My MIL has been at my house since Nov 17th, and I have had a roller coaster ride of trying to set boundaries and adapt to this whole dynamic that was thrust upon me. She has been diagnosed with Dementia and End Stage COPD.
She has been hospitalized twice since then for falls/delirium related to UTI's. Each time, they have suggested Skilled Rehab, and the 1st time they couldn't find a bed for her, the 2nd time, they found a bed, but then said she made too much money (she was over the Medicaid amount by $200 a month)
The middle ground came when the Dr, gave a letter of medical necessity to Medicare that she was homebound and needed Skilled Nursing, Physical Therapy and Home Health Aide.
We were able to set up the Skilled Nursing and Physical Therapy through Carter, and the nurse comes twice a week, and the PT comes three times a week. Apparently according to the nurse from Carter, the census wasn't large enough for them to have Home Health Aides. So we have to get them ourselves. The only Medicare approved provider in my area, is having issues sending people to take care of my MIL, because she's a life long smoker, who REFUSES to NOT smoke around the Health Care Providers.
I have STOPPED buying her cigarettes but she ALWAYS finds a way to get cigarettes, I have told her repeatedly to STOP smoking in MY HOUSE! But she just ignores it, Now, full disclosure, My husband and I will partake an occasional cigarette on the back porch. I have children in my house, and I NEVER smoke in my house.
I have a suspicion that my neighbor who is also a life long smoker is giving them to her, but when I asked him, he said he hasn't since the last time I asked him not to give her cigarettes. I haven't caught him red handed, so I can't keep accusing the man.
I would have NEVER thought my MIL was so manipulative but she somehow has manipulated someone to keep her habit up even under my almost near constant supervision. I have searched the house, her bed, drawers, I have no idea where in the hell she's hiding these cigarettes, but they always magically appear as SOON as a home health aide shows up. I take the cigarette away, remind her to STOP, and 20 minutes later she's got ANOTHER cigarette, By that 2nd cigarette, the damage is done, the HHA just states they can't be in the house with a smoker, makes apologies and leaves. Now I understand that no one should be subjected to second hand smoke that does not choose to be, but this is beyond frustrating to me.
My husband has repeatedly told her that she can NOT smoke, Smoking is what got her in the position she's in, and that if she succeeds in running these people off that are trying to HELP her, then she's just gonna go back to the hospital where she can't smoke anyway. But I swear my MIL is having selective dementia sometimes when it comes to the issue, ( I feel horrible even thinking that ) she just keeps saying "I don't remember you telling me that, I forgot you told me that. "
So at this point, I need to find a middle ground. I NEED the respite time provided by the Home Health Aides, (Even if it's only 8 hours a week, I kinda need that to decompress) and I just wonder, what my options are, if I could shop around for another service I swear I would, but there is only one Medicare provider of Home Health Aides in my area. My MIL can't be the only life long smoker out there, smoking was generally approved in her generation, but with her waning memory, and stubborn me first attitude, I have to find something.
Any help or thoughts would be greatly appreciated.
I guess what your husband means is unless she's willing to go on her own, he is not willing to force her.
What is your husband's idea for resolving the smoking/home care issue?
A dementia patient who has access to a source of fire is a very dangerous thing.
Take MIL outside to smoke 10 minutes before the aide is scheduled.
And yes, send MIL to SIL this summer. And DONT take her back.
She's been lighting the cigarettes with my candle lighters. I threw three away already, and put the last one on top of the cabinet in the kitchen, I have to get on a step stool to reach it myself.
I would think my husband was giving her cigs, because he's definitely a momma's boy, but he's only home every other weekend, And she still manages to get cigarettes when he's gone, I never find packs, I find single cigarettes when I do find them, they are always different brands too, some have white filters, some have brown, some are short, others long.
When I say my husband and I have an occasional cigarette, it's really occasional, like maybe 1 every two weeks, and it normally is after having a glass of wine, or a couple beers.
When she was in the hospital, they gave her nicotine patches, and she said they didn't help, she had two patches by the end, one 18 mg, on one arm, and one 6mg on the other arm. (Well, until she started taking them off because she said they didn't help)
I have been in constant contact with the HHA coordinator, and she tells me that it's noted in her chart, that she's a smoker, and the best she could offer is to keep sending different people out until one is able to tolerate her tendencies.
I keep telling my husband that at some point we need to discuss 24/7 arrangements for her, He says that unless she's willing to go on her own (which she's not), he can't force her. His sister holds the POA and she refuses to even consider the idea. ( I think she's trying to protect her inheritence) So I told my husband that maybe Momma needs to go live with SiL. My husband said this summer when we go back to Kansas to finish selling the house there, that he was sending Momma to SiL, so I hoping that she'll just stay when she gets there.
But how is she LIGHTING her cigs? A dementia patient with matches or a lighter seems like a source of danger to everyone in the home. Get the source of ignition away from her first.
Then, explore VAPING, PATCHES, NICORETTE GUM, ETC.
I saw plenty of residents in my mother's NH who picked up their cigarettes at the nursing station and went outside to the "smoking area" even in very cold whether. Some wore a large fire-proof bib. Some had to be pushed out in their wheelchairs. Smoking is an EXTREMELY addictive behavior. (I assume you know that, since you haven't given it up even though it is bad for your children to be exposed.) Your mother is dying and her brain is broken. I don't think it is realistic to expect she can stop.
Would it be possible to set up a "smoking area" outside? Could your mother use the same space you do? Would this compromise resolve the aide problem?
No wonder your mother-in-law still smokes... you and your husband are smokers. You say you NEVER smoke in the house, but in reality you are bringing into the house what is called "third-hand smoke".
Third-hand smoke is a contamination that is on your clothes, in hair, on your hands, and even though you can wash those items - you cannot wash your lungs, thus every time you exhale that contamination is there. What ever you do, do not hug any children after smoking, as that reside can get on their skin, on their hands, and with small children their hands will go in their mouths.
And since mother-in-law apparently smokes when there are no health aides in the house... there is third-hand smoke throughout her room, on the walls, ceiling, floors, her mattress, the TV, her telephone, clothing, shoes, light bulbs, and combine it with 2nd hand smoke into the furnace vents where it travels into other rooms. You and hubby probably can't smell it because of your own smoking.
Really now, you have no clue how your mother-in-law is getting her cigarettes? Put on your detective hat now and pretend you have a warrant to search mother-in-law's room and the rest of the house. Watch MIL when she has visitors. And give hubby the 3rd degree to see if he is enabling her.
It could be since mother-in-law has late stage COPD, she feels the damage is already done, why not let her enjoy the cigarettes. Taking away the cigarettes at this point won't help her, her lungs will not repair themselves, that an old myth from decades ago to help wake up people to stop smoking.
Probably the next step is to hire a professional caregiver to help with Mom. You use her funds. Do not pay for it yourself.
Get this poor lady the 24/7 care she needs in a facility.