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I have mentioned this before but it has evolved in what I consider to be a more dangerous situation. Husband is 83 and has smoked since his teens. Had a quad heart bypass 35 years ago and a bilateral femoral bypass 12 years ago. He smoked on the hospital patio both times-even in the Seven Day Adventist one just 2 days after the quad. During the years he has tried every patch, acupuncture, hypnosis, and nothing has worked for him. In the years just prior to the onset of his dementia he was down to 3-4 cigarettes per day, then finally down to 2. Since the dementia onset cigarettes have become an obsession more than ever. His cardiologist said not to fight this battle, and I agreed that at 83 the damage is done. I have tried very hard to just have the cigarettes and give him one when he asks for it. He wants to buy his own so that he does not have to rely on me, but if he has the pack, he smokes all day long. I insist that he smokes on the patio-have always done that, as I have seasonal athsma. But this is getting harder. The other issue is that he is becoming more and more careless with his smoking in that I find small holes in his pants, shirts, the cushions, burn spots on the patio table too. Most recently he has been hiding "shorties" in his pockets and sneaking them into the bedroom to puff on later when he gets ready for bed or just goes there after using the toilet. It hasn't happened often, but all it takes is once, to create a tragedy. And of course he cannot remember that he has smoked. Most often he walks into the house and asks for a cigarette, having just finished one. I don't know where to turn now to protect him and us. I am told by family members: "he's lost so much", "just let him have what he wants." I hear this over and over again. He has non-insulin diabetes, but just let him have the ice cream, the cookies, etc. at what point do I as his wife and caregiver have to say "no"?

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I feel so bad for you She.
Having been a smoker for 10 years, I understand his addiction. I doubt that he's mentally prepared to quit (especially with Alz.) because it's a familiar habit.

You have to say no to "excess".
Is it possible that you accompany him outside so he
can be monitored? (regarding the burns on everything and him stashing the smokable butts in his pockets). I'm sure that's no fun for you but another pair of eyes might mean the difference between burnt or not.

Can an you show him every morning that he has 3 cigarettes for the day? Then he chooses when to go out and smoke them. He won't remember he did, so I suggest that he write his initials next to the time on a piece of paper (proof). Usually a smoker enjoys their cigarettes after eating.

As for the sweets, there are lots of choices for no sugar ice cream, cookies, etc. (Not saying they don't have carbs but just no refined sugar). If he is not dependent on insulin then he could probably tolerate the no sugar choices without raising his blood sugar too much. Everything in moderation.

I understand you don't want to "police" his every move. You are trying to do what's right for him but he wants something different. A game of wills. Give in a bit but don't throw caution to the wind.

To me, at this point, 3 cigarettes and a bowl of sugar-free ice cream a day is enough of a give in without ruining his health.
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Reply to SueC1957
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I sympathize with both of you. I'm a smoker, and I know how hard it is to quit, having still not had success in that area myself. But I know this is frustrating for you too, in being worried about his health and safety. Would it be possible to designate certain times for smoking? Then maybe remind him, "Honey, the next one's at 3, remember?"

About the sweets, will he eat any of the sugar free stuff? I bought mom (insulin dependent diabetic) some sugar free ice cream that she liked when she lived with me, and would let her have a little bit of candy, sweets, etc if she wanted it but I tried not to keep a lot in the house, and if we had a package of cookies, etc. I would hide them so she wouldn't eat a whole bunch and run her blood sugar up.
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Reply to FrazzledMama
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How do you handle it when he asks for a cigarette just after finishing one, is it a confrontation or can he be distracted? If you are able to talk him out of having another I think there is a possibility of talking him out of having any - talk to the doc about nicotine patches to cover the withdrawal cravings and get rid of the smokes completely.
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Reply to cwillie
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