Addiction, while sometimes menacing, can have positive sides to it as well.  Perhaps your loved one has smoked for decades, enjoying every minute of it.  Lately, however, you have become concerned over safety issues.  Finding burn holes in their clothes, blankets, countertops, or in carpets speaks volumes.  Change must come.

But what can you do?  They adamantly confirmed they do not want to quit smoking.  Spoken with powerful words of resolve, you clearly understand they will not quit.  Their argument being quality of life.  “I’m old.  I’ve lived a full life.  I’m going to enjoy whatever days I have left.”

Set up a designated smoking area.  Shop around and buy a burn-proof smoking apron.

The very word addiction carries negative connotations.  Don’t bring that negativity to their smoking area. Make it a relaxing, enjoyable spot.  Comfy chair, maybe an end table with a lamp and ashtray on it.

Put cigarettes and lighters “away” until it’s time to smoke.  Design a memorable one-on-one activity.  Bring them to the smoking area and remain with them until the cigarette is put out.  Maybe look at magazines together.  Many prefer reading a newspaper.  Some even enjoy watching a TV program or drinking a cup of coffee.

Addiction options

Another option is to talk to their physician regarding the nicotine addiction.   Maybe a nicotine patch would be appropriate.  Make sure their skin doesn’t develop a reaction to the patch.  Check for redness of skin each time you change it for them.

You do have to make sure they don’t “accidentally” pick the patch off.  It may confuse them if they see or feel it.  Curiosity encourages them to remove it to see what the heck it is.  Remember, they no longer remember they agreed to wear a patch.

There are indicator signs the patch is either no longer working or has been removed.  An edgy or cranky mood-state may begin to be exhibited.  Their body is experiencing withdrawal.  Before thinking they are having a bad mood-state day, check the patch.

“Strawgarette” alleviates addiction

Yet another, very successful option is to hand them a straw cut to the length of a normal cigarette.  I call this a “strawgarette.  “Give them an ashtray and you will find they are completely content to sit there and “smoke.”  Maybe add a cup of coffee and newspaper if that was also their habit.

They have no idea it is only a straw.  Their senses send messages to their brain telling them they are indeed smoking.  This is because they are replicating a daily habit they have experienced probably the majority of their life.  Much research has been done regarding the fact that smoker’s habits are as addictive as is the nicotine itself.

Smokers favorite moments

Smokers like to light up as soon as they get on the phone, even if they had just put a cigarette out.  Lighting up after eating a meal is another special moment.  If they drink alcohol, they light up.  Even while reading the newspaper or a book you’ll see that cigarette come out. 

Two other smoking faves are during social situations and when their smoking buddies are with them.

Alcohol

Check first with their physician to confirm alcohol will not be contraindicated.  It is not uncommon for this generation to have a glass or two of their alcohol of choice every night before bed.  Other than not mixing well with medications, there really is no reason they need to stop that habit now.

The reason I say this is because by now your loved one has given up many of their favorite or routine-type habits due to the dementia itself.  Weigh the cost between stopping a lifelong habit and overall quality of life.  This may help eliminate future unwanted behaviors.

If your loved one has a history of heavy drinking you may want to keep the alcohol in a safe place. This allows you to be the dispenser of drinks, not them.  It is helpful in cases like this to begin a new habit for your loved one to enjoy.

Maybe set aside time after dinner where you both sit down together with the drink(s) of your choices.  “Happy hour one-on-one.”  Add special cocktail napkins.  Through in finger-food snacks like peanuts, pretzels, or popcorn to nibble on.  All this will assuredly enhance their experience.  

Try the non-alcoholic drinks

An excellent option might be to buy non-alcoholic wines or near-beers to serve.  Believe me when I tell you your loved one’s addiction will not be able to tell the difference.  I used to take four to six residents out for lunch once a week.  We were known as the “Lunch Bunch.” 

One time we ate at a Denny’s-type place.  Each table had a glass-encased lit candle sitting in the middle.  This triggered Riley’s brain to believe we were in a cocktail lounge.  When asked what he wanted for lunch he said, “A gin and tonic will be fine.”  I did explain this was a family restaurant.  They didn’t serve alcohol.  That realization, however, did not compute in Riley’s brain.  His brain clearly told him it was a cocktail lounge. 

The waitress finally began taking our orders, starting with Riley.  He again requested gin and tonic.  The waitress explained they didn’t serve alcoholic beverages.  This information only confused Riley.  Looking for help in clearing up the matter, he turned to me.  I simply ordered a seven-up-type of soda for him.  

After drinking three fourths of it the waitress asked if he wanted a refill.  “No, I better not.  The room feels like it’s spinning a little.  I better stop right here,” Riley responded as he covered the top of his glass with his hand.

At that the waitress became alarmed, thinking Riley maybe was stroking out.  “I’ll call the medics,” she nervously said.  Calmly and quietly I explained Riley was just fine. 

As best I could I tried to relay the idea Riley only “thought” he was drunk because he thought he was drinking a gin and tonic.  At that point I believe the waitress became more confused than Riley.  I opted for paying our bill and heading back to the van with Riley by my side.  He felt he needed physical assistance to get there because he “was too drunk to make it on his own.”

Addiction and the placebo effect

There you see the placebo effect.  Riley’s mind told him we were in a cocktail lounge drinking alcohol and Riley’s mind told him he drank too much.  I will say once back at the facility I had a little explaining to do.  The administrator asked how things went.  Riley quickly explained he drank too much and needed to take a little nap so he could “sleep things off.”

If your loved one prefers mixed drinks, pour the coke and seltzer water.  Add ice cubes.  Definitely put a straw or two in it or one of those tiny umbrellas.  Add an olive just before setting it on a cocktail napkin.  Make this a pleasurable experience.  They will never notice the absence of alcohol.  Their brain is literally tricked into thinking they are imbibing.  And truly a good time will be had by all.  It’s a win/win for everyone.

I shared this adventure to point out that a person with dementia does not really need to smoke or drink alcohol to get the “benefits” of it.  They just need to think (perceive) they are doing the behavior.  

Psychosocial encouragement

• Ask them to help you do chores around the house so they can feel needed.
• Thank them for tasks they perform.  Pick one point in particular that you liked and tell them.  “You really did a great job folding those pillow cases, thank you!”
• Do a craft with them.
• “Sneak” a chocolate covered cherry for each of you to eat.  It always tastes so much better.