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My mom lives with me and as her dementia progresses, her smoking becomes dangerous. She has used the stove to light up when out of matches or missing a lighter. Aside from the fact that she could light her entire head on fire, she has left the flame on for hours when we are not home. When she was out of cigarettes (and having a really bad day mentally), she tried lighting her lipstick. The rule was that she smoked outside but now she is sitting on my screened porch and I'm afraid she is going to set it on fire or start moving closer and closer to inside.


She has been on the patch and has stopped for about a week but always goes back. So even when she isn't still feeling the need for nicotine, she doesn't remember that she isn't supposed to smoke. It's a constant fight which I hate but this is not something I can waiver on. Any advice?

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How difficult! This is certainly dangerous. Getting your mother to quit smoking by willpower, patches, etc is going to be impossible. There may be no alternative except to remove all access to cigarettes, in spite of the distress that will cause. It is worth remembering that if your mother went to any facility, there is a strong chance that she would not be allowed to smoke. The same thing at home is no worse. It may be that smoking rules are not as strict as I am used to – though I am sure that there would have to be supervision, which you can’t provide all the time at home. Perhaps others may have better ideas?
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jacobsonbob Nov 2018
Some nursing homes allow it. My mother is in one (although she doesn't smoke) in which the residents and staff who want to smoke are taken outside at specific times a few hours apart. Some who are "independent" (not demented or otherwise a wandering risk) are allowed to go outside on their own to smoke.

There is one man who tries to get my attention when he wants to go outside to smoke in addition to the prescribed times. I'm there enough that some people think I work there, and I'll help with certain things but this is where I've drawn the line. I certainly don't want to be around people who are smoking--it's miserable enough when an outside door is opened and smoke gets sucked into the building!
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I'm a smoker, and I'm trying to cut down. Nicotine addiction is physical. Cold turkey's never worked for me, and I do not have dementia (as far as I know). Cut me off from *all* nicotine? Whole continents shall pay for my irrational wrath!

So. What to do?

Patches do help, especially at the highest level, 4mg of nicotine. But there's a hand-to-mouth habit, as well. Habit, not physical addiction, but *really* tough to break, even without dementia.

Pharmaceuticals may reduce the urge ... or create more behavioral issues. You may want to try them, but with vigilance.

Main concern you mention is fire danger. Yup, that's critical.

You may need to use more than one method, simultaneously. In addition to gums and lozenges, there are vape pens (e-cigarettes) that look like, and taste like, standard cigarettes. Vaping *may* help with the hand-to-mouth habit, especially if you remove all matches and lighters, *and* remove/hide the burner dials from the stove (with most stoves, you can put 'em back in anytime you actually want to, like, cook). Many drug stores stock vape pens.

Yes, vaping is controversial, as well. But vapes won't burn down your house. Neither will multiple, non-smoking, delivery systems for nicotine.

Hope this helps. Please let us know how it goes.
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The nicotine addiction aspect is well proven and I wouldn't argue with that for a second, but on its own it's only part of the story. The rest of it, and I personally suspect the greater part of it, is a combination of habit, distraction and boredom.

I assume you don't smoke yourself, correct?

And is your mother still suffering from her broken hip? Is it difficult for her to get outside comfortably?

To explain my perspective, I moved over two years ago to a rented house and smoking on the premises is not allowed, there is a clause in the lease. So I can only smoke outside, and I have been 100% rigorous about complying with this. It has probably saved me quite a lot of money... but here we are more than two years later and I still have to be careful to leave all smokers' requisites in the porch so as not to light up absent-mindedly when I'm reading, watching tv or using the computer.

To be honest, it's driving me slightly round the twist, now that I sit still and think about it. Sigh. That's what you get for twenty misspent years in your home office. Writing, or, as Maureen Lipman put it about her beloved husband Jack Rosenthal, "lighting cigs and typing."

What about the chewing gums, has she tried those?
What are her typical daily activities? Does she or could she knit, crochet, draw, play electronic games?
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I know I am going to get flack here but I lived with a chain smoker growing up, my Dad. I find some smokers are not sympathetic to non-smokers or the rules. My Dad would lie about smoking which he was not suppose to be doing.

Really, if Mom is leaving the stove on and doing other dangerous things, she should not be alone. With Dementia/ALZ they no longer reason or remember what u told them. Get rid of the cigeretts. Ask her doctor for other options. This woman could burn down your house.
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I am having the same problem. My mom always lights hers on the gas stove. Twice I have found the gas on because she didn't turn it off all the way. She does smoke in her room or she goes on the porch when its nice out. If I go to the store she will smoke in the living room witch I hate. Before I came to stay with her she burnt the carpet around her bed and where she sits in the livingroom. I will be her payee starting tomorrow. I really don't want to buy her any cigarettes. If I don't she will freak out. Beside that my brother smokes them and they cost $75. a carton. She is use to having a carton and smoking a lot. I am going to give her a pack at a time. Try to get her to cut back on it. Maybe get her to stop some day. Plus my brother won't be able to still her packs.
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MargaretMcKen Nov 2018
Leaving gas jets on is very very dangerous, and the reason why my first FIL had to go into care. Tiabug needs to focus on this, not just on smoking.
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Whenever a habit needs to be quit a new habit must be put in place. I quit smoking 7 times before I learned this lesson. If you don't put something in place it is nearly impossible. Nature abhors a vacuum, true story.
Unfortunately, I'm not sure how you will accomplish that in another person. I engaged in my new habit immediately after a cigarette. To build the dopamine receptor association. What that did was make it so that after I stopped smoking whenever I engaged in my new habit my brain associated it with smoking which was what got me through cravings in the beginning and the not eating uncontrollably after the cravings stopped.
Hopefully something here is useful.
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MargaretMcKen Nov 2018
What was your new habit that did the trick?
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It's not likely your mother will stop smoking with dementia. Rather than thinking you can get her to quit smoking, perhaps a better way to think about it is "how to curtail her smoking, or control when she smokes?" This happened many years ago with my grandfather -- he'd light up in the middle of the night, drop matches or ashes on the carpet, light multiple cigarettes and walk away, etc. Answer: My mother managed his cigarettes -- took them and put them away so he didn't have access to them. My mother would laid one out on the table, with the lighter. He'd see it and light it and that would be all he'd have access to for the next few hours. He didn't like it, but he got used to it...
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I agree, monitor her smoking. It may be one of the only things she has left that she enjoys and reminds her of her past.
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What a difficult situation for you! Major empathy sent your way.

When she’s not smoking while being monitored hide the cigarettes AND THE LIGHTER(S)!!! I agree with the above comment re a vacuum. Substitute hard candy. Maybe get a kitten to distract her! Kind of kidding! Her hands would stay busy holding and petting.

Have you though about her vaping? Especially the Juul. Different device that doesn’t need a lighter.

I’ve NEVER smoked however I know people who do.
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Ummm Who is buying the cigarettes?
Now I have never been a smoker but both parents were as well as my grandparents. As a matter of fact one of the last images I have of my Dad was in the hospital (could have been a Nursing home I don't really know) they had rigged up a holder with a clip there was a tube attached and they would clip a cigarette on and light it and give him the tube so he could smoke in bed. Granted this was in the late 60"s and he was dying of Lung Cancer. And mentally he was aware of what he was doing.
Have you tried...
Setting a timer and when the timer goes off she can have another cigarette? Lengthen the time each day until there is no timer. But at least you control when she gets to smoke and where. You would have to control the cigarettes as well as how she lights them
Give her a "pill" like a TicTac and inform her the doctor just prescribed these and while she is taking them she can not drink, drive or smoke. Does not matter if she does not drive or drink it is just "instructions" that come with the "medication"
Telling Mom she quit. She quit last week, or last month....You just keep telling her the same thing.
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Margaret, calisthenics. Probably not going to work in this situation. I found that the exercise released endorphins that made the dopamine receptors happy and tricked them.
It also kept me from gaining weight.
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My dad liked to “work” on the stove and I found the gas on with no flame a couple of times. I bought the child stove knob covers, he can’t open them to get to the knobs now. I’m with all the others here who say you need to give her one cigarette and the lighter to light it up, then put away the lighter and cigarettes.
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she's going to burn the house down with her in it. You need to have her live with you and do not provide any smokes--if she drives you need to lock up the keys.
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Mary9999 Nov 2018
I so agree with cetude! She may not be the only one who happens to be in the house if and when she burns it down. However she is getting her cigarettes needs to stop. Don't buy her any and don't let her drive to get any. As a former nicotine addict myself, I know you're not going to talk her into anything, especially since she's got dementia. She's totally addicted. Just stop enabling her, however it's being done. Don't put away or hide the cigarettes. She'll find them or hide more herself.

After reading over some of the other responses, mine may seem rather harsh. I would change her to "vaping," as it delivers nicotine with no flames or smoke. The big issue here seems to be smells, smoke and danger of fire, and these apparently would not be an issue with "vaping." She's not going to quit nicotine, and she'd go through some agony going cold-turkey, not being able to have her nicotine fix. There's no way she has the mental ability and desire to give up cigarettes on her own. It's very sad, but it's a stronger addiction than heroin, from what I've been told. I quit in 1986 and would be happy to give my method to anyone who messages me privately. Good luck with your mom. I don't know how much "vaping" costs, but it certainly can't be more than the cost of cigarettes!!
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Tiabug, I would not cold turkey your moms smoking, this can be fatal for her. Nicotine addiction is serious and you should not completely take them away with out having her doctor involved.

I, personally, smoked for many years. There is a layer of reasons it is hard to quit. They are like a big hug, they energize a tired body, they give you something to do and they release feel good chemicals in our brains, to name a few things.

Try her on the e-cigs, you can buy ones that look like cigarettes and the end lights up. They have regular cigarette flavors so she won't feel like you gave her koolaid when she asked for bourbon. These will address her need for nicotine and provide her whatever else smoking has for many years. Please do not try to take this away from her, it's one of the few things she has left and it does provide her with something only she can understand. They will not stink everything up either. I used them to quit smoking and it worked but I was ready.

Over the years I tried to quit and was never really ready, not only was it hellish for me but everyone around me. So until she's ready, probably going to be more problems for you if you try to make her. Just a thought.

I would suggest that if she is now doing dangerous things she probably shouldn't be left alone anymore. Loosing your house to a fire is devastating to say the least.
It does sound like she needs someone monitoring her actions 24 a day now.

Good luck finding the right fix for her.
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Take the knobs off the stove when you are not home. Hide all lighters and matches, etc.

As an ex-smoker who had the habit for 25 years, it was the toughest thing to do... but I was motivated. In mom's case, if she doesn't want to quit, nothing you do will stop her urge to light up something. Maybe tell her regular cigarettes are no longer being sold in this country and get her to use an eCigarette. I know that lying isn't the best option but just telling her 'You can't smoke anymore' isn't doing her any favors... the withdrawal from nicotine is horrible enough on its own, I can only imagine how it might be compounded in someone with dementia. Part of the addiction, too, was the smoking ritual: holding the cigarette during certain parts of the day (for me, doing my makeup, driving to work, watching TV). Mom might find just holding an eCig comforting to the point where she might no longer miss lighting up.

Be safe and take care of yourself first and foremost, and do what's right for you and your family.
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Getting her some tasty vapes.
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tiabug, I so empathize with you. First step is for sure to keep all smokes under your control, to be enjoyed by her only under your direct supervision. You control the lighters, she has no access to them. Childproof the stove knobs as Glendaj2 said and she will have no way to burn down the house.

My dad has long forgotten that there is no smoking allowed in his apartment. He'll ask me or his caregiver for a match and say he's got a cigarette right in his pocket, then pull out his glasses and try to smoke them. E-cigarettes are a good idea, although my dad found them unsatisfying after a lifetime of filterless smokes and he started lighting them too.

If Mom is at the stage where she is lighting her lipstick, she probably needs 24/7 supervision. Finding another habit to replace the smoking is a good idea, although I would worry that the addiction may be so strong that she'll take to wandering in search of a fix. At least my dad did, and was hospitalized a couple times due to a fall on the long walk to the convenience store.

Many hugs to you and your mom! Make sure to stock up on any other things she enjoys--candy, sweet drinks, favorite snacks--and that will help some.
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I would suggest steal the cigarettes and lighter (matches) away from Mom and when She's really craving and out of Her mind for a puff then introduce the vapour cigarette which will quench Moms craving for a smoke and it is a zillion times safer. Good Luck tiabug.
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I feel for you tiabug123. I am in much the same position as you right now. My 94 year old Dad went into hospital last week and there's no way he would be able to go out and have a cigarette so they put the patch on him. He is home now and has been using the patch for 5 days without even knowing it (dementia). For the first time today he actually asked for a cigarette from his caregiver but he managed to change the subject and all went well. What I'm concerned about is once the patches are finished he's going to go right back to smoking as he has no desire to give them up. At his age, I wasn't going to encourage him to quit as I feel it might do more harm than good as he's been smoking for 80 odd years. He is on a long term care list so I know once he goes in there they will take his cigarettes away and he will have to ask for them if he wants one as they're not allowed in the rooms, which is understandable. I know that's something that's not going to go down well so it would be a good idea for him to quite. What we might do is finish of the course of patches and if he starts to ask for him just tell him that he quit a few months ago so why would he want to start again. Not sure if this will work but worth a try. I also worry because he's now on his own in a retirement home and it scares me if something were to happen with the lighter.
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Fire is involved - it lights cigarettes. You are at a point where you must do something you may not want to do. First, you REMOVE any access to ant cigarettes no matter what she does. Second, she will find ways and god help you because this is an accident waiting to happen and the end outcome will be horrible for all concerned - no if's, and's or but's - it will happen. Therefore, you MUST remove her from your home, for your safety as well as hers. Let the professionals deal with her and you save your life.
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This is a dangerous situation because she may set the house ablaze. Time for her to relocate.
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