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I've been on what seems like a very long journey with my mother. She's had COPD for a number of years and gone through several exacerbations. Each one has been more difficult than the last. I've spent a lot of money on a lot of things to help her quit smoking. She's allergic to the patches, hates the gum, tried and quit the vaping, can't use medications because of her current medications. I even shelled out $$ for hypnosis. She said she thought it was working, but just needed a little more. She had one last scheduled session before her last COPD exacerbation coupled with AFib.


They told her in the hospital that she has no choice. She is now a non-smoker. She is on 3LUs of oxygen 24/7 probably for the rest of her life. She is supposed to do nebulizer treatments of albuterol and ipatropium 3-4 times a day, inhaler twice a day, and her 16 other daily medications for heart, BP and other problems. Smoking at this point = death and I've told her this repeatedly. She can smoke or she can live.


Today, she lost a friend. I know that she is grieving and its understandable. I've been delicate in approaching it. Unfortunately, she's used this as a reason for not being compliant with her treatments/meds. I called her at 8:30am, she had not done her first treatment. By 3:30, when I called her again, she still had not done the first of the three minimum daily treatments. She also spent 1.5 hours off the oxygen when she came back from an appointment.


Then I saw it. I have cameras in her apartment at the request of her doctors. If they were not there, she would have to go into a facility. This was the compromise so that I could check on her to make sure she's doing what she's supposed to be doing with respect to her treatments, meds and the like. Otherwise she would need a full time companion to watch her for these things. So here's what I saw. After my phone call at 3:30 she sat down in a chair with her back to the camera. Took off the canula, and went out to the patio balcony. Her tubing for the oxygen concentrator is ample in length (25ft) and will go to the patio. I've seen her out there with the oxygen on before on multiple occasions. So I know there is NO reason to take off the canula to go outside. I believe she went out to smoke. There is no camera outside. When she returned 5-7 minutes later, she put the canula back on and sat in the chair before returning to her recliner to do her breathing first breathing treatment.


As much time, effort, energy and money that I have put into making sure she is as healthy as she can be, safe, and as independent as possible, I am feeling a bit angry right now after seeing this. I get that she is sad. But all it takes is one to start the habit again. I'm kind of feeling a bit betrayed that she doesn't seem to care that she's gambling with her life. It seems like I care more than she does about whether she lives. I know she doesn't want to die but it just doesn't seem to sink in that she's going to die if she continues to smoke, sooner rather than later. Should I be this angry over her smoking? Should I giver her a pass as long as its just this one time because she's grieving over her friend? Is it a waste of time to even bring it up with her? Chances are she'll just lie, and even if she doesn't she's just going to make excuses. Am I completely off base here in feeling this way? At the pace of her decline in health over the past seven years, she will be lucky to make it 70. I mean it seems like she's possibly already at end stage COPD at this point. I don't think she'll survive another exacerbation. At the same time, I'm reaching a point of frustration where if she doesn't care enough to help keep herself alive, why should I fight the inevitable?

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You can't care about her more than she does.

What you are feeling is completely normal when you try to care more than she does.

Realizing that she is free to make bad choices and she will pay the ultimate consequence may help you feel less angry.

Prepare yourself for her passing sooner then later, she has very serious illnesses for her age and if she had cigarettes to do it today she has probably had them all along.

I would let my mom do whatever she wanted at this stage of things, but that's me.
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Make sure she was smoking. After all, maybe she took off the canula for a break from in the fresh air. If she's smoking, it's easy to smell and confront her. Perhaps she was smoking but only for her grief.

I can't imagine being in your position: working so hard to keep her safe and in the best health only to see her potentially toss it all for a cigarette.

Does she know about the cameras? If not, that might be a bit awkward. Good luck, Gabbygirl.
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Gabbygirl Jan 2019
In answer to your question, yes, she knows about the cameras. They are in full view out in the open and were put up with her consent. She knew it is giving her the freedom to stay in her own place. She can’t afford full time care. Without cameras, her docs don’t feel she should be living alone. Her only option would be a facility which she doesn’t want. This keeps her in her own place at least.
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Although my situation is not as dire my issue with my mother is her weight. She is 88 and quite overweight. Our doctor basically told my husband and I she should be dead. She has a host of health issues. Her weight compromises all of them. She basically lies about what she is eating in AL. I have dealt with this for decades and am basically fed up. This distances me from her. I have to take her to specialists for her health. Why bother but I have no choice. When we cleaned out her apartment over 5 years ago we found letters from doctors pleading her to lose weight. It's all so hopeless so I basically have given up on this issue. She will only lose weight if she has no control over what she can eat which happened when she was hospitalized after a fall. She lost weight and then put it all back on. I understand your frustration. In the end only that person can control their behavior and they have to want the change more than the problem. It is exhausting and undeserving and sadly our reality until it isn't.
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NeedHelpWithMom Jan 2019
Riverdale,

Any addiction is tough. No matter what it is.
Yep, we’re all on the same page. We can’t force someone to do something, even if it’s in their own best interest.
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You should fight because the lady is your mom.
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Riverdale Jan 2019
Have you read how much and for how long she has been trying?
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My grandfather, long passed, chewed tobacco. He once asked a visitor for a cigarette. He tore off paper and filter and shoved in mouth to chew.

You know, I am to the point, that you and medical professionals can tell them whatever. They will not change. For some it's smoking, or booze, or weight or what have you. They will pass sooner. I know a terrible thing to read, but there, you have it. It does not make your role any easier. I know and know well.
I am sorry for the stress it does cause you, though. Take care of you.
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AnnReid Jan 2019
Mine too. He was an engineer on a freight train, and he could chew and spit while he doing worked, so it was his drug of choice.
He was an amazingly handsome man, but my memories of him are always of his horribly disfigured mouth, missing and discolored teeth, and labored voice and breathing.
Addiction is surely among the toughest ills to overcome.
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You have every right to be angry. My heart goes out to you. My mom has COPD too. She’s on oxygen 24/7 and has been for years. She just turned 70.

We can’t fight our moms battles though. We can’t make them do what they need to do. In my moms case, she did stop smoking around 12 years ago but the damage was already done. I think the COPD diagnosis came not long after that. She’s had bouts of alcoholism and it doesn’t help that my brother is also an alcoholic. He’s 34 and his liver is in bad shape. He’s been unemployed for 10 years. Last spring he was hospitalized with pancreatitis because of all the alcohol. There were times when he was in a sober period and I would get a text at 10 at night telling me mom was drunk, combative and had fallen down. When he was back on the booze, i hear it from mom-that he was being verbally abusive to her and my dad, causing all sorts of arguements and then the health problems started! So yes I’ve bren very angry because she brings alcohol into the house knowing they both have a problem. Or she gives him money knowing he will go buy beer. But the worst is, she lives in a high altitude state (moved there when she retired and the altitude also damaged her lungs) and she’s been told by her doctor for years to move back down to California if she wants to prolong her life. And I cannot get her to do it. She puts up with a lot of abuse from my dad and brother. She has cried about wanting to be closer to me and her grandchildren. But she won’t move! She can, she knows I would pack her stuff and bring her down here. Her income would pay for an apartment here. My dad has cognitive decline and doesn’t really care about my moms health and doesn’t lift a finger to help her. He gives no emotional support. So it really upsets me that she chooses to stay in that toxic environment. She complains about the house being a mess and not being to clean it because of her breathing. I tell her to hire a cleaning lady because that’s what they do— they clean! But it’s always the same excuse-she’s too embarrassed by the condition of the house. If she moved back here, she would add years to her life and she knows it. But she won’t do it. Even if I secured an apartment or a spot at an independent living community and showed up at her door with a moving truck, I don’t think she would get in it. So it is what it is. It makes me angry but it is out of my hands and it is better for me mentally and emotionally to just.....let it be. So go ahead and be angry at your mom. But don’t dwell on it. You don’t have to accept it but please, don’t let it consume you. Don’t try to force her to quit-it’s not going to work. Focus on something else with her. I try to encourage my mom to be more active, to get out of the house even when she’s not breathing well or feeling well. I try to keep positive basically. The more active she is, the better she feels and easier it is to bounce back when she has a flare up. It’s good for her mentally too. When she’s stuck at home she loses her energy and gets depressed. So I always try to encourage her to do the things she normal does Iike her hair and nails done every few weeks. When she’s not feeling well and managed to go buy groceries, I commend her on it. In the hopes she keep it up.
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NeedHelpWithMom Jan 2019
WorriedinCali,
Hard isn’t it? I grew up with a brother who fought demons too. We go through a range of emotions. In the end, we cannot let the anger control us, naturally we feel it or we wouldn’t be human but you are so right in saying that we can’t let it consume us.
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Many years ago I had an uncle who smoked even after having his larynx removed. The old time cigarettes without a filter! He knew he was dying and had smoked forever. I understood how he felt so it didn’t bother me as much. The damage had already been done and there was zero chance of improvement for him.

He figured at that point, who cares? He was going to die anyway. Your mom may feel the same if she is indeed in the last stages of COPD.

I understand that it bothers you. Especially since it’s your mom. I bet she feels guilty about hurting you but she’s struggling with a very strong addiction and like many habits, it takes time to break.

My dad was able to quit cold turkey but the majority of people don’t do it the first go round. Very often it takes many, many attempts before successfully quitting, if ever.

She did just lose a friend and she may have automatically reached for what she finds to be comforting.

Personally, I’d give her a free pass after losing a good friend. You may feel differently and feel that she has to learn to cope with her grief in other ways besides having a cigarette. Not sure if there is a right or wrong answer here. That’s a tough call. One thing is for sure, you love your mom. That’s pretty clear or you wouldn’t be concerned.

Just encourage her, without judgment if that’s possible. It’s got to be her choice. She can’t quit for you and may never be able to.

I spent many years as a child confused because back then there were no narcotic support group for families. I lived with the secret of my oldest brother (now deceased) being a drug addict. (heroin)

I loved him as a brother. I despised his actions. There was no attention brought to the opioid crisis like there is now. So I felt shame even though I did nothing wrong.

My other brothers abandoned him. As an adult I took care of him until it nearly destroyed me emotionally. I was always terrified of finding him overdosed. I had seen him overdose when I was a little girl and had never forgotten it.

I finally said I couldn’t do it anymore. I wasn’t even sure I could go see him in hospice as he was dying from hepatitis c but my mother wanted to see her son before he died. So I took her. I looked at his very frail body and only saw one thing, my brother that I dearly loved suffering with something bigger than he was.

He wasn’t a bad kid. His best friend asked him to try drugs with him. Neither of them knew anything about addiction. They got hooked. They were only 13 years old. Breaks my heart.

My family tried for so long to get him to quit. It wasn’t his choice. He thought he could handle it.

On the drive to see him in hospice I asked God to take my anger away. Because like you, angry at your mom for cigarettes, I was furious about him doing drugs. I had no idea I was capable of non judgmental, unconditional love. I was the last one with him and there wasn’t any anger in me at all. He didn’t make it to 70 either. It hurts, I know.

He kept hanging on in hospice. My brother could never apologize to me for hurting me. Three nurses came up to me, telling me that he told them he was so sorry for hurting me. I accepted that and smiled. I didn’t require him saying it directly to me. I think I learned more about myself then, then I did my brother.

I asked the nurse if he would be able to leave hospice. The nurse assured me he was dying but holding onto hear something. I said, what? She said, I don’t know but when he does he will go very quickly. Those hospice nurses are amazing. He was in a coma towards the end.

I touched his frail knee and told that it was okay to let go. I said I love you for the last time and I told him I forgave him and I meant every word I said. As I drove out of the hospice parking lot the nurse called me and said he was gone. I’m so glad that my final days with him were filled with love for my brother with no anger. Follow your heart.
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Isthisreallyreal,
Makes sense to me. Sometimes it takes awhile though before we are able to do what we know we should do. Sure does help to have someone like you give us a reminder. Thanks!
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You can be angry about the time, effort and money you've wasted, if it helps.

And you can be annoyed about the broken promises.

But then once you've done that, the important thing is not to go on wasting your time effort and money, and not to foster unrealistic expectations about her promises, and instead to think about what, for your mother, constitutes good quality of life.

She's a lifelong smoker, and she has not given up, and she doesn't want to give up. Now that she is on oxygen - yelp! - there are certain cast iron reasons why most of the time she cannot smoke unless she literally wants to go out with a bang; but if a cigarette genuinely makes her feel better, relieved, relaxed... what benefit will it deliver to her if she is prevented from smoking? Longer, more active life? Nope. Too late.

You can improve not only her but your own quality of life by gracefully surrendering this particular battle and refusing to comment further on what she does. Before you take her to task over this latest escapade, for example, pause and ask yourself whether you're telling her anything that you don't know she already knows.

You will also save yourself from having to listen to a load of boswelox excuses and evasions, and goodness won't that be a relief?

Her choice. You don't have to like it, mind; but neither do you have to fight it when, as you rightly point out, she'd rather not.
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NeedHelpWithMom Jan 2019
Oh my gosh! Fantastic attitude. I need to print out your answer in bold print and remind myself of several things you said every time I think about reasoning with unreasonable people.

Sometimes I think that I can make people see something they haven’t seen before, or encourage them to give it just one more try to quit smoking, drinking, drugs, food, etc., only to feel like a fool when they have proven over and over they are not interested or unable to change. People need to start taking mental health issues as seriously as physical issues. There shouldn’t be a stigma attached.

Some people don’t even get enough rest. My cousin works 80 hours a week! He beat cancer years ago but just had a heart attack. Got his attention, for sure. I begged him to slow down and work fewer hours. He’s extremely goal oriented and accomplished his goals but unfortunately it cost him heart trouble.

We also have to question ourselves as to what our motives are. Is it to benefit the person, ourselves or both?

We can’t be embarrassed to reach out when we need it. All of us struggle in one way or another at some point in our lives. No one is born knowing all the answers.
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I hope you can put the anger aside and move on it. Not good for you to be feeling that way. I'm fairly certain that nothing you say will change the situation. So, I guess it's time to come to terms with her addiction.

Maybe acknowledge that you think she might be smoking again. But not in an angry way, just matter of fact. Say it's her choice, and she knows how bad it is for her, but that she's the only one that can make her stop.

Very frustrating, but there's only so much a person can do. I guess make sure that other things are done to keep her safe and comfortable but if she makes bad choices, that's on her, NOT you.
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It is so very hard to love someone & watch them make decisions that are against their best interests. You have done so much in providing care & support for your mom to stay at home. You are awesome & she very lucky to have you!!! She in all likelihood is not going to stop smoking. You need to have a calm, honest conversation about her safety re: oxygen use, smoking, flames, live ashes, etc. Thank goodness she knew to leave the oxygen inside when she went on the balcony to smoke.

My grandfather with emphysema, on oxygen, would light his cigarettes & smoke with his cannula in! My grandmother on the other side of the family, same diagnosis, would put her cannula on her forehead & light her cigarettes at the gas stovetop!!!
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NeedHelpWithMom Jan 2019
Longears,

Wow, talk about where there’s a will, there’s a way. Come to think of it, I know a few people who would probably do that too. Tough addiction to break. Very creative ways to be able to smoke, huh?
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Thank you, everyone for your kind and supportive advice. You are right. This is her choice and it’s better for me to just resign myself to the fact that she is going to do what she wants to do. If it kills her faster, there’s nothing I can do about it. I’ve done what I can do get her to do the things she needs to be healthy. She’s making the choice. Thanks, again.
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NeedHelpWithMom Jan 2019
Gabby, you’re very welcome. You are a caring person and that is what your mom needs most. Just knowing that you care will be enough for her.

If she decides she needs additional help, she’ll ask for it. Then you can assist her in a way that works for both of you.
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Smoking is just a demon to get out of one's life. Best wishes to you; she's needing comfort in the familiar, poor soul. It's awful hard to see one's efforts to help thrust away.

My stepdad hauled oxygen around for 10 years with his emphysema and such; he quit smoking often and was so hopeful each time that the patch, hypnosis, etc., would be effective, and then he backslid. It got to the point where he would have a worsening of symptoms to make mom call the ambulance. He'd sit on the front porch, smoking until the ambulance arrived and made him throw it away. He was a proud 20 year Army man, and once gave a speech to my Youngest's second grade class about smoking, saying "I can't quit." I like to think that a young person out there made the decision not to start smoking because of that speech.
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What will happen if her doctor finds she is not taking her treatments and is still smoking? Do they have the power to put her in a home.? If so, maybe this will have to happen. You cannot make someone do what they don't want to.
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worriedinCali Jan 2019
A doctor cannot force you to go anywhere you don’t want to go. At least not in America. So no he doesn’t have that power. What he can do is declare a patient incompetent. But her mom doesn’t sound incompetent.
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It's not wrong to feel angry, and it's a waste of time to say anything about your mother's smoking addiction. When I was in the hospital having complications with my pregnancy 34 years ago, smoking was permitted in the common rooms. I'll never forget the man who had a tracheotomy.........and was smoking through the hole in his throat! If that doesn't say it ALL, then nothing does! Some people make the choice to continue smoking until death since they've already received a 'death sentence' with the COPD or lung cancer diagnosis. I watched my aunt & uncle do that very thing. You can't 'make' somebody want to change..........they have to want it for THEMSELVES.

Stop monitoring your mom's every move, that's my suggestion. Allow her to live her life as she sees fit, so you can live yours!!!

Best of luck!
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Smoking/nicotine treats mental illness symptoms. Your mom feels sad, I'm sure. I wouldn't waste any time or energy being mad at her but maybe you can look for other ways to help her cope with her feelings. And in general, I just don't think there's much any of us can do about another adult's choices in life. I went through this with my dad, where I was taking him for COPD doctor appointments, teaching him to use inhaler, and he wouldn't stop smoking or use inhaler properly and then would complain that he couldn't walk without being out of breath.

The nicotine gum just made him smoke even more. All the "talking to's" and lectures by myself and docs did nothing to get him to quit. In the end, others do what they want and sometimes a moment of comfort -- however bad for them-- is what they want.
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Nicotine is a highly addictive substance, as you know. If your mother prefers to indulge in her addiction rather than care for her health, that is her choice. You have every reason to be angry with her.
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Are you mad at her for other diseases she is suffering from? Addiction is a disease. I imagine addicts wish they had easier lives or different diseases to deal with.

The icing on the cake for people dealing with an addiction is the message that it's completely under their control and they just have insufficient willpower. It's their fault they are ill. "No one's making you smoke, drink, or gamble. You are doing this to yourself ."

There are chemicals in our brains. They move us towards and away from behaviors. Some people get extra "feel good" chemicals from actions like drinking, smoking or other addictions. It's kind of like an allergy. They can withstand the pressure to use for so long. There are steps they can take to try to control the urges. But it's like running upstairs holding your breath. You can do it for awhile but eventually your body will force you to breathe. If you haven't experienced this, count your blessings.

If you could look at her nicotine addiction as more of an illness and less of a character flaw, you might find a kinder way forward.
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Would your mother be eligible for hospice? If might be good for you to google the requirements and see how close she is. Then let mom go. If she wants to be compliant, fine and you do everything you can to help her.

However, If you go over there after seeing her turn her back and go outside so suspiciously and you smell, see, suspect cigs, you care too much. She's dying and wants to smoke? Fine - but you don't have to put yourself out to help. I would tell her docs that I simply can't face all the duties anymore and that she needs placement. She does not think you will do that at all, as she has you trained to forgive her at every turn. No, enough is enough, have her placed.
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What you have to first understand is smoking is an addiction. Just like any addiction the addict turns to it during times of stress and depression. The only way to make sure she doesn’t smoke is to have someone with her 24/7. Your mom is well aware that she is dying and probably has the attitude of “I’m already dying so what does it matter if I have a smoke or two?”
No one wants to die but addiction is strong and tobacco is more addicting than heroin. Be patient with her and do your best to make sure she has no access to cigarettes, even if it means posting signs that say do not give her a cigarette around her yard, home and wherever you think they are needed.
A side note, if she wants to smoke she will find a way. My sisters father in law smoked up to the day he died, even though he kept setting his oxygen on fire if he forgot to remove it.
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I want to thank everyone for their responses. Regretfully, things have changed. We were informed today that she very likely has lung cancer. All that remains to confirm is a biopsy and then staging. To say that my feelings are all over the place is an understatement. Scared, sad, angry, frustrated, and overwhelmed by them all. It’s fresh. That’s all I can say. I can’t change whatever is about to come and despite my anger of her ignorance and denial, I still love her. She actually tried to say that no doctor warned her that she was headed towards lung cancer if she didn’t quit smoking or not in a way she could understand, as she put it. It’s denial.

The sad part is that if she can not start complying with her treatments and medications she will disqualify herself from treatment options. Really, it’s all up to her now.
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GabbyGirl
I am so so sorry that you have gotten this terrible news. Hugs to you and your mom. Breath and take extreme care of yourself as you go through this next phase.
If you haven’t already, pick up the book “ Being Mortal, Medicine and what matters in the end” by Atul Gawande.
It will help you and her map out next steps. Do keep coming back and let us help support you through this time. We are here for you. She is so lucky to have you.
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We have the same mother! Mom will do anything to smoke. Setting a chair on fire was the last straw, she was no longer safe so I insisted on assisted living. We found a place she loves, and the staff is very aware of her addiction. Most importantly she is happy and I have my life back. PLEASE put you own health and sanity first!!
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