Would it be cruel to stop buying my dad fags

[Sunnyday1203]

My dad is currently in hospital, he is being discharged ( I do have another thread going) but would really appreciate some opinions on this. Dad has dementia and a heavy smoker. Due to his smoking it is making almost impossible to find a home that will accommodate him smoking in the garden. The only way he can get Ciggs is if I buy them ( with his money). My DP thinks we should stop buying him and so making him a non smoker. I think this would be very distressing for Dad but equally I do know people seem to have problem with smokers. I don't know what do for the best

When I worked in a care home (post smoking ban) we used to take the residents who asked either outside or into the little conservatory with the door open and the interior door shut (I did nights).

I think it’s laziness to refuse on the grounds he’s a smoker, they have procedure and risk assessments which cover it.

I don’t think not buying him cigs is a good idea, it could really distress him.

I'm a bit shocked by the "why not bring him home" and "he's an adult" brigade. My FIL recently died of dementia. He had to go into hospital and then a care home, because it was impossible for his wife to take care of him 24 hours a day (he didn't sleep much). My FIL was not a smoker, but it would not have been safe for him to be handling lighters and lit cigarettes. He was not safe to leave to do anything let alone waving lit cigarettes around.

I can see both sides of this.

Yes, he is an adult and it is his choice but he does also have dementia. I've recently lost a grandparent to dementia, she was a smoker but it was dangerous for her to smoke, like PP said, she wasn't safe with a lighter and she wasn't safe with a cigarette not just her own safety but others as well.

It's not as simple as letting him smoke, I'm so sorry you're in this position

We all stopped buying my dad fags. He still managed to get hold of them and only stopped when he couldn't even get enough breath to take a drag. The only good thing out of his long lingering death to COPD is that none of my 3 dcs will entertain smoking. My dad might have been an adult but I wasn't helping him kill himself quicker stubborn old fool

zzzzz

Do you have experience with someone who has dementia? They completely cease being an “adult” in the most fundamental way. He is not able to live anywhere but a home and therefore it’s madness to reduce his chances of getting into one. Usually a cognitive adult would understand this, but with dementia it’s difficult and OP has to make the difficult decisions for him. My grandfather was akin to a toddler for the final years of his life.

But op doesn't say his smoking is unsafe, just that
It's harder to find a home who'll take him. IME most homes do have procedures for this (an outdoor smoking area, usually with set fag breaks).

Sorry haven't read the full thread, just to say, we did this with my gran after she'd lived with us for a year and we'd (kids) all had various illnesses- bronchitis to asthma.
She said, until the day she died, 'could you get me some ciggies when you're out?' every single time we went anywhere
But she didn't smoke again and it made the air clearer for us.
She lived to be 93 so we saved ourselves from a lot of second hand smoke

Nursing homes wouldn't be exempt from the requirements re smoking in the workplace I shouldn't think. The staff there have the same rights to a smoke free environment as any other worker.

And this is one of those times conflicting rights is an issue. I used to work in a related field and felt very strongly that our clients were entitled to make decisions just as stupid as everyone else. Homes arent prison and peoples rights to be an idiot if they want shouldn`t be compromised.

It`s very worrying to me how many people think that because you have power over someone (because they are sick or incapacitated) you have the right to exercise that power.

MrsTerryPratchett

But this isn’t about someone saying that someone can’t smoke because it’s bad for them or anything like that - it’s a danger to other people but, mostly, will impede his chances of getting into a home where he sorely needs to be.

That's one way of looking at it. The other is that the family, SWs, homes and plans should work to maintain as much of the DF's independence and agency as possible.

If he's forgetting to put out vigarettes and starting to burn holes in the frnishings then it's not safe for him to smoke. Really sure that the "rights" of dementia patients include being kept safe.

Ive worked with chain smokers on dementia assessment units. We allowed 1 cigarette every hour, plus an additional 1 after food, so 20 a day in total, which is what they smoked before developing dementia. The repeated asking for cigarettes was frustrating but we would just gently remind "John Doe you have just had a cigarette you can have your next one at x time".

YY to PP about least restrictive option.

Why "rights" rather than rights?

@BarbarianMum in a care home he wouldn’t have unfettered access to cigs and a lighter, he’d be supervised for his own safety. So it is about keeping everybody safe. It’s also about his right to smoke if he so chooses. Having dementia doesn’t mean you can have your wishes ridden roughshod over.

MrsTerryPratchett

In an ideal world, yes. But in a world where carers are incredibly stretched as it is and have a whole host of arising issues to worry about, it makes a lot more sense to say “maybe the cigarettes have to go”, rather than the enormous fire risk or amount of time and work that would go into supervising every cigarette for every patient who smoked. The reason I used my grandfather’s driving licence as an example was because obviously someone could’ve said they would accompany him on all his little car journeys. But no one has that kind of time; and the risk of him losing his lucidity and hitting a child or running a red a red light (aka his risk to other people) far outweighed his need to feel independent. It’s a horrible situation and I really feel for OP. She obviously isn’t trying to remove the cigarettes for any selfish reason and is doing the best she can.

Driving a 2 ton weapon cannot be compared to someone having a smoke under supervision.

And carers (unless it’s massively changed since I was one) are supposed to empower residents to make their own choices and to do the things they’d usually do. Not remove things they enjoy to make the carers lives easier!

SoddingUnicorns

A dementia patient won’t have a cigarette and remember that he has had a cigarette and be fine until the next one. He will have a cigarette, immediately forget and more than likely throw an enormous tantrum because he would like one. Carers don’t have time for this.

SoddingUnicorns

I don’t think that it’s the same with a dementia patient, sorry. They don’t have any real level of independence because of the nature of the disease. Decisions need to be made for them constantly, and I am surprised that as an ex-carer you think that time should be dedicated to facilitating something completely unnecessary such as smoking.

That’s a sweeping generalisation, not all dementia patients are aggressive or angry.

And what exactly do carers have time for if it isn’t supporting residents to live their lives their way?

In an ideal world, yes. But in a world where carers are incredibly stretched as it is and have a whole host of arising issues to worry about, it makes a lot more sense to say “maybe the cigarettes have to go”, rather than the enormous fire risk or amount of time and work that would go into supervising every cigarette for every patient who smoked

The homes should be meeting people's needs. An environment where the staff are incredibly stretched is not one where I would be putting my parent, as it indicates that profit is more important than employing the correct number of staff.

I don't agree. I think we need to at the least aspire and work towards a world where we care about people who are sick, old and have less power. And one of the ways we care is facilitating them being themselves, not a 'better' version.

I've realized this is perhaps a little close to home, hence why I'm annoyed. I lost a lovely client once who I supported to continue to eat food he liked even though his very unsupportive family kept telling me to 'just tell him he cant'. It's important that people get to continue to make decisions for themselves as much as they can.

I would hate to be stuck somewhere being told how to live.

It’s unnecessary to you, not to the gentleman in question. Why are you surprised by my attitude as an ex carer? Because I don’t feel like someone should have everything taken from them because it’s inconvenient? Because I don’t feel like telling a confused, probably frightened (in a new environment) and definitely poorly patient that they can’t do one thing they enjoy is unfair?

I’m pretty stunned at a carer who would think that acceptable and bloody glad my Dad won’t go into a care home if the time ever comes

@SoddingUnicorns just so you know, as a person who used to write care plans and find carers, I'd have chosen you.

Im sorry about your dad.
I looked around several carehomes for my nan with dementia and alzheimers. She was a smoker.
One car home had a special 'smoking room' which was good for the smokers.

The care home we chose my nan could go outside to smoke. I suppose its not ideal that the workees have to escort them but they still took her in knowing she was a smoker.

Some of their rooms had a door straight into a little courtyard which was good for smokers.

To be fair though after a few months and nans alzheimers getting worse she forgot she even smoked. If we were in the garden in the summer and had one she would ask but not even smoke it.

There are places that will accomodate. I hope you find somewhere.