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My Grandma is 71 this Oct. and has been in an assisted living home for about 5+ years. She had a brain aneurism followed by 2 strokes in 2001 and her cognitive health has never been the same.


She has smoked cigarettes' for many years as well as weed. She still does, however, our family can only afford to buy her 1 pack a day at the most. When she does not get that pack or decides she wants more, she has been stealing from other residents of the home. This has been happening for about 6-8 months now. (2020 pandemic) Recently, it has gotten worse and now the other residents are threatening to call the authorities. When confronted, my Grandma said that she NEEDS two packs a day or she will kill herself. Suicide is very serious and my family is really scared and not sure what to do. We have very limited money and my aunt and I are the only ones close by.


I don't even know where to start, or who to go, so any suggestions would be greatly appreciated.

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I just read Riley's post. Just voicing my opinions here and info from my RN daughter.

First, no facility can lock a RESIDENT in their room. When you are in an AL or NH it is considered your home. As such, you cannot be restrained in any way. Locking them in their room is a restraint and a fire hazard. And I capitalized resident because they are not considered patients even when they are in NHs. They are paying to live there even if on Medicaid.

In the NHs I have visited there is no smoking allowed. Anyone who smokes has to go outside the building. I never saw anyone smoke in Moms AL. If they were, it must have been in their own rooms. There was no smoking in the Common areas. There was a resident on oxygen. ALs are not health facilities. They are residences that give assistance.

"The staff must step in and discipline her in these cases" This is not the staffs job to "discipline". What is going to happen is Grandma is going to be asked to leave. Tenancy is usually monthly. All that is needed is a 30 day notice. She is becoming too much for the AL and staff to handle. They don't have to tolerate her behaviour or deal with it. Unlike a NH that by law has to "discharge safely", ALs are not under that law. Just like living in an apartment, you can be evicted.

My State has a law banning smoking in offices and public places. Places I have worked have designated areas outside the building. Schools you have to be off the property to smoke.
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What about vaping? I know nothing about it but my neighbor switched to doing that and it's supposed to be a somewhat healthier way of getting the nicotine--I don't know about the cost however--I think it's supposed to be less.
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IamAmy Jul 2021
It is less expensive to vape. 🙂
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Joann29,

That's amazing that your father quit smoking cold turkey after so many years. My mother did it the same way. I don't know how they were able to.
I didn't decide to quit smoking. Covid-19 made the decision for me because I got very ill.
I make the decision not to smoke and I'm going on one year cigarette-free. There's no way I could do it if I thought in terms of never smoking again for the rest of my life. So, it's one day at a time for me and I decided not to have any today.
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JoAnn29 Jul 2021
Yes, it was amazing because before the valve and bypasses he had been told to quit smoking and he didn't. He would sneak one when Mom was out and leave the butt in the sink. When she questioned it, he would say one of my Uncles did it. She knew better, they all smoked different brands.
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First of all, why on earth is a health facility allowing smoking. It should be l00% banned completely and enforced. Can the health authorities step in if this is legal. Second of all, I think she is crying suicide for attention and to get the smokes she wants - ignore it and DO NOT GIVE IN. I doubt the outside authorities can or will do anything about her. Try different medications to cut down on her "needs". The staff must step in and discipline her in these cases - the stealing has to stop. Perhaps they need to place some kind of a restraint or lock on her door to keep her "confined" so she can't continue stealing. But first the facility should NOT ALLOW SMOKING - EVER. Perhaps the local fire chief can step in here or the state officials.
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Riley2166 Jul 2021
And how on earth could she commit suicide? I doubt it would happen. And if it did, she would be at peace.
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Joann29,

You're right the behavior may very well be something new with the grandmother that isn't about her not having enough smokes.
Every suicide threat has to be taken seriously. In the grandmother's case though this new over-dramatic behavior could be many things.
Like boredom and loneliness. Or a need to attention. Or even plain old spite. I can't tell you how many elders I've worked for who would fabricate dramas about everyone stealing from them. Or bad-mouthing them. Or their families and caregivers are neglecting and abusing them. I had a couple of clients who went so far as to say they were being starved and refused medication. One who threatened suicide several times a day if she didn't get ice cream. I've had ones who accused their family and myself of beating them too. I even got questioned by the cops once because one old lady I worked for was that convincing to the police. Of course the cops quickly realized that nothing was going on and she was completely out of it. Her family finally put her in a nursing home.
pwalker90's grandmother may very well need medication as the woman was also a regular weed smoker too and isn't getting any that either.
If the family can afford pack a day, they can easily make four home-rolled packs for the cost of one if they did it themselves.
Then deliver them a couple times a week in person. Maybe come with a plate of cookies or a pizza and stay for a bit.
The grandmother's new behavior could be caused by something medical or advancing dementia and she should be evaluated.
It could also be driven by loneliness and plain old boredom too.
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JoAnn29 Jul 2021
Thank you, you have experienced a lot more than me and I now understand where ur coming from. I also am not an addictive person. Never smoked, don't like alchohol or anything that would keep me from being in control of myself. So not always sympathetic to others addictions. I have seen, first hand in family members, how additions effect everyone else, though.

My Dad was a chain smoker. Started at the age of 12. Was sitting on the front step one day waiting for my Uncle to drop off a carton of cigs because he had run out. (He worked in a state nearby where cigs were cheaper) At 65 he had a heart valve put in and 3 bypasses. Was told to stop smoking, he went cold turkey. I will never understand how he did it.
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Try getting her on an antianxiety medication....there are docs around for geriatric patients....she is carrying on due to being isolated and feeling depressed...group therapy in the facility will help .Iam 72yrs old and push myself to move move move..
excersise...it is miraculous when u get outside and breathe...i restarted smoking after having quit for six mos. but i dont plan on continuing my self abuse..its all a con game from the companies..there are drugs in tobacco that keep u hooked get her the famous book on stopping smoking that details how the filthy smoke goes into your body...get a tape she can listen to about stopping..be creative people
i had my dad in a nursing home at 97 yrs old and would go daily and get him up
to walk take him outside in the sun etc. he always had a good attitude..grateful.
this from his own pshycological makeup..he was a chrurchgoer most of his life.
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Smoking weed is nuts especially in an Assisting Living facility! Is she in California, Oregon, or Colorado? Does she smoke weed for medical purposes or recreational? Now the cigarettes is another issue. Your mom is an addict who needs to be put in a mental Rehab hospital to get off the weed and nicotine plus help for suicidal thoughts too! She keeps smoking both it will kill her over time.
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Imho, theft and threatening suicide are two concerning issues.
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Sounds like it's time for mandatory nicotine patches.
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Where are all these residents smoking ??? In the home ????
I would roll them for her … cruel to force her to quit now !!!
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BurntCaregiver Jul 2021
Helenn,

You are right. It would be cruel to force her to quit now.
She's old and lives in an assisted living facility.
Why take what's probably the only thing she still enjoys away?
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It seems like now would be a good time to get her off cigarettes with the help of a Dr. Call her Health Insurance and talk with her Dr and work on getting her off cigarettes completely.
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I totally get the cost of cigarettes, I quit in the 80s when they went over $1 a pack.

In this case if a pack of cigarettes or an additional one would solve every one’s problems I’d find a way to supply it

My mother with Parkinson’s is blowing 80 thousand a year maybe more, we can’t find everywhere she’s hiding it. And causing irreversible damage, there seems to be nothing and no way to stop her.

Count your blessings if a pack of smokes can smooth things over, take that step before it’s bigger then you can manage
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Sounds like she needs to be Baker Acted (involuntary hospital hold) for psychiatric evaluation. I'm surprised the assisted living facility keeps her and has not called 911 due to her threat of self harm.
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Alva is right. You may not want to hear it, but AL is not the place for that level addiction. Bad choice to begin with, but POA needs to get dr involved and admin immediately. Cig machine? Omg whoever said that no.
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BurntCaregiver Jul 2021
AT1234,

I am the one who suggested getting a cigarette machine to home- roll the grandmother's cigarettes to save money because it's a lot cheaper then smoking store-bought.
The grandmother is 71 years old and lives in an assisted living facility. Honestly, how much pleasure in life can this person have? It would be downright cruel to cut a person that age off their cigarettes. Really, what good would that do? Maybe she can get her miserable life extended by a few years if she's forced to quit smoking? My God, have some compassion already.
I started smoking when I was a pre-teen and that was a long time ago. I quit now going on one year. I'm not an old woman living in an AL facility. But I know what it's like when you run out of cigarettes or don't have enough.
If a person at 71 years of age can still enjoy their cigarettes and hasn't died of a smoking-related illness, then I say let them have it. No one at that age should have to suffer and struggle the way I do and every other addict around the world does every minute of every day. Not at that age. People that old have enough suffering and struggles. They don't need more. Let the poor woman have her cigarettes.
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Maybe it is all she has left. At her age to take them away would be traumatic for her. If she is threatening you to get what she wants this is not acceptable. She is making you feel responsible for her well being. You are not. You do enough for her. As far as stealing, that is commonplace for dementia patients. They would steal from my mother all the time. Once, someone stole her purse. I think the staff should take measures to prevent this from happening.
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BurntCaregiver Jul 2021
Isabelsdaughter,

You're right. It would be traumatic to take the grandmother's cigarettes away.
As for the threatening, well needy people get pushy and desperate. Especially a needy person who's also an addict and smokers are addicts. You're also right about the staff of the AL taking some measures to make sure the dementia patients aren't stealing and ripping each other off. Those places cost a fortune to live in and this type of security should also be offered.
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Please have her admitted to an impatient psych unit. She has inappropriate behavior that must be addressed.
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paintertr Jul 2021
Brain damage is not helped by psychiatric measures. My husband was incorrectly diagnosed with mental health issues and spent 4 months in a psych ward, 10 Electric shock treatments and 5 different antipsychotic drugs later no change. They said they could give him up to 35 electric shock treatments!! I took him home found a good neurologist and got the correct diagnosis of frontal temporal dementia. It is not curable but at least he is not being tortured by treatments that do him not good. Inappropriate behavior is one of the hallmarks of FTD
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See if nicotine patches might help. Or talk to doctor about other meds. It is pure torture to be addicted to cigarettes, want one, and not have one available. Non-smokers don't get it. If you happen to be an overeater - or eat for satisfaction to stress - then imagine the frig being empty when you're having a bad day. We all have our demons.
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BurntCaregiver Jul 2021
my2cents,

I smoked for 35 years. Nicotine patches don't help. Chantix won't help. I've used both. In fact, I've used every kind of smoking cessation program and product there is and none of them worked for more than a couple of months. They didn't work because I didn't want them to work. I didn't really want to give up cigarettes.
Nothing will help a person quit smoking if they don't want to quit.
It's the same thing with alcohol, drugs, gambling, food, and any other addiction. If a person doesn't want to give it up, nothing can help them until they do.
I'm going on one year smoke-free because this time I really wanted to quit and am serious about it.
A 71 year old in an assisted living facility isn't going to be serious about wanting to quit. That's not gonna happen.
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I understand where Barb is coming from not because I was a smoker but because my 44 yr old daughter is. She has smoked since she was 13. Stopped when pregnant (not saying she didn't sneak one or two) as soon as she had the baby, she lit up one.

OP says her grandmother had an aneurysm and 2 strokes. She is in an AL for a reason. Her mind could be effected. OP said family can't afford more than a pack a day. Thats what $8.00 a pk? Thats $16 a day. About $500 a month, $6000 a year. Thats asking a lot of family members to foot the bill. Maybe there is an alternative. Some medication/patch that will help cut down on the need and one pk will be enough?
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Certainly I agree that suicidal threats must always be taken seriously. However, when they involve "If you don't get me cigarettes...." or "if you don't get me this or that" they are often more threats than real suicidal ideation. That said, it sounds as though your grandmother's condition is deteriorating somewhat. I would encourage the family or the POA to sit with the admins at the facility and discuss what changes they are seeing. It may be time for a visit to Grandmother's MD and perhaps a neuro-psyc eval. This could be depression, it could be dementia, it could be a UTI. Basically anything from us here would be guesswork. Time to call in the professionals. The answer if not two packs of cigarettes a day; that's for certain.
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BurntCaregiver Jul 2021
AlvaDeer,

I'm guessing you weren't a smoker. If you were then you know what it's like to be addicted to cigarettes and when there aren't enough or they run out. If you weren't, then you have no idea how the smoker suffers emotionally and psychologically when they don't get what they need. It's not a UTI. It's not dementia. She doesn't need a neuro-psych evaluation. She needs to have enough cigarettes.
I smoked for 35 years. I know the anxiety, panic, and even depression that comes with running out of smokes or not having enough.
They have to make sure grandma has her two packs a day. Even if they have to roll her smokes themselves to save money. If she has enough cigarettes, they will see a big change in her behavior.
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Start by getting a cigarette machine so she can roll her own. When a person makes their own a pack of cigarettes costs about 25% what a store bought pack costs.
It's very easy to do. You just buy the cigarette tubes they come 200 in a box like a cartoon of cigarettes. (they have the filters already on them and they look like an empty cigarette), put them on the machine and add the tobacco that you buy by the bag.
I did this for years when I smoked. In my state a pack of Marlboro or Newport is about $12. Rolling your own is about $2 a pack. Big difference.
If your grandmother can't manage to roll her own then do it for her. Make her a few cartons a week.
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marte48 Jul 2021
What do you do about the smoke affecting non-smoker patients?
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You start by telling the people at the ALH what she has told you. They may be able to help, or at least stop her from stealing from others. And keep an eye on her since she has threatened suicide.
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pwalker90 Jun 2021
Thank you so much! Yes, the head nurse at the ALH is who told us this information. They are watching her closely but she is still free to leave the facility if she wants.
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