How can I make sure my mother's facility isn't giving her cigarettes to other patients?

That could work. We could do it up like arts and crafts time. lol I'll make all the little baggies and label them with a day of the month and my mom can fill them. Bet it would drive the nurses nuts, but it would be effective. 

It might work, I was reading your other replies. I like Jane’s idea about the lock box, it will give your mom peace of mind that her cigarettes aren’t being stolen. I agree with Jane that the real problem is most likely that your mom  is smoking more than she realizes. 200 a month sounds like a lot,  but that averages out to about 6 a day which isn’t that much for a long time smoker. 

One issue I could see arising that you may want to consider, if using the lock box, is the possibility of her losing the key and thinking someone stole it . If she gets agitated running out last few days of the month, misplacing the key mid month could cause a bigger issue. Just something to think about before going that route. 

Yes, there's always room for issues. I actually have a lock box that uses a code versus a key. She remembers numbers very well. If I do something like set it to my birthday or the street address of my childhood home, she'll remember it and won't have to worry about the key. Dexterity may be an issue there too... but I'm going to take the box in with me today and see if she can work with what I already have on hand. If not, we'll probably try bagging them up. Realistically, it's a project she and I can work on together. When I go visit, I'm always at a loss for what to do with her anyway. So, maybe we'll spend 30-60 minutes bagging cigarettes. It serves a dual purpose- giving her more interaction too. 

That is very clever.  I'm impressed.  

I am too.  I hope it works because I hate these kinds of stories.  

The lock box is a good idea. 

The only thing I heard from the staff member was from a social worker who saw me giving my mom her cigarettes once. The social worker made a point of coming over and telling my mom to make sure she didn't share them because then she runs out and gets angry. On the spot, my mother argued that she didn't, and the social worker just smiled and said, "Ok" and walked away. My mom gets weird though. It's post-stroke brain. This is the same woman who accused me of changing all the clocks in the house so I didn't have to get up early with her. When I pointed out to her that it was still night, she said I did something to make it dark outside. So... it could be her or it could be the staff. 

I like the lock box idea. A lot. I'll talk to the nurses and see if they'll allow that. Failing that, I may run with Jaimie's idea. 

Of course she'll find something else to gripe about, but that's not the point. Remember, we're talking about someone with vascular dementia here. She is an absolute creature of habit. She totally loses her sh*t when things are out of order. When she runs out before the month ends, she becomes really combative. She's already been kicked out of several facilities and is on thin ice with this one as well. This just adds to her stress and the stress of those taking care of her. And, while I don't like her smoking, it's pretty much the only time she leaves her room and engages socially. Ergo, missing cigarettes derails her day in a big way. She doesn't cope well. And, considering the diagnosis, she really can't be expected to. 

The reason why I bothered explaining the situation in the first place is because there really could be something more going on than what she thinks is happening. Maybe she is giving them out, smoking more than she is counting, or they're giving them to others. I will never know the truth. And, the truth is rather irrelevant. It's more about finding a way to make her feel like she's got some power and calming her nerves about it. I could put them in a lock box and if they disappear, she'll say someone broke into it. I can do up the baggies, and if they disappear, she'll say they're still being stolen. There are outs and excuses with any angle. It's not really about preventing it, so much as it is affording her some measure of reassurance or comfort. She wants to feel like she's got some control. She doesn't have control over virtually everything in her life, but this one thing, she can. I don't mind indulging her. 

You are not paying attention at all to the mechanics of what is going on here.  What end are you hoping for?  I think you want to solve something that cannot be solved. Your mom is sick.  You are not going to give her any reassurance or comfort because she is sick.  She is not going to find any surcease in this issue.  YOU are.  For one minute. And then it will be something else.  You want to solve this.  I say to what end.  

To me this sounds like a desperate measure to tell yourself that you solved some problem for her that you care about more than she does.  Because the cigarettes are not the real issue.  Her losing control is the issue.  For both of you.  Cigarettes are expensive, but I would just buy more for her and pretend she has more than she thinks.  It sounds a lot less nerve wracking than what you are trying to do. Don't you think she will quit worrying so much about running out if she does not run out?  Sneak some extras in at the end of the month, you don't have to buy a carton, just a few more packs.  

"To me this sounds like a desperate measure to tell yourself that you solved some problem for her that you care about more than she does."

Ah, no. I hear about this on a regular basis (several times per week), including about two minutes before I posted this question. I asked about it because it is a huge concern for her that has been ongoing for many months and I have not addressed it.

I'm just talking out loud like you are.  I know I am not coming up with anything earth shattering.  I know.  But, I am practical, and I could afford a few extra packs of cigarettes a month if it meant I would not have to stress.  I know that is putting a band-aid over the entire issue and I also know that you know the situation far better than I.  

If you think you have lost nothing by trying, then that is certainly an answer for you.  I, for one, would feel like I am spinning my wheels for nothing.  But that is me.  That is not you.  There might be some dynamic where your mom senses your concern and that is the satisfying part for the both of you.  This may be the only way you can show her how much you care and how much you would be willing to help her if you could.  This is the only thing left.  So, I understand that. This post was edited by WM BARR . =ABSOLUTE TRASH at May 12, 2019 2:05 PM MDT

Keeping them in her room invites her to smoke them there, which is probably not permitted.  There is also the consideration that she could start a fire with matches or a lighter.  

Spunky is right. Most assisted living facilities will allow my mom to keep her stuff with her. However, this is a skilled nursing facility and they have different rules. She's never broken the rules by trying to smoke in her room or whatever, but they say she can't keep them on her because they're worried about fire risks and the oxygen tanks. 

My mom initially did not want to give them up and refused to. It became a huge thing where they were going to kick her out over refusing to surrender them. With her mental state being what it is, she said she would prefer to live on the streets anyway. Ugh. Sorting that one out was a nightmare. 

I don't know how care homes are in the UK, but they're not great here. We have a hard enough time just getting the staff to see to her basic needs. They aren't going to track cigarettes too. They're aware of the issue, but, again, they blame her, and she blames them. There's no resolution there. 

She will eventually be moving and this won't be a forever issue, but her behaviors have gotten her blacklisted from a number of facilities already and I haven't been able to find her placement. That's why she's in skilled nursing instead of assisted living. 

You're absolutely right. I feel like we've talked about similar issues before. The situation isn't as clean-cut as that though. I've already been through the wringer with my family on this. They're the ones who started bringing her cigarettes after the stroke. And, there will be considerable backlash if I stop bringing her cigarettes, both behaviorally from her (she becomes combative and suicidal) and from my family, who believes she should be allowed to have them. Ergo, it's not so simple as making a decision to stop giving them to her. We're talking about someone who's already unstable who totally crumbles when things like this change. She has said in the past she'll either live on the streets or kill herself. I can't do anything to prevent her from taking either action, nor can her facility. We could move her to a 48-hour watch for suicide if she admits she's suicidal, but there is literally nothing to stop her from rolling out of her facility. I'd have to get a court order to have her placed in a higher level of care, which they won't do until she's actually done it before. I've tried to have her placed in behavioral care, but insurance refuses. I've gone through the appeals process there too. She's also tried to have my guardianship removed before. It took months to untangle that. Ergo, any decision I make has a potentially horrific outcome with very little potential gain for anyone. 

I did say it previously, but I take anything she says with a grain of salt. I will never know if she's accurate or not. However, if I can provide her with some measure of comfort or reassurance or make her feel like she's somehow empowered, then I don't see the harm in trying. 

You're right - it isn't black and white and since you would be getting pressured from every angle, I would probably do the same thing you're doing.  I don't know how you can prevent them from giving her cigarettes to someone else, assuming they do that, but you can try some of the suggestions given here.  Good luck and Happy Mother's Day. :)