Should I let me father-in-law smoke if it means he'll take his pills?

1 answer | Last updated: Mar 25, 2011

An anonymous caregiver asked...

I care for my father-in-law, who has just come home from a 4 month hospital stay. In June of 2010 he had a diagnoses of small cell lung cancer. July he started a month of radiation. In Sept. He developed pneumonia. He was admitted in to the VA Hospital and was told he recently had a mild heart attact. 2 days later he had a stroke. He recovered very well. He has short term memory loss, but walks with help of a walker, and talks. Now my problem is it is March and he has been wanting a cigerette.I won a couple battles. He stopped eating the end of Jan. and then stopped his meds. Now here we are the begining of March, and he has stopped his meds again. I Just told him I will buy the smokes if he takes his meds. I don't know what else to do. He has many health problems, besides the cancer. He has COPD, (on a good day he has 40% lung capacity). I don't want him to smoke, but what can I do? I can't force the pills down his throat. I realize, to him, this is about having "control" in his life. Haveing a "say-so" in his actions. What can I do? Buy the cig's so he takes his meds? It seems like a no win situation.

Bonnie Bajorek Daneker

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Bonnie Bajorek Daneker is author and creator of the The Compassionate Caregiver's Series, which includes "The Compassionate Caregiver's Guide to Caring for Someone...

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Bonnie Bajorek Daneker said...

I have seen this before -- you're not alone in bargaining with the patient to do things that are GOOD for them. It doesn't seem to make sense. However, there See also:
Should I take cigarettes away from my mother, who has Alzheimer's, for fear she'll start a fire?

See all 101 questions about Lung Cancer are many considerations behind it: Could they clinically depressed? Are they fatigued or in pain? Have they given up on a cure or on life in general? Often, if you can get these conditions addressed, patients have a renewed sense of life and start to help themselves.

From what you say, it sounds like his quality of life is not so great: difficulty breathing, walking with a walker, extended hospital stays. Have you had a discussion with him on how he feels about all of this? I would encourage you to ask him what else he'd like to accomplish in his life and how you can help him do that. Encouraging him to keep living may be difficult if he doesn't want to.

I know these are serious discussions, but you need to understand where your efforts are best utilized. Maybe it's not the right thing to do to force him to take meds. It's your job to understand his needs and give him comfort. While I don't condone smoking, it may relax him and counter some cravings, which will add to his quality of life. At this stage, that may be the best way you can help him.

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