Ethical question: Am I supporting Mom's personal choices or enabling her unhealthy behaviors? Or both?

Would you go out and score drugs if she was an addict? Feed her a shrimp po'boy if she had a deathly allergy to seafood? Bring a bottle of scotch if she were an alcoholic?
I don't think there is anything wrong with refusing to enable her self destructive behaviour, she's free to find another source.

I agree with cwillie. You say you don’t want to take over Mom’s life, but that’s exactly what you’ve done. Then, when you feel guilty for doing so, you buy her junk food and cigarettes.

Mom is like a petulant and rebellious teenager. The more you organize, scrutinize and push, the more she pushes back.

Step back. Say nothing when she is stuffing junk in her mouth or smoking. If she is mentally competent, she knows exactly what she’s doing. For heaven’s sake, do not enable her. It will be difficult. She can fuss and cry all she wants. When she starts, walk away. Leave. Hang up. When she thinks you no longer care about her well-being, things may change.

Not only are you unintentionally controlling her life but she is definitely controlling yours. I wish you didn’t have this horrible situation. Step back as others have said. No doubt you had good intentions. Sometimes our vision gets clouded and we choose the wrong solutions. Trial and error. Good news is that we can start again! Best of luck to you. You are dealing with a lot. Take care of yourself.

Now I’ll give you the other answer, just so that you can stay confused. Your mother’s choices are likely to put her into an early grave. Perhaps she thinks (like her GP) that she probably has cancer, and is quite happy to keep all the habits she has. The unfortunate truth is that an early grave may be the best option for you, as well as the option she is choosing by default. Caring for her as she declines may be beyond what you can do, as well as potentially killing her. Perhaps you could put it to her fairly straight – this is going to kill you, is that what you want? Or not quite so bluntly, this is going to lead you into a nursing home much sooner, is that what you want? Weaning her off her habits is likely to be as effective as trying an amateur ‘cure’ for an alcoholic or a drug addict, and make both your situations very unpleasant. (People with a seafood allergy are easy, they don’t go chasing shrimps.) Talking to her GP about what you can do might be helpful for you, even if she won’t go. You need to feel that you are doing the best you can, whichever way it goes. Sympathy and best wishes, Margaret

I had a neighbour who was diabetic and choose to eat himself to death. I would go visit Al and he would be sitting at this desk eating donuts, drinking regular pop and having candy on the side. He had horrible ulcers on his legs for years, was morbidly obese and knew exactly what he was doing.

I only asked him about it once. He said that since his wife had left him, and he had retired, he had nothing left to live for. He knew that the junk he was eating would kill him and it did. He was only 67.

My former step father in law, told us if he ever got a cancer diagnosis he was going to start smoking again. He had quit years ago and missed it every day. He did not get cancer and died without starting smoking again.

Rainy I do not have an good answer for you, but I know if I were in your shoes I too would be struggling.

I agree with Margaret, there are a lot of deeper nuances beyond the superficial response I chose to give earlier. I don't know if it is possible for you to have that discussion with your mother but it would be helpful if both of you are on the same page, AgingCare has an article I think is a helpful beginning:

https://www.agingcare.com/articles/an-end-of-life-conversation-led-by-gawandes-questions-205721.htm

You are way too invested in mom's life.
You don't give her age--but a lifetime of smoking and diabetes--well, I'm sure her health is not good.

You're definitely enabling her.

YOU decide how much you will do for her. If she is going behind your back and cancelling appts and sneaking food and smoking-there really isn't anything you can do.

Maybe tell her you will grocery shop for her or show her how to do it online. Tell her if she makes a dr's appt you will take her, if you can.

If she cancels, or balks, be tough and don't play along. It will be hard, but you will adapt. Your own little family comes first.

It's hard to watch a LO self-destruct.

I think we get overwhelmed with caregiving and give in, simple as that. But we make it harder in the long run when we do that. We have to reprogram ourselves before we can reprogram them!

I have been in your shoes to a degree.

My dad is obese and diabetic, denies being diabetic yet takes a medication for it. He was adamant that he would eat what he wanted. Okay, I'll go buy you 10lbs of donuts, want chocolate milk with that? Because I, nor you, can be more concerned for their wellbeing than they are.

When I told him, it's your funeral, do what ever you want, he stopped eating sweets and candy like mad. I think just letting him know the cold hard facts shook his world. He will still cheat on occasion but not like before, he wouldn't eat anything but junk.

Maybe just telling her that it is hard on you to contribute to her early death or worse, amputation, blindness, kidney failure, stroke...and you would like to help her find a way to get these items without you feeling like your are loading the gun. Be very clear that she can do whatever she wants but you need to live with your choices as well and you don't want to have her demise on your conscience.

Brutal honesty can jar someone to make changes, if not, you know you have done your very best to help her.

Hugs, it is so hard when a parent doesn't take care of themselves and then wants to hang themselves and their poor health on our hearts.

Whatever you end up doing, you are not responsible for her condition. If she has cancer she may very well want her quality of life and not someone else's idea of quality while giving her quantity. It does get to a point that nothing will change the outcome and we just have to love them for who they are, stinky buts (cigarette) and all.

We cannot save other people. They have to want to do it for themselves. I am surprised her doctors see her anymore. She is not doing what they tell her why go. They are just making money off her. If she can cancel appointments she can make her own.

The one thing I commend you on is picking up daughter trumps Moms appointments. Seems funny her appts are always made at same time daughter gets out of school, though.

Its going to be hard, but you are going to have to tell her you no longer will buying her junk. Her appts are her responsibility. If she wants you to make them OK, but if she cancels, she remakes her own.

Mom will eventually be hospitalized. Her organs are going to be effected. Heart and Kidneys. Kidneys are going to mean dialysis.

If you have young kids Mom must not be that old.

I also think cwillie has the best answer. OP question was, am I supporting Mom's unhealthy behaviors or enabling? Actually, it's the same thing, so yes. You are "enabling" her self-destructive behavior. In either case, you are not *helping* her. By purchasing for her those items that are killing her, you are doing her no favors. You are her "supplier," just as if you were getting her deadly drugs.

Yes, it is incredibly difficult to say no to her. You are enmeshed with her and she manipulates and controls you with guilt. So you may need to limit your exposure to her. Don't get into arguments with her. If you can't stay away from her, tell her, "Mom, I love you too much to get you these things that are destroying you. I hate watching you destroy yourself and I know I can't stop you, but I will no longer be party to it. Please don't ask." Then leave if you can.

Understand that the begging, the crying, the guilting, the manipulating will get worse before it gets better. Steel yourself, knowing you are doing the right thing, even if it's difficult. Even if she continues doing what she's doing, and dies from it, you will have delivered yourself from a lifetime of regrets and true guilt.

God grant you courage, peace and strength going forward!

My friend's FIL was like this. Overweight and badly diabetic... once crashed his truck while driving because his sugar bottomed out. Police thought he was drunk at first.

He ate whatever he wanted and as much as he wanted. Had an attitude of "I'm a grown man and no one's going to tell me what I can and can't eat"... which is a terribly immature attitude for a grown man. He died at 64. Pretty much ate himself to death. His wife, children, and grandchildren weren't enough reason for him to get his act together.

As for "Mom screams and cries if I don't get her what she wants"... well, too bad. She'll have to scream and cry, and see that it doesn't affect you. It's role reversal.
You are now the parent and she is the child. No loving parent would let their kid eat junk food all the time or repeatedly give in to a tantrum. You love them by giving boundaries. I suppose there's room for negotiation. "I'm happy to bring you a treat once a week, but I can't bring you a box of donuts today."

When Diabetics don't take care of themselves, they get wonky, for a better word. I had a fellow employee that we watched for signs of slurring his words. Not making sense when he talked. We were to call the ambulance when this happened. If your Mom takes shots, I am surprised she hasn't needed hospitalization. But it will come. When it does don't let the doctors and nurses guilt you concerning her care. Thats her responsibility.

Right now you are giving in to her personal choices and enabling her behavior by getting her whatever she wants. Time for Tough Love 💕 .

If you don’t feel it’s right-don’t do it. You are compromising YOUR values to pacify her so you won’t have to deal with a screaming woman. How did you raise your kids? Did you give them everything just to shut them up? It’s the same thing. Believe me, she’ll find a way to get what she wants without you.

As for her health, that’s her choice (as long as she’s able minded). We all have free will with our own bodies. It’s hard to stand by and watch and even harder to pick up the pieces when their health comes crashing down all around them. Do only what you feel comfortable doing when she gets sicker.

Sorry for you-it’s so hard when our parents make bad choices.

I haven't read any of the responses below so if I'm repeating my apologies. I totally understand both parts of your predicament. My mom is generally much more cooperative but she is diabetic, has been for many years amongst other things and far too often chooses foods she knows she shouldn't have or doesn't drink the minimum amount of water she needs to each day and so on. I agree with you it's her life and if she choses to cut it shorter or do things that make her suffer more later, well it's her choice. However when she does things or doesn't do things that cause issues for us, my brother need to run up because she isn't answering her phone or making any sense when she does, her BS is so high or low that we need to intervene, she is retaining fluids and has to go to the heart clinic or worse ER and we keep bordering on her kidneys being at the point of needing dialysis. My brother needing to make a trip up there to check on her in person or me needing to find someone else to do that or make the 5 hr trip myself because he's away, one of us (whoever is on that day) needs to call every hour to get her to do the minimum things she needs to. It's a constant balancing act but we don't enable quite the same way. So we (mostly my brother because he lives 20 min away) take her to the food store where she does her own shopping, I feel he gives her too much latitude on this which is how she get's 9 chocolate cream Easter eggs in the house but I get it, she would never put sweets and cakes on the list for us to pick up because she knows we wont do that. If I'm shopping for her I simply wont get things that are that bad for her, she can do it to herself but I don't have to contribute. I don't feel like I'm taking control of her life by not purchasing thigs for her I know are harmful and I wouldn't buy for myself.

I would say you could do some variation of the same, if she wants her cigarettes and cakes that badly then she can get herself out for a little exercise to get it herself. Now I don't mean she has to find her own way to the store, she could arrange a shopping trip ride with you but she will need to go into the store and purchase those things herself. If she is going to throw a fit you could start with some white lies I suppose, I had (a child) with me and I wont purchase cigarettes with her/him around, I know yo don't want them to start that habit any more than I do. Oh they were out of that cake you asked for or I totally forgot, I'm just not used to shopping in that isle. But my choice would be to be up front that you simply can't in good continence contribute to her health decline, you wont stop her but you wont participate. You might even try a little guilt about how it affects you when she doesn't take care of herself and ends up in the hospital, needing medical care etc. Medical issues that happen is one thing ones we can see coming, prevent and know how to prevent is another.

When it comes to her medical appointments and issues, you really can't force her to admit they exist so I would try a softer approach here, it really is better for her to hear these things from a doctor even if she ignores what they are saying and if you can be at all of the appointments with her then she can't ignore that you too heard what was said. I would just then act on the assumption she is going to follow doctors orders, just take her for the bloodwork, set her up with BS testing schedule and meds (make it as easy as possible) and then give them to her at the right time. If she resists you just remind her this is what Dr X said we need to do but if you choose not to follow those directions it's your choice I just wont be able to control what happens next (Dr might call in state who might place her). It's a fine, not easy line getting your point across firmly but not alienating so they shut you out but your instinct not wanting to "run" her life, agree with her choices or not, & coming from love is the perfect approach to find that balance

I gently suggest that you are enabling her to continue to destroy her health. Your compassion is genuine, I hear that. Your respect for her dignity of choice is admirable. However, if she was an alcoholic would you buy and deliver alcohol to her? As her caregiver, I urge you to google compulsive eating which is now considered to be a psychiatric disorder, a mental illness. Just like Alcoholics Anonymous, there is a free, lovely program called Overeaters Anonymous. There are telephone meetings on free phone lines throughout the day and night. As a caregiver life is hard enough. Your mom may feel she has no choice but to eat to cope with her depression and anxiety. There are other solutions. True love is compassionate and honest. If I were in your situation, I would talk to her about it. Tell her how you feel about buying her harmful foods and cigarettes. Anger is a defense but if you are sincere, you may help her have some healthier happier times ahead. And for your sake, as a caregiver, you have the right to ask her to try to take better care of herself. If she refuses, perhaps she can find a way to get her own health destroying addictive foods and cigarettes. OA provides, love, support, friendship and a spiritual path of recovery. Worth trying. overeatersanonymous.org
Good luck!

Growing old sucks, ain’t it? All sorts of problems. And if you have no children to help you, you will be in a very bad shape. My husband has dementia, so I help him. We have no children, so if I get sick or have dementia, no one will help me. I’d probably move to Sweden to end my life my way at the time of my choosing.

Sorry, I am no help here. Just expressing sadness about growing old alone.

Either You need to talk Turkey to Mommy Dearest Here, Dear, For Her own Health...Or Die Trying...You are Indeed an Enabler for Mom to get away with Whatever You Hand to Her and Put up with it.
maybe it is Time to Intervene with Suggesting a Facility and Put your Foot Down..Be a Straw Boss Today or lay the New RULES DOWN.

How old is your mum? I only ask this depending on her age and what she has to enjoy in her life? I don't mean this in a cold way at all. I took care of my mom and she refused to do anything to help herself and was resentful to me whenever I tried to help with what physical therapy told her to do. She became bed ridden at home. I tried everything and she was resentful of me. She thought I was controlling her but I think she was not happy with her life because my dad died 3 years before.
I don't know..we are not in their shoes...yet. It has to be hard for them and very hard for the caring family member that try to do the right thing..I know. I feel for you. It is exhausting, especially when you care and want to do the right thing. My thoughts are with you.

I'm sorry I don't have any great advice for you but you're not alone. I went through the same thing with my mom. We use to be partners in crime it's always been just her and I and I smoked. When they started passing all the new no-smoking laws we would be up in arms about the petty non-smokers lol. I realized before she did how bad it was and how bad second hand smoke is. I never made her feel guilty about it but looking back I saw signs that her smoke has effects on my health before I started smoking.
She ended up with noticable cognitive decline that seemed to turn into dementia over night. She has now forgotten that she smoked. I can't say that I would have done anything different as far as going to the store to get her cigs even though I had basically quit. The role reversal everyone talks about isn't as easy for me as it seemed to be for a lot of people in similar situations.
The way my mom is and the dynamics of our relationship wouldn't allow her to put up with a role reversal when she was still mentally fit. Right or wrong that's the way it was. When the dementia set in it took me a while to accept the "new normal".
I had quit work because, well honestly because I hated my job and she needed me all the time. I thought it would be easy to be paid as her caregiver after all that's what she did for her mom. It took a lot longer than I expected and we were trying to live off her $935 a month. If she didn't have cigs I would go into a panic but when I noticed that she didn't notice that I wasn't smoking anymore it made it a little easier.
Anyway, sorry I'm totally talking about myself again. Even though our situations are probably not all that similar I know what you're going through and can tell that like me you worry just as much about not wanting to hurt your mom's pride as much as her health.
I know people will argue that that's wrong but for me saying no would have caused more problems than it would solve.

She has a right to purchase whatever she wants with her own money. You are not in any way responsible when she does that. However, she doesn't have the right to purchase whatever she wants with your money. By way of a small compromise there are cakes, cookies and pies you can purchase that are made without sugar. We don't restrict pop's intake of whatever foods he likes but, thankfully, he seems to prefer a balance of healthy items along side his junk food.

Compare and contrast:

- I want to support her autonomy.
- I'm sick of arguing and pleading and being yelled at and cursed when I don't do as she asks.

Both of these are perfectly understandable reasons for complying with a person's request, but only the first has a defensible ethical basis. The second is merely pragmatic, and who could blame anyone for feeling it?

Look. Your mother is free to make her own choices, yes; but she is not free to direct your actions. If she had a gun and wanted to shoot herself in the head - perfectly legal choice for her to make - you wouldn't obediently trot off and fetch the bullets for her, would you? Of course not: you would be assisting a suicide, which IS illegal.

But she would still be free to get some bullets mail order, hypothetically; and in reality she is equally free to avail herself of any delivery services or shopping services available in your neck of the woods. But she's not free to send you on errands you refuse to run.

And she most certainly is NOT free to help herself to your money. If her money doesn't cover her genuine needs, then help her to access additional resources such as benefits or other kinds of assistance. But paying for extras is no part of your responsibility when it comes to supporting her choices - whether the extras are cigarettes or a cruise or a Hermès scarf, doesn't matter.

Being clear about where your responsibility begins and ends is only half the battle, though, isn't it. If you don't comply, you come under fire and it's miserable. But here is the reason it is worth the battle.

You are enabling, yes, though I hope it's really clear that I don't blame you. And the real problem is that what you are enabling is your mother's rejection of really crucial treatment. As long as you supply her cravings for quick rewards like junk food and ciggies, she has zero incentive to co-operate. Things can get a heck of a lot worse, be absolutely dire, but she can comfort herself with the fixes and continue to ignore the realities of her situation. You know the complications of uncontrolled diabetes, I'm not going to get ghoulish about it. But if you need a reason to stand up to her, and stand up for yourself, there are plenty of pictures online.

Don't frighten her - that would be bullying, and that is unethical. Just inform yourself so that when you have to say no you have the reasons clearly in mind.

And pick your battles. Don't try to transform her overnight. Start with her grocery budget and the medical appointments, maybe; but also get other people involved. Do you have good working relationships with any of the professionals involved in her care? - not just doctors, but community teams, social workers, anyone like that? It isn't all down to you.

Your mom cannot have cakes, pies and cookies. It will kill her.That is the bottom line. So, what ever you need to do, you must do. My ex husband was diabetic, and I remember what a challenge it was to keep him away from sugar. I would buy sugarless pies and cookies, but the the problem is there are a lot of calories and being overweight is bad for diabetes. Once I heard he was in dunkin donuts so I pulled up and waited for him to come out. When he saw me he just froze (lol) and I took the bag of donuts away from him and went back inside and bought the sugarless ones. It's hard to keep on top of it. They will fight you.

Hi...
You have some real good Answers here..truly!
I'm chiming in becuz I lost my fiance' @ age 57, from diabetes complications/kidney failure....here 1 day, dead the nxt. He ate horribly & smoked & drank & sweets...he was in full blown denial, many diabetics ARE.

what I noticed you saying was:
You didn't want to take away her ability to make decisions..
However, I see her doing that VERY thing to you?
You too, have decisions. & that's simply, put, " mom i'm not going to contribute to unmanaged diabetes"
& maybe point out she' noticeably not loving herself. & you Do love her.
Goodluck

Your mom sounds like one tough cookie! There is no one right answer. Even if you stopped purchasing the junk food and cigs, she still would not follow up with her doctors or take care of her medical needs, so her health will deteriorate no matter what. Given that fact, it's very important to discuss with her about her wishes for medical intervention when that time comes, especially because she is still mentally competent now. I know it's hard to talk about, but vitally important. Here is a link to some short videos about your choices and some tips about how to discuss this with your mother that I've put together. I hope they might help you a bit.
http://bit.ly/2IeYzMW

When I started cooking for my mom I refused to give her sodas and other junk foods. She complained. She got over it when she started feeling a lot better. I know the smoking is a more difficult one, but I would not have ever in my life bought cigarettes for anyone for any reason. My son is an alcoholic and I certainly would never supply him with alcohol. For the cigarettes and sweets, your mom will find a way to get them if she's that stubborn, but you should not supply them. You should not do what you know is wrong. It messes with your well being.

I know it feels like a difficult dilemma for you because you love your mom and want the best for her. She, however, does not want the best for herself. If she is, in fact, competent because she has been medically assessed, she is free to choose her course of self-destruction. You can tell her you love her and all the reasons you hope she will choose to work on her own behalf, but enabling her behaviors with purchases you know are potentially deadly is not an ethical quandary, it's an ethical abdication.

You know you would not feed peanuts to an allergic child just because they wanted them. The wisdom of adulthood is easy to find in this interaction but perhaps it seems more elusive when you are the child trying to guide your parent's choices. Enabling behavior is as addictive as unhealthy choices so this work is yours to do. Unfortunately, even if you do your own work well, your mom still may not survive her own choices, and she may not want to.

When my mom decided to discontinue her chemo treatments after having only two, I felt it was a mistake but I realized that it was her decision to make and not mine. I set about being as supportive of her, in spite of her decision, as I possibly could, rather than demanding that she make me happy by choosing my perspective for her own path. Sometimes the only thing you can do with competent adults is offer them unconditional love for who they are and stop demanding that they perform to your standards for acceptance. They are free to choose well or poorly.

I'm sorry for the heartbreaking relationship you have with your mom. You can continue to offer the support of enabling good care arrangements but, as my dad's doctor told me, you can only do for him what you are able to do AND what he will allow you to do. You'll have to work with the entire formula and not just the half you favor.

Best wishes on coming to terms with all of this.

You are doing the right things in getting the appointments back on track. She needs her next appointment to be with a Neuropsychiatrist to treat what looks and sounds like clinical depression with addiction and/or early onset dementia. Yes, though, you are still enabling her in some ways (like the sweets); not only in ways that are continually self-harming to herself, but you as well. Her illness is controlling you. My heart goes out to you.

IMPORTANT-What looks like her unwillingness may actually be INABILITY... the brain is very susceptible to underlying, manifesting dementia in exactly the perfect storm that describe. As with most dementia, it will likely develope slowly and undetected. Make a list of normal behaviors 5 years ago and backwards, then a separate list of newly detected and experienced behaviors in contrast to her declining medical condition. Keep this with you at all times and especially appointments. You will see patterns if you're not already. You will need to give clinicians specific examples moving forward in order for them to clearly assess. You may have to make two appointments as talking in front of her will only allow for her to refute the situation.

If you are willing, then bear the burden of her shortlived anger. Once the excess sugar, salts, fats are not in her body, she probably will feel horrible...its very similar to a drug withdrawal and often also affects the dopamine receptor of the brain. You must, though, find out if this behavior is indicative of another progressive disease process on the rise. To help spur your awareness, look at signs and symptoms of Diabetes Type 3... the new American Diabetes Association guidelines. As with most dementias, it is not memory persay, that is initially (noticeably) affected, it is decision-making.

I empathize with you. I moved my dad in with me 9 months ago. After he lost his wife (my mom) 3 years ago he has steadily gone downhill, with one suicide attempt. He is depressed and anxious. He stays in his bed and gets out only for meals or trips to the bathroom. He will not do any of the exercises the PT recommended. He quit smoking almost a year ago but wishes he could start back. He has mild COPD so I do not offer to buy him any. He keeps up his behavior he will be bedridden or in a nursing home. His doctor said not to push him. Let him be. So that is what I have done. In his opinion, he has nothing to live for. I cook healthy meals for him but he has a sweet tooth. I do not deny him this one pleasure. He is 86 but it drives me crazy that he has lost the will to live. He refuses to see a psychiatrist. I'm lucky if I can get him out of the house for his regular doctor appointments. I guess I am saying let her enjoy the things that she looks forward to. Perhaps don't buy them for her but you could drive her to the store and let her buy what she wants. It's hell getting older for sure. I love my dad but hope he passes away peacefully in his sleep so he can be with Mom.

There are some very good answers here. One specific idea might be to try cutting her a deal. I will no longer be buying you things that exacerbate your diabates, but if you go on insulin, I'll get you X treat once a week.

Something like that, basically trading small treats for compliance. Once she starts complying, she may start feeling better and a positive cycle could begin.

This sounds kind of terrible and infantilizing, but maybe deperate time call for desperate measures.

Smoking is a very tough addiction. Maybe you could get her on the patch? Rather than having her quit cold turkey.

I agree with those who urge you to get her evaluated for depression, and treated. If at all possible.

She sounds really stubborn. So sorry you're having to deal with this.