affecting me greatly and tried to communicate how but was cut off continually that ended badly as I just left after not feeling heard and apparently I'm the selfish one. Just this Christmas after my brother took her one time to an appointment and told me he won't do it again, I asked her again to make a commitment to stop smoking again. I told her I would buy any cessation, take her to appointment about that, and provided her with nicotine anonymous info ( phone and online meetings). She is well aware about addiction and used to go to ala-non due to her ex, but doesn't equate the two addictions. This entire process has been eye opening to say the least. I look down the future at her health diving further and am sad about that. she continues to smoke needing more and more care, and I see my commitment increasing. My aunt asked me how the job hunt was going last year and I explained how only part time was available in this area, and my aunt asked if I was considering moving. My mom answered (before I could) that I better not. I started this process during the initial diagnoses for eyesight and COPD trying to communicate with my brothers and sisters, especially because at first she couldn't during pneomonia but as it became clear I was becoming the primary caregiver because it was summer and I had a more flexible schedule (though still working full time!) I was feeling pent up resentment and anger and everything I read said you need to communicate but basically was shunned when I did so. I'm unsure what to do about the smoking part. Should I set any sort of boundary? What is healthy? I don't want to be cruel but don't want more resentment and I care about her health. I set a boundary for money saying we provide X amount and any food you need a month, this was helpful as I don't feel resentful that she is still buying cigarettes which she can't afford. I tried saying I'd take her to every 5th appointment because she has 5 kids who live an hour or less from her and I work both full time and part time, and looking for a job. But that isn't working. Suggestions? Anyone else dealing with habits that make disease worse, but expected to help more?

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I know it must be frustrating, but, I'll just share my thoughts. There are many ways to deal with tough situations. To me, when a senior has health issues and they chose to treat or not treat their condition or they make poor choices with diet, medication, treatment, etc, AS LONG AS THEY are competent, it's their decision as to how they live their life. Once, you make your opinion known, I'd leave it up to her. Of course, you don't have to be around it and you don't have to enable her by transporting, assisting, etc., Perhaps, letting her spend her money her own way, will have some impact.
I've just found it very exhausting and nonproductive to try to manage senior's heathcare, if they are resistant. It usually doesn't work and my time can be spent better elsewhere.
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Thanks. She does spend her money her own way so I'll little confused about that. I give her as a gift as I explained I know those costs for doctors are costs you can not afford but however you spend on those things or others is your business. I don't pay the doctor etc. She also has a fixed income that she spends how she wants. I don't do any money management. Though I offered if she wants help there I will as I'm trained in that specifically.

Re: "Of course, you don't have to be around it and you don't have to enable her by transporting, assisting, etc. "

I'd like feedback about this.

So you would not take her?
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I have to confess that I hate smoking with a passion, hate being around it and smelling it, and would certainly hate enabling it. Why on earth is she going to specialists for her smoking-caused conditions if she is not willing to stop smoking? Palliative care would seem to be a more logical choice for her.

I think you care more about her health than she does. I vote for detaching for love, and helping her when you want (but not the pointless appointments and at the expense of your own family, work, finances and life).
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So you give her money? You are not obligated to pay her bills.

She will not change, you will have to set boundaries and stick to them. Regardless of what anyone says, you get to make choices for what you will and won't do.

I would not give her money, she has enough to smoke, she has enough to buy food.

Unfortunately our parents will use us as hard and long as we let them and it usually takes a hospital stay for them to make any choices that cause their lives to be impacted, as long as they get to continue as they choose they don't care what that costs us.

Best luck finding and implementing your boundaries.
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Vegasgrl13 Dec 2018
Hi isthistealyreal...Basically I was trying to communicate the issue is NOT money. I set that boundrary with a small money gift monthly and I'm comfortable with that. It's a small amount monthly given. I have offered assistance in budgeting but will not push my way into her finances. And left that as is.

What I'm struggling with is logistical in her care, specifically with me taking to specialists and appointments, etc. She isn't supposed to drive. She never drove the freeway anyway which is needed for some specialists appointments (monthly eye injections, for example). And thinking down the line with needing more care coming...., or possibly lung cancer. And brothers/sisters shunning.

I've appreciated the reminders you all have left, about refocus of energy and reminding she is making those choices. I'm glad I communicated my opinion about her not smoking and I'm going to try to stick with my guns about not being the go to person.
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Does your city offer paratransit services? The Department of Transportation would be able to help you. They give rides to and from, here in AZ it is based on income and disability, being blind has special considerations.

It sends a van or a taxi depending on where they are going, you buy vouchers at a set price and use those with the taxi, keeps drivers from setting prices.

That would be where I started, that makes your point loud and clear that you are not the transportation service.

I hope this helps.
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Call her county Office of Aging. See if they have info on places that have drivers for a small fee. E have something called Access here.
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I agree, you can't tell Mom how to live her life. You can't make deals with an addict and that is what she is an addict. She will agree to anything to stop you from bugging her. I agree about the specialists. Why go if you aren't going to do what they say.
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Vegasgrl13 Dec 2018
She goes to get refills on medication.
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First let me say, that I am sorry for what I am about to say! This tug-a-war with your mom's smoking might be pointless. She is 75 and by your post has smoked most of her life. If you think she is going to quit now...well that's not going to happen. You could try the patch however, the addiction is more than the cigarettes itself.

Moreover, I am sorry but for her to stop smoking now won't make that much of a difference in her health. It sounds like the damage has been done. Like Isthisrealyreal stated you have choices, but so does your mom! If she chooses to continue to smoke than she will have to pay the price. Stop giving her money.

And you can not just expect for your mom to wake up one day and say, "ok, I won't smoke anymore and just stop"!

I think your mom will continue to have to see specialist whether she smokes or not! Yes, I know smoking is making her condition worst, and I am sure she knows and still smokes.

See if you can find someone to give her a ride or do what Isthisrealyreal says.

Don't mean to be harsh. I am just being real.

Good Luck
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worriedinCali Dec 2018
I agree with you 100%. The damage is done. Stopping smoking., especially cold turkey, will probably cause more harm. the damage is already done. Sadly. My mom smoked from her teens until she was 59, she stopped smoking for 7 years in the late 90s. Anyway the damage was already done by the time she stopped for good at 59. She was diagnosed with COPD over 10 years ago.
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I don't get why you are giving her any money at all? If she has money for smoking, she has money for these things you are giving her money for. Stop the money supply and she will be forced to make choices: Doctors or cigs.
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Vegasgrl13 Dec 2018
Hi Karsten thanks for your response. Money has never changed her addiction or opinion about smoking. She basically does what most people who live now a days in debt... Transfer money from one form of debt to the other and keep up with the minimum payments on multiple credit cards.

In fact, growing up, I didn't learn how to manage money until I became debt-free by cancelling all my credit cards, learned how to make a realistic budget, and started buying everything in cash. The money I give her as a gift doesn't keep her buying cigarettes... because it's not one or the other.

Nor am I in need of the money I give her.. See above, I budget everything. If I didn't give her the money, things would be the same, just her with an extra credit card, still buying cigarettes. I've pointed out the hypocrisy of using credit cards/debt versus buying cigarettes to her, and that it may not make a huge budgetary difference overall but would make a difference in her health and even stress about her finances. She is still over her fixed income even if she stopped buying cigarettes though. So that is why I give a small monthly gift.

Anyway, I'm not stressed over the money, it's a very small amount. I'm stressed over time and energy , time if from work, and lack of support from sibs, along with fear and anger from the possibility of progression of these chronic diseases.
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I know this sounds really terrible, but, at age 75 and she's smoked most of her life....and she's addicted, I sort of understand it and I am not a smoker. I can see how the smoking brings her pleasure and comfort. Even if she stopped, how much would it help? I'm no medical expert, but, I could see why a person would continue smoking. I might explore Palliative care and try to stay as comfortable as possible.
I know a couple of people with COPD and they did stop smoking, but, they were younger than 75. Is she on oxygen? There are lots of things to consider, but, to take the stress off everyone, I might try to accept her choice and support her in her efforts to stay comfortable. I would not stand by to inhale second hand smoke though. She could step outside, if she wanted to smoke in my house.

I never knew the high risk of sudden death due to cardiac arrest by women who are long term heavy smokers until about a year ago. I know several female heavy smokers who died pretty close together. EVEN if you quit, your risk remains for some time, according to what I have read.

I know this must be very troubling. I'd try to let go of some of the stress. It can really bring you down.
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Vegasgrl13 Dec 2018
That is actually incorrect and what smokers use as rationalization to not stop smoking. Scientific evidence backs giving up smoking, even with the diagnosis for many reasons associated with problems outside of her COPD she has.

Especially since she still has sight in her one eye.
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