Help ASAP - finding a nursing home for a smoker?!

watergalFebruary 14, 2009

It looks like MIL is too weak to go back to her assisted living place, so we'll be going nursing home shopping this coming week. Oh joy. I am very concerned, because MIL is a smoker. Last March, when we initially thought MIL would need a NH, the wonderful hospital social worker explained that most NH's in her area won't even accept a smoker at all. She did find two for us to look at, the nice one turned her down because of the smoking, the creepy smelly one seemed OK with it. But then she got strong enough for AL, and we found one that would accept smokers, so the problem was solved for the time being. Even so, she got in trouble several times at the AL for breaking the smoking rules. And now with her dementia, she's even more clueless.

I talked to a friend of mine who works in sales for a nursing home, and she told me they screen smokers very carefully, because they have a tendency to sneak smokes and are dangerous. I so understand - they can't take that risk.

MIL CANNOT live with relatives - she's a toxic personality, and we all work and have stairs in our homes. She can't go back to her home, because of stairs and no family nearby, and fulltime in-home aides would be costly and not what she needs.

She is a huge fall risk (they said she has "zero safety awareness" because she forgets to use the walker). They said she is not safe behind closed doors. She wanders. And she is complaining about the aides not taking her out for a smoke (she thinks she's back in the AL where she could do that). Her dementia is getting much worse, so she'll probably need a locked dementia unit.

At this point, we are perfectly willing to cut off all supplies of cigarettes and lighters and tell her no more smoking. She'll be furious, but it looks like it's the only way she MIGHT get care.

My biggest concern is - if we can find a nursing home at all, it's likely to be a crappy, desperate one. I guess that is the logical consequence of her smoking habit, though, and there's not anything we can do about it.

And what if NO ONE will take her? What then? My DH asked if they can force us to take her home with us. I assume we have the right to refuse.

But honestly, what happens now? Anyone been through this? Help, I'm starting to freak out.

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Don't tell her you are going to stop bringing her cigarettes, just do it. When she starts to complain, don't argue, just tell her "next time". There is a good chance that when "next time" comes, she won't even remember what you said. There will always be a next time.

Can she have candy? If so, hand it to her with a smile and hope for the best. Her favorite magazine?? Just so you can hand her something when you need to.

Tell the NH that you will cooperate in seeing that she doesn't get cigarettes.

The chance of fire in a nursing home is something that good ones simply will not take. If she gets too hard to handle, I am sure she will get medicated until the addiction gets easier to work with.

Good luck! It might take a while, but she will settle down to it.

    Bookmark   February 14, 2009 at 2:46PM
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If she has to go to a hospital for any reason then it's their responsibility to find one that will take her. My husband was a roamer and had trouble at the first home he went to. The only way they could get rid of him after accepting him was to place him in the hospital, then they did not have to accept him back. The hospital called other homes who sent someone to evaluate him and seeing the restraints no one wanted him. I asked the social worker what they were going to do, they said he just stays in the hospital. You might tell her doctor about the problem, he may be able to admit her for an evaluation, then they may place her.

    Bookmark   February 14, 2009 at 10:51PM
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Just wanted to put in my two cents' worth... The nursing home near me takes smokers, but there's only one other smoker. They told us up front that they cannot take Mom outdoors to smoke every time she asks. They intend to get her outdoors a couple times in the morn and a couple times in the aft. She's been there since August and is now down to 2-4 ciggies a day. I find her sitting out at the nurses' station waiting to find a willing nurse/aid/helping hand to take her out. My husband calls it fishing...They tell her they don't have time, but maybe in a little while... There's also a gal that can maneuver her wheelchair over by the window where they hand out the dinners...I hear her begging Coffee!!! Coffee!!!! She's fishing too.
There are aids to fill this need to get out and smoke, but they are busy girls, so I understand that Mom has to wait even tho she doesn't like to. I see that she isn't quite as desperate...doesn't get quite as upset as she used to. But whenever I go there, she casually mentions that we should go out for a coke...but I know she really means for a smoke... Makes me feel real good about why I am needed!

They keep her cigs and lighter in a desk drawer; they have not allowed her to keep them with her. This just killed her at first but she's used to it now.

    Bookmark   February 19, 2009 at 10:58AM
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Well, we finally found a decent place for MIL, and it wasn't even a NH, it was a nice assisted living with a locked dementia unit. We never even asked about smoking, it was the only place available that could meet her care needs and had an opening.

They say it's a smoke free place, but they have a smoking area out by the loading dock, for staff only, I guess. Oh well. At least MIL has a place to live. I'm not sure how much longer she'll even be able to remember that she smokes.

    Bookmark   March 6, 2009 at 7:05PM
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I'm glad to hear back from you, and that you found a good facility. Check with the staff about putting her on nicotine patches. Smoking is an addiction, both chemical and behavioral, and stopping can be tough. Maybe the patch will help her?

But you've done a good job of taking care of her, and I hope that things continue to work out for you.

    Bookmark   March 7, 2009 at 6:13PM
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    Bookmark   August 28, 2010 at 11:27PM
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I think when she is admitted she needs a doctor to treat her for the withdrawal from the cigarettes. When my sis was in the hospital they treated her for it. Care home usually have doctors that come in to see the patients rather than being taken to see one.

    Bookmark   August 29, 2010 at 4:54PM
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The doctor put my Daddy on a med that he took a pill once a day and smoked all he wanted to. Dr. warned Mama that the first three weeks Daddy would be extra grouchy and smoke extra because of the sub-conscience thought that we were Taking away his cigarettes, but slowly the smoking cravings would subside.

The medicine attached itself to the chemicals in smoke and then caused the area of the brain that each chemical effected to not crave it anymore.

It took nine months when one day I explained I wasn't pushing, but how was he doing on his cigarettes? (It was the first time anyone had asked him through the process.) With tears in his eyes he explained that he woke up that morning and realized it had been three days since he had a single craving, so he threw 3/4 of a pack away. He never had a craving again in the last 13 years of his life, even when his brothers came to visit and they smoked around him. There was no jitters, no shaking, no grouchiness (after the first 3 weeks), no weight gain, ... nothing. I'm not sure I can list his med here, but if you are desperate email me through the site and I'll let you know its name.

Years later, a pt. of mine had to go into a NH. His Dr. prescribed two meds. One patch to ease the cravings and a pill to keep him calm. Once those measures were in place the really good NH would accept him, because the issue was being controlled. He "fished" for about three months, then even that stopped. At one point they threatened to put him in the really awful NH until he got his attitude better under control, but threaten was all they had to do.

If you have to you might think about vigilantly keeping MIL in a not so good place until they get the medicines regulated, then work to switch her over.

good luck.

    Bookmark   September 27, 2010 at 2:09AM
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