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My father is 91.5 years old. He has smoked for 75 years. He smokes outside and still lives at home. He is VA eligible, but the VA will not take him because he smokes. Their care homes and campuses are now smoke and vape free. Most care homes will not take him, or they will charge him a ton to take him outside to smoke 10 times a day. Any suggestions? In-home care is cost prohibitive at this point because he is almost at a point where he needs 24 hour care. Even at $15/hr that's more than he or I can afford. I am also worried that as his dementia and mobility gets worse, that he may decide to start smoking in the house -- which I have caught him doing a few times, already -- and burn it down because he can't see well, which could lead to him placing a hot cigarette someplace where it can catch the house on fire. He almost lit his deck on fire once, already. Looking for creative ways to keep him safe. I do have smart cameras, a smart lock and smart smoke/carbon detectors in the home. Thank you.

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What about home hospice? Is Dad on Medicaid?

I do worry about the dementia and smoking. Try to get Dad on e-cigarettes. Also, get some cocktail straws and some large golf tees for Dad to play with, chew on and pretend smoke. Whenever he's hankering for his ciggies, make sure he drinks a glass of water first; my smoker friends have reduced/quit smoking by drinking water this way. I'm an on/off smoker. Addiction to nicotine is strong. 75 years of smoking - you've got your work cut out for you. Good luck.
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My husband had to stop smoking because of Pulmonary HT.
Our PCP gave him a prescription for Chantix, a drug to help smokers stop. This is was when I started questioning his mental condition.
The instructions said to start taking the pills on day One (they were packaged with the number of pills you were supposed to take Day 1, Day 2, etc) and either 1) continue smoking for the first week, or 2) pick a day to stop.
Hubby decided he was going to stop smoking on Day 8, and started taking the Day 8 pills.
I called the pharmacist to make sure it wouldn't hurt him, as the pills were set up to gradually introduce the meds into his system. Our lovely pharmacist just laughed and said it might make him jittery and unable to sleep, but it wouldn't kill him. In the end, he did quit smoking.
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Smoking is a health hazard for him and everyone around him.  Also, when he moves into a facility, there may be folks on oxygen.  He could blow the place up if he lights a cigarette around a live oxygen flow.  Add in the fact that he now has dementia...he could burn the place down should he lay his cigarette down and forget that he is even smoking. 

I've watched many of my family members suffer and die from their smoking habit.  Gasping for air, unable to sleep while lying down, hauling oxygen around, having surgeries to remove a lung, etc...it's awful.  Their habit makes them oblivious to how they affect people around them.   

I have a friend whose mom had dementia and smoked 4 packs a day.  When they forced her into memory care (her dementia was well advanced and she went screaming and kicking) within a week she didn't even remember that she smoked.  They had her on patches to help physically wean her down from the nicotine.  I think the change in her surroundings and routine were so much for her to take in that she just completely forgot to smoke.  Maybe you will get lucky and the same will happen for your dad.

I know some of the comments have been a bit harsh, but everyone's right to breathe and stay safe overrides your dads addiction to a cancer causing habit.

If it were me I would ask his dr to put him on meds and patches and then don't buy the cigarettes for him.  If he doesn't have them, he can't smoke them.  When he asks about them, just tell him that he quit a long time ago and then change the subject and ask him an unrelated question to derail his thinking. 

Good luck with dad.
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Well, you answered your question about why care homes won’t accept smokers. They are a danger to themselves and other residents.
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When you are joining a community, general consideration for others is necessary.

Smoking poses an increased risk to all the residents—beyond secondhand smoke.

Smoking is less safe for someone who has memory loss. It is also less safe for someone who spends a lot of time sleeping or resting in bed. When other residents are required to use oxygen, smoking could cause serious property damage or personal injury.

Understandably, evacuating a facility when residents have limited mobility is very difficult.

Elderly neighbors are at a higher risk for pneumonia and other smoking-linked diseases.
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Call his doctor & get a prescription for a Nicotine patch or OTC. Explain to dad that he has to give up smoking, that he has no choice, in order to go to the VA facility. Call 1-800-QUIT-NOW for help.
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It's ridiculous that people are treated like criminals because they smoke cigarettes for petesake. Yet it's legal (state-wise) to smoke pot here in Colorado! Go figure. Anyway, my mother's ALF does allow smoking outside and so did the other ALF she used to live in. Keep looking until you find a place that allows your father to smoke or vape. Vaping is just like smoking but won't cause him to burn the house down, so you may want to look into it for him as an alternative to cigarettes. The very first time I tried vaping, I threw my cigarettes in the trash and never picked them up again. That was quite a few years ago & I never went back *and also quit vaping as well* And before anyone has a cow, no, vaping isn't 'healthy' either but it's safer than smoking a LIT cigarette for an elder. And, healthy or not, nobody gets out of this life alive, one way or another.

Go to a vape store & buy a kit; let dad try it and see what he thinks. It's worth a try, in my opinion and experience, as he may be willing to throw his real cigs in the trash right on the spot!! "Forbidding" him to smoke can wind up creating more problems than it solves, not to mention you'd be stripping him of one of the last pleasures he has in life.

Wishing you the best of luck finding a solution to this situation.
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Isthisrealyreal Jul 2021
E-cigs that look like real cigarettes are good too.

Helped me quit and was able to satisfy the physical holding of a smoke while doing activities long associated with having a smoke.

I turned my SM onto them and they helped her as well.
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I don't care if he smoked for a thousand years - no matter what or how, YOU DO NOT ALLOW HIM ANY ACCESS TO SMOKING - ANYWHERE. Don't let him drive or get cigarettes from other people. Set boundaries. NO SMOKING. Let him rant and rave - it is healthier and safer and DO NOT GIVE IN.
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Not much you can do unless you explain the problem to dear old Dad and see if you can get him to start cutting down on smoking until he can stop.

Tell him all the money he can save.
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My mother was 88 when we had to put her in SAA. She had smoked since she was 17. Facility did not allow smoking. dr put her on very low dose anti anxiety pill. Took her off after 30 days and she has been fine for past 3 years. Check with facilities to see how they handle situation. It is amazing how much folks can change at any age.
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you can't keep him safe if he smokes.
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I think you answered your own question. A smoker who forgets where he/she is smoking or where they put down their cigarette is a fire hazard. Some places will allow smokers to go outside with a staff member and the cigarettes are kept locked up in the nurses' station. It may take longer, but keep looking for a place that can accommodate your father's habit.
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well we all know smoking is not good for our health and at least he is going outside, but the smoke will linger on clothes. How is he getting his "smokes"? are you buying them? if so.........take charge of how many he gets a day.........cut it back slowly by giving him the "smoke" and if he wants another too soon, tell him that he just had one and that you will give him another in a little bit. yes he will get cranky but IF you can manage how he gets them and how often he smokes that will help. And yes.......forgetting where he puts a "smoke" could cause major damage. how far away do you live from him? even with the cameras, etc installed, if the fire starts will you have time to get to him (while you have called 911 to go to his residence).....will it be too late or not? Even if he goes into a nursing home, they shouldn't charge extra just to take him outside.....and they may have other ways to get him his "fix" by using the patch without having to take him outside.......and IF he gets bad enough with the dementia...you might be able to convince him that he QUIT years ago. wishing you luck.
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jacobsonbob Jul 2021
"...and IF he gets bad enough with the dementia...you might be able to convince him that he QUIT years ago"

That's great and appears original--I wonder if it will work. If he feels a craving for a cigarette, could he be convinced it's really a need for exercise or food? I've never smoked, so I can't really imagine what it's like when a smoker craves a cigarette--although I recall seeing a couple of smokers desperately trying to salvage enough tobacco remaining in their discarded butts to get at least a couple extra puffs!
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You may want to try to switch him over to vaping for safety’s sake. I think it might cost less, too.
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babziellia Jul 2021
Or E-cigarettes
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Why? Because his habit can directly limit the rights of others to safe breathing, or being safe from risk of death or injury from fire.

The tragedy is that as you know, his addiction was not his fault and it’s not his fault now.

I learned to love the odor of cigarette smoke on my dad’s clothing, and I’m sure that his smoking for years caused his death. He had actually stopped smoking about 10 years before his first heart attack, but the damage had already been done.

Have you asked a VA Counselor for suggestions? This situation can’t possibly be rare among gentlemen in his age group. In our experience, dealing with the VA can vary- some counselors are great, some not.

I hope you can find some sort of solution for him, and peace for you.
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notgoodenough Jul 2021
"Why? Because his habit can directly limit the rights of others to safe breathing, or being safe from risk of death or injury from fire."

Not to mention smoking/open flames around the tanks of supplemental oxygen that many residents depend on is dangerous.

You're in a very tough situation. I hope you can find some help soon!
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Imho, ask his town's social worker/elder care advocate for advice.
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Ohme, they are adult care homes.

A senior placement specialist can help you find them. I would avoid a place for mom and others like it, they will refer you to the most expensive places, regardless of your budget. I found they didn't listen to a word I said. Go with a smaller, local business to help you.
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Try board and care homes. They tend to be more understanding that they are dealing with human beings.
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OOMEZOOME Jul 2021
Thank you. I will do that. Are those adult family homes?
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