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We just got guardianship of my mother in law. It's been a long and frustrating process. She currently lives with a "friend" about an hour away. He told me today that she is out of cigarettes and since I'm her guardian, I need to be the one purchasing more. She shouldn't be smoking. Not only because it's bad for her, but because her dementia makes her smoking dangerous. I just ignored the request for cigarettes at the moment, but I know I will have to confront him about it eventually. Am I "in the right" to tell him that I will not purchase her cigarettes, legally speaking? Our end goal is to get her into a living facility, but that could take a while. We can't afford one for her and we don't think she can afford one on her disability. Until then, I am a little nervous that he will accuse us of neglect.

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Yes you can refuse to purchase cigarettes.
Technically if you are responsible for her finances as well, and you do have to report to the court where her money is spent and on what to refuse to buy them is financially responsible.
Refusing to buy cigarettes in no way would be considered neglect.
If you have not yet started application for Medicaid begin now, if necessary the lawyer that handled the Guardianship can help.
If her “friend” wants to supply cigarettes that is up to him.
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rovana May 2021
Could be wrong, but I read it that MIL had no funds for guardian to use. Guardian was expected to pay for cigs out of their own personal funds.
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I would absolutely say NO to purchasing anything that is dangerous or bad for her.

Would you bring an alcoholic liquor? Of course not.

Just last week, a friend of mine who has her MIL living with her had a major fire (luckily in the backyard) at her house. MIL has to go outside to smoke and she simply 'forgot' she was smoking and dropped the cigarette on the lawn. She is a hoarder and my friend was still have panic attacks about what might have been--and what is very much a worry down the road.

Legally, I doubt there is a precedent for refusing to buy her cigarettes.
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If the friend doesn't mind her smoking in his house, why should you? Yes of course it's unhealthy, might be dangerous with her dementia, but there is probably little that she enjoys at this point, so why not just let her enjoy?
Smoking is a drug addiction, and with any addiction, it's not easy to quit "cold turkey." You may just create a monster if you take them away.

Now don't get me wrong, I have never smoked, and don't like anything about smoking, but I think there comes a point when we as caregivers have to pick our battles wisely. I'm just not sure this is one battle I would chose to fight at this time.
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Helping77 May 2021
I don't disagree they should enjoy what little they have left but I'm sorry I would NEVER allow smoking if nothing else because I'm (possibly) allergic to it. I spend maybe 5 minutes with my mom's cousin who smokes and I will cough for probably an hour. If it was like chocolate she's hurting herself so be it but I'm sorry, especially if you are young enough to still have kids in the house... basically you're saying someone should let a person kill themselves, you and possibly your family because of their age? You not hearing yourself?
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It's a matter of $$$, not a matter of whether you have the right to tell your MIL she should or should not be smoking, which by the way is still legal. If a family member took guardianship over me and told me what I could or could not do, like smoke, or eat chocolate or whatever, I'd have a screaming fit he or she would not soon forget.

I don't think you should be worried about 'legal neglect' but about doing what's best for your MIL, and that's not leaving her high and dry with a raging nicotine addiction in force and no idea why she's feeling so poorly and can't have a smoke! Dementia is bad enough without taking away what may be one of her true comforts. If she is on board to quit, at least get her a nicotine patch or an e-cig or something to help ease the horrible withdrawal associated with quitting nicotine cold turkey.

People who love to say ABSOLUTELY NOT to buying an elder their drug of choice must never have had a bad habit themselves that they had a very hard time breaking. Otherwise, that sort of advice would not be handed out so flippantly.

I would imagine your MILs roommate keeps an eye on her to make sure she's using caution when smoking and isn't likely to burn their house down. If it were me, I'd have a chat with the roommate about it, and then buy her some cigarettes or other devices if she's agreeable to quitting.

Good luck.
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cherokeegrrl54 May 2021
Hey Lealonnie…your post is spot on. My soon to be (in a week) 88 yr old mom does me this way. I follow a different spiritual path than she does. Without going into long details, i always knew i was different when it came to staring up at the beautiful full moon , fascinated me. Anyhow, this is what she does in a small group of friends. A friend of hers says im praying for you, mom says a few things and i shldnt be smoking. “Ive nvr smoked or drank”. That particular day she pushed me past my limit so i looked her squarely in the eyes right in front of her friends and said, “well mother i guess now i know how ive been such a disappointment to you all my life Oh, and i guess none of us are as perfect as you are!” And i turned around and walked off. There isnt any dementia or anything like that involved here. Just some normal aging things. Oh and yesterday she said to me, you need to take care of your health issues(i need a total knee replacement) bcaus you have to take care of me til i die. I just let that go…..i cant hear on my left ear….in the grand scheme of things, i moved back to Florida to help her if she needed it. My sister wont be of any help. Shes years too far into her pity party ….so i suck it up and as my military daughter says, Drive on!!). Sorry so long, i just needed someone to talk to this morning. Have to go see a cardiologist today(frst appt) and i dont want to go.
thank you, Lealonnie for reading this. I always look forward to your posts. Many blessings to you 💓💕
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Forcing someone to quit cold turkey is cruel.

Buy her cigarettes but, don't buy enough for all her friends.

What will you do if the friend decides that he isn't going to take care of her because she is going through withdrawals and is a bear to deal with? You will be responsible for her and if you can't get her into a facility pronto, what is your plan?

I wouldn't risk losing the best thing you have going for you because you now have the power. It could back fire and you will be so sorry that you now have to take care of her or it is neglect by a guardian and that is no joke.
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rovana May 2021
If the OP is correct that they really cannot afford cigarettes for MIL and food for the family, I don't think it is right to have to spend one's own money (not the person's under guardianship) in this kind of situation. Feeding the kids should come first. Are there addiction treatment programs that might help in this case?
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Now you have guardianship you are in charge of her and her money. Like said keep good records because the State will need a report.

As a guardian you are not responsible to give her any money. You stay within what she brings in monthly.

Medicaid will pay for her to be in Long term care. As her guardian you can have her placed.
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I would not recommend cutting off an addict without a transition plan. You can discuss with her doctor what the alternatives are and find out whether they are feasible, e.g., will the friend apply a patch or will you need to hire a caregiver to do it. Most likely, transitioning her to alternative delivery systems and tapering down will probably work better once she moves to a facility.

Realistically, if she has funds to pay in the short term, you are probably better off keeping her supplied until you can transition her.

Nicotine withdrawal is not a pretty sight. When this happened with a family member, I observed decreased cognitive function, tremors, and a desperate desire for the cigarettes. Desperate people do desperate things.

If you decide to just cut her off, you should at least have a plan to use any resulting crisis to get her into an ER or police-to-psychiatric environment and then into the system for placement during spend down and on to Medicaid.
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cherokeegrrl54 May 2021
Words of wisdom….thank you
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Update: Let me clarify some things. She does not have the money to pay for the cigarettes. She was transitioned off of the cigarettes last year during a month long hospital stay. When she left the hospital, she ended up staying with her friend. He got her hooked back on her cigarettes (so he wouldn't have to smoke alone, he told me) and has been buying them for her for the past year. Now, he is saying that we have to pay out of our own pocket for her cigarettes because we are her guardians and he isn't going to pay for them anymore. Of course I am worried about her well-being. I wouldn't have fought for the last year+ to get guardianship of her if I wasn't concerned for her. But, she can't afford them. If I don't pay out of my own pocket for cigarettes (which I can't afford either. It's a matter of my kids eating or her smoking), could I be facing jail time? As lovely as it would be to only think of what would be nice, I have to be pragmatic here. I will be making phone calls to her insurance company and her doctor starting tomorrow. But for today, I am only concerned about whether not buying her cigarettes is within my legal rights, or whether I could face charges of neglect for not buying her cigarettes (which isn't changing anything, since we haven't ever bought them for her). I was thinking of her being an addict and facing nicotine withdrawals. According to the social security office, though, cigarettes are considered a luxury, even to addicts. We've been following their advice for the last year. But, do I have to pay out of my own pocket from mine and my kids' grocery budget to buy her cigarettes because she is an addict? Will nicotine withdrawal kill her like starvation and malnutrition could kill me and my kids? Will I go to jail if I don't buy her cigarettes and she goes into withdrawal?
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notgoodenough May 2021
I can't imagine you would go to jail for not buying cigarettes for someone. I have never, ever heard of anything remotely like that - and I have 20 years of enforcement experience under my belt. Could it be considered elder abuse? Also doubtful, considering everyone knows how bad smoking is for you.

Is the the act of buying the cigs that you find so unacceptable, or is it the fact that you really can't afford them? It seem to me that if it's mom's vice, then it should be her money that pays for it.

You say that mom only started back up smoking a year ago. Many people quit smoking many times, without permanent damage from withdrawal - my SIL "quit" 3 times, going back each time until the last time when she quit permanently. Her doctor put her on Chantax (spelling?) to help stem the physical symptoms. It really helped her. Maybe you could encourage mom to get on a program to quit, since she did it once before. I know in NYC they'll give smokers anti-withdrawal medications free of charge to help them quit if they can't afford to get them on their own. If mom qualifies, you might want to look into that.
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I have no legal knowledge but trying to see the wider picture here to understand.

Is the Guardianship because it was deemed your Mother required someone to make decisions for her? Including *financial* decisions? Including *lifestyle* decisions?

If so, then is her friend considered to be her Caregiver? Is the friend 'employed' as such? How does he currently pay for your Mother's expenses? Eg: groceries, rent, utilities? Does he pay upfront & invoice you (as Guardian) for reimbursement or do you (as Guardian) pay directly to the landlord, store & providers?

Seems the friend had been gifting her cigarettes, but enough is enough & his gift ran out. Fair enough.

Who & how are the groceries bought now?

Obviously it would be better not to be smoking.. But if the cigarettes go into the shopping basket with weekly shop... I would treat it like buying donuts. Wholegrain bread would be better.. sure, but you don't have that level of control.
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I doubt you would go to jail for neglect resulting from not buying her cigarettes. But, cold turkey could get you into trouble. You need a plan for successful withdrawal.
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Where is her check going? as her guardian don’t you have control of it?
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lealonnie1 May 2021
Exactly. The MIL gets a SSI check and should be able to use some of that $$$ for cigarettes w/o causing the OP to use her own funds and 'starve her children' as a result.
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At my brother's assisted living facility there were quire a few smokers. They had an outdoor lounge outside the communal dining room. I would certainly discuss smoking cessation with my MIL, but no, I would not forbid her to smoke after a lifelong habit. As to it being "bad" for her after nearly a lifelong (I am guessing) habit, what real benefit is there in another year of life in an assisted living. In fact, when my bro and I years ago visited my Mom in her elder community he said "You know, if you told me that one cigarette would take a month of life off my span, I would start smoking today". We laughed, but honestly, talk about the "land of loss". One loss after another.
You are correct when you say it presents a risk. So does crossing the street. But I am loathe to rob an elder of yet one more thing. I recall when I quit smoking those many decades ago. I was so depressed I honestly wondered if life was worth living without that cigarette with my a.m. coffee. How much closer she must be to that very thought.
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disgustedtoo May 2021
If she needs to move to MC or NH (approved guardianship implies she probably isn't AL bound), it would be better to get her off the butts as it won't be allowed there. AL, outside might be okay, but if she isn't going to AL, she will need to be off them (also OP comment says she WAS off them, this "friend" got her back on them!)

The bigger issue is expecting OP to pay for the butts. NO NO NO NO NO, not with her own money. A 3rd party guardian would never be expected to expend their own money to buy things, neither should a family member who is appointed.

The bigger issue is finding another place for her, until they can get her in a facility. A place that has NO smokers, and get her off them.
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Ive read all the posts so far. I have some questions. You state this is your MIL youre taking care of? Where is your husband in all this? Why is he not handling these situations? After all, it IS his mother, right? And please accept my apology if there is a reason your spouse is not able to handle this. I just dont get why we women are the “go to” when a spouses parents need help. In Nancy Reagans words, Just Say NO!
Sent with love and care for you…..
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Buy her the cigarettes*. Nothing has changed in her daily living circumstances that justifies your enforcing a ban; and you are ignoring the real distress that sudden cessation will cause a lifelong smoker.

If you wish, you can insist on smoke alarms and/or that she cannot be left unattended with matches or a lighter.

If I had my way, I'd also provide some sort of protective apron - a couple of weeks ago my ninety something year old client denied all knowledge of how the large circular hole with the singed edges could possibly have appeared in her skirt. I felt quite faint on her behalf.

* With her money, obviously. Not your own.
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disgustedtoo May 2021
I think this is where the real problem lies. It isn't the smoking (although it would be better if she didn't, esp if they plan to move her to a facility such as MC or NH) that OP is trying to ban. The question is whether OP is required to spend her own money to buy said butts. The answer is NO.
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i have not read your profile or the other posts yet.

I have never smoked, but quitting smoking is very hard, to force her to quit cold Turkey is cruel. I am not discounting the safety aspects.

Can you look into e-cigarettes, patches etc? An alternative that will give her nicotine more safely? I understand that with dementia she may not manage to learn to use these products.

Or ensure her smoking is fully supervised?
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You and your spouse have guardianship over your MIL. That means both of you have full access to whatever money or assets she has and you make her decisions.
I'd say you and your spouse really dodged the bullet if the daily care of your MIL with dementia is not put on you. You're very lucky she's got a 'friend' who's doing it for you.
Get you MIL as many cigarettes as she wants. Pay for them out of her money which you have legal access to. Try to put yourself in her caregiver's shoes for a minute. You certainly should be nervous that refusing her might look like neglect. It is neglect if her guardians will not spend her money to get cigarettes for a person who is a lifelong smoker.
She's probably going nuts from nicotine withdraw and that's making her caregiver's job a lot harder. Don't make it too on him or he might just drop her off at her guardian's house. You.
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disgustedtoo May 2021
Based on a long post from OP, MIL was OFF the butts. Said "friend" got her back on them, to have someone to smoke with. He is responsible for this dilemma.

I would NOT spend a dime of my own money to buy her butts (this is what she's being told to do.) No idea what MIL's income is or what it's used for - one could assume it is minimal SS and it is needed for housing and food.

I would want her OUT of that friend's place ASAP and then get her off the butts again. If long term facility isn't available, find a respite place or a care home for the interim and get her out of the smoking den!
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The hospital transitioned her off of cigarettes because they knew that being forced to quit cold turkey is unacceptable.

Send a small allowance for cigarettes before you are forced to take her into your home.

If you think it is rough now, have this person in your home and you will know what rough feels like.
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So, based on your previous posts, she was living with you, you rehomed her dog, she left, etc. Now, you are her guardian and she isnt living with you but with a friend. Are you paying him rent or caregiver fees to take care of her? That is your responsibility.

Even demented in a facility have a minimal personal needs allowance, what are you giving her?

No, within the scope of a guardianship, you do not have the right to tell someone they cannot smoke.
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rovana May 2021
Have to disagree here because of the danger factor (not health danger so much as starting a fire that could kill innocent people). It is a real deal IMO. Aren't there treatments for nicotine addiction?
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Have you tried, or will MIL consider, any other kinds of nicotine delivery that aren't cigs? Vapes, lozenges, patches, etc. Those wouldn't contribute to fires or smoke damage in a house and are all considered harm reduction methods for smokers.

Getting her a chargeable vape with refills wouldn't be an expensive investment. She might adapt to them. If it were my MIL, I'd encourage her to vape at this point in her life. She's addicted to nicotine but there are safer ways to provide that to her.
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The facility where my relative lives does not permit smoking anywhere on their property. I think most places are like that now. Tapering off with the patch ahead of time could help a lot.
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I doubt this would work.. but rationed to a pack a week? With funds diverted from her grocery money?

(That's how our backpacking share-house bought them anyway. Home brand bread, home brand baked beans & one pack of ciggies. Bad choice, yes, but our bad choice at the time).
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Get her a vape or e-cigarrette device so she doesn't make your home smell bad. She's in her last days so let the woman live.
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Your MIL has so few pleasures left ...
it would be abusive at this point to refuse her cigarettes...
if you can’t afford some cigarettes
for her .. why would you fight so hard for guardianship???
it’s all about $$ for some caregivers...
put yourself in her shoes .. where’s the love ... she has so few pleasures
left ...
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disgustedtoo May 2021
"...it’s all about $$ for some caregivers..." OP says it's butts for MIL or food for her kids. There is NOTHING in guardianship that says you pay out of pocket for their needs.

There's nothing that says guardians get paid. Guardianship is a step up from POA, where you make decisions and can move someone to a facility, with court approval. Why would they fight for it? Because she needed oversight and was likely beyond POA ability.

If MIL has a pittance SS, it is more likely being paid to the "friend" so she can live there and eat. My mother's SS probably wouldn't have covered housing and food (thankfully dad's pension was good, she had savings and net from selling her condo, so that wasn't an issue for us.)

Also, she HAD been weaned off the butts and this "friend" got her hooked back on them! He wanted someone to smoke with. I'd have very little sympathy for that "friend."

It would be better to get her out of there, find a temp place until the facility has room and get her off the butts. If she's moving to MC or NH, she won't be able to smoke anyway.
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You're in a difficult situation. Are you giving her friend a stipend (from her disability) for her food and other personal expenses while she lives with him? Should it be enough to cover cigarettes? If so, then he should be living within the budget that she has. If she is not already on Medicaid, and if she is eligible, try to get her on it so that you'll have some options for putting her in a facility. Speak to a social worker in her area who can advise you on her options. When she moves to a facility they will not allow her to smoke anywhere on the premises.
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Isthisrealyreal May 2021
All of MILs money should be going to her living expenses.

Guardians can not use any of the money for themselves and she doesn't make enough to pay for facility services, so she will be a Medicaid recipient when she goes to a facility.
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You are the in-law, step aside and let your spouse make these decisions.
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You need to talk to your husband about that. Talk about she can burn the place down due to a neglected cigarette. Instead you can get her nicotine patches.

If she is on Medicaid nursing home placement is easy.

Some states do not allow smoking in facilities including nursing homes. Tobacco products prohibited include e-cigarettes or vaping. The danger is sometimes they explode and with oxygen delivery systems, the fire will be massive.
https://psnet.ahrq.gov/web-mm/e-cigarette-explosion-patient-room
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Actually, Medicare does not pay for nursing home care for dementia. MIL will need to have actual nursing needs to be placed in a nursing home. If she has other health care needs you may be able to get a doctor to order nursing care. Good luck. This country is woefully inadequate when it comes to memory care help.
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disgustedtoo May 2021
"This country is woefully inadequate when it comes to memory care help."

Multifaceted problem. Some people never really made enough to "save" for their future needs (How many posts I've read lambasting people for not providing for their own needs!! Some who work minimal jobs never can put aside nearly enough to cover the costs needed), some frittered it away, so that IS on them for not having planned ahead, and some use the EC atty route to "hide" the funds and rely on Medicaid, thereby cheating those who truly need the help.

No one anticipated this tsunami of dementia we find ourselves in and it's projected to get worse. It is true that most Medicaid programs do not cover any AL or MC. A few states do cover some, but most likely the waiting list is miles long! Agreed also that people need to qualify for NH care (and Medicaid in general has requirements for the need - dementia alone isn't enough, rightly so, as NHs are for specialized nursing care, which dementia really isn't. Yes, they need care and oversight, but not generally nursing care.)

The current bill they are trying to get passed has some, but not all, benefits for care-givers and the needs people have in caring for a family member, but it's hung up. Much more will be needed to resolve the issues with dementia. So many people are struggling trying to provide the care and many have to give up jobs to do it, since there isn't money to cover a facility, thereby jeopardizing their own health and future financial needs as well! No extra money on hand to save and not working will reduce SS funds for that person as well. It's like a giant snowball heading down the mountain - it will only get bigger and more dangerous!
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I've noticed several posts about not being able to afford the cigs. I do NOT see that anywhere in the OP or the profile. the poster states "Our end goal is to get her into a living facility, but that could take a while. We can't afford one for her and we don't think she can afford one on her disability." I read this to say that her MIL may not be able to afford a "living facility" on her disability, not that she cannot afford cigarettes.

Quitting cold turkey is harder for some than others. I quit the nasty habbit about 40 years ago while working a a prison guard. I hate the smell of cigs now and can't stand getting near someone who has the smell on them, their clothes and it seems, just the air around them.

There are some very good meds available today to help stop smoking, but they only work for someone who truly wants to stop. My wife started smoking again after having quit about 35 years ago. She went 25 years without smoking, but started hanging around some sorry neighbors who were a BAD influence on her. She started smoking cigs, pot and drinking. I don't know what else might have been going on. I finally sent her to her sisters home with the plan of her quitting the bad habits , mainly due to health reasons, or for her to file for divorce. I sent her nicotine gum, patches, and lozenges as she needed them. about 3 months later she was ready to return home. She continued the nicotine supplements for about 6 more months and to this day has not started again. Was I hard on her? Yes, but with COPD, oxygen, several strokes under her belt already(at that time), and her heart struggling to function, I did not think I had another choice.
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BurntCaregiver May 2021
garylee,

I'm glad you quit smoking. I was a child smoker (11 when I started) and I'm almost 50 now. I quit a year ago. One day at a time.
Alazrielle's MIL is elderly and her family's end goal is putting her in a care facility. Why take her cigarettes away now? The MIL lived long enough to become elderly being a lifelong smoker and all. Let her have her cigarettes. When they put her in a care facility she'll be lucky if they let her have one a week.
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This "friend" is well aware that your MIL law smokes. This person is most likely aware of the health risks associated with smoking as well as the risks to his/her home.

I suggest talking to the "friend." Talk about your reluctance to contribute to her "smoking" problem. Offer to bring nicorette gum and a limited supply of cigarettes. Tobacco is addictive and a hard addiction to break. Maybe you can discuss with this friend cooperating together to help reduce MIL's smoking. If "friend" is not willing to do this you have a few options:

1 - Take MIL into your home and help her to stop smoking. This is really the only way you can control how much tobacco she ingests.

2 - Get MIL into a facility that doesn't allow smoking. Get doctor's prescriptions for nicotine patches or nicotine gum. let the facility try to wean MIL off her nicotine habit.

3 - Buy the cigarettes that MIL needs while she continues to live with her "friend."
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Riley2166 May 2021
If you have a no smoking policy in YOUR home, YOU GET TO SET THE RULES.
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I agree with Alva,
This disease takes things from you little by little.
Let her have what little she has left.
My Mom smoked her entire life.
At the end she forgot how to smoke and would
carry an unlit cigarette around all day.
Let her have a bit of comfort.
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