When caring for someone with Alzheimer’s or another kind of dementia, “I want to go home” is a common question asked by the person living with dementia. In addition, people with dementia frequently utter phrases like “I need to leave from here” or “I’m looking for my mother.”
With a dementia diagnosis, the brain goes through a series of chemical changes in addition to the physical ones. With Alzheimers, the hippocampus region of the brain (which helps us preserve a timeline of the events that have occurred throughout our lives and allows us to adjust ourselves to our surroundings) is one of the first sections of the brain to sustain damage. The hippocampus also plays a major role in new memory formation.
The order of damage and precise location of impairment within the hippocampus may vary based on the type and form of brain alteration. However, it is the first section of the brain to be impacted in the most common form of dementia, which is Alzheimers.
When a sufficient portion of the hippocampus region has been compromised, damaged, or chemically altered, the individual will have difficulty trying to maintain their sense of the chronological order of their life. This will result in difficulty remembering a variety of things, such as remembering the layout of our homes or recalling where we are and how we got there. As you can imagine, this can be very scary and/or confusing for the person living with dementia.
Dementia is a condition that causes damage to the prefrontal cortex of the brain, which is the part of the brain that allows us to be sensible and logical. This makes things even more complicated. In addition, a person’s language abilities and communication abilities decline, resulting in a diminished capacity for the individual to articulate their thoughts and feelings.
Remember that saying “You are home!” to the person who is asking to go home while they are standing in the house where they have lived for many years won’t help either of you. However, it may be frustrating for you as a caregiver to listen to the person asking to go home while they are standing in the house where they have lived for many years.
8 Ways to Respond to a Person With Dementia Who Wants to Go Home
When you find yourself getting frustrated, relax, take a few deep breaths, and apply the following tips:
1. Check if They Have Any Unmet Needs
The elderly person may express a desire to “go home” when unmet needs are present. Is this question happening after meals or at a specific time where other unmet needs might be concerned? That person might be trying to communicate they need to use the bathroom, but are unable to express that need.
If our brains are healthy, we can either fulfill those requirements on our own or seek assistance. However, with a diagnosis like dementia, then it is possible that they will not be aware of what is making them uncomfortable, which can impact their ability to it this need.
Therefore, if the person you care for who is living with dementia tells you, “I want to go home,” this could mean they are hungry, thirsty, or exhausted.
You might be asking why a person who is now living with dementia and has an unfulfilled need would ask to go home or see their mother in this current situation. When you think about your own life and what your house and your mother might mean to you, the answer is probably that it’s a place that comforts you.
When experiencing discomfort, you can stop at a location where you can receive something to drink if you’re thirsty, some food if you’re hungry, and get someone’s help. Therefore, if the person you care for has dementia and repeatedly expresses a desire to return home, it’s possible that what they’re really trying to say is that they want to be in a familiar environment where all of their requirements may be satisfied.
So, the next time the individual you’re caring for expresses a desire to go, think about how their day went for them and refer to the list of unfulfilled requirements that is located above.
- Have they used the restroom recently? How much time has passed since then?
- Were they able to get something to eat?
- Do you think they might be in discomfort?
- Are they experiencing discomfort because their clothes are wet?
- Are they feeling bored or lonely?
Determine if there is a need that has not been satisfied that you can help them with.
2. Is The Environment Bothering Them?
There could be a variety of reasons behind a person’s desire to return home, one of which could be associated with fulling an environmental need. A person who is living with dementia may experience a great deal of discomfort if the setting in which they find themselves does not have a welcoming, comfortable, familar, or practical, vibe to it.
Are there any smells or textures that would be comforting and familiar to them?
3. Look For Clues
Although it is understandable that a person’s immediate reaction to hearing “I want to go home” may be to respond with something along the lines of “I don’t understand what you really want – you are home!” it is important to keep in mind that if a person is unable to recognize their own environment, insisting that they are at home will not help the situation.
Take a few deep breaths and focus on turning your anger into interest rather than giving up. Then, put on your best detective hat and see whether you can figure out what their request is really all about.
Therefore, the next time the person you’re with says, “I want to go home,” you could want to answer by saying, “Oh, you want to get home.” “Tell me more about your home.”
Curiosity may lead to the discovery of an unfulfilled need that you are able to satisfy, as well as additional possible motivations for the individual’s desire to go back home. In addition, by empathizing with the other person and expressing interest in their concerns, you are meeting them where they are at. This contributes to the maintenance of the relationship that the two of you have.
4. Avoid Arguing With Them
When speaking to a person with dementia, the word “home” may refer to more than just the location where they reside. For example, when someone with dementia wants to go home, they typically refer to the feeling of being at home rather than the home’s physical location.
It’s possible that when people think of “home,” they remember a time or location that was cozy and safe and where they were able to unwind and be happier. But, it’s also possible that this location is indefinable and doesn’t even exist in the real world.
It is in everyone’s best interest not to argue with the person or attempt to argue with them about their desire to go home.
5. Reassure Them
The phrase “I want to go home” might be used by seniors to express their feelings of nervousness, anxiety, or fear.
As long as you’re patient and kind in your response, they’ll know that you care about their concerns. This gives them a sense of belonging and acceptance.
Maintain a calm, sympathetic, and unhurried demeanor when speaking with them. Keep your cool, and they’ll frequently follow your lead.
This is a nice moment for a hug if they enjoy receiving them. Others may prefer to have you sit with them and give them a gentle touch or stroking on the arm or shoulder.
Another option is to give them a comforting blanket, a therapy doll, or a stuffed toy.
6. Distract
Have a photo album on hand at all times. Anxiety can be reduced in some people by just glancing at old photographs and being given the opportunity to reflect on happier moments in their lives. It is always advisable not to question them about the photo or about the past. Instead, try making comments such as, “That looks like Aunt Martha.” When I asked Grandpa about it, he told me about the time when she….’
Alternatively, you could try to distract them with a snack, some entertainment, or other activities, such as going for a stroll.
7. Check if There is a Pattern
There may be worse times of day than others. What is it about these times that seem to have a common denominator? What time of day is it (and may a snack help)? Is it at times when the surroundings are more crowded? What time of day is it? Is ‘Sundowning’ a factor?
Some of the triggers might be reduced or avoided if you notice a pattern.
8. Don’t Feel Guilty
Regardless of what you do or say, you will certainly be confronted with this request. It does not matter. I know this can lead to feelings of guilt, but it may help you feel less guilty if you keep in mind that the house the other person is looking for is probably no longer standing.
Even if you were to pick up your loved ones and take them to the home they had before, there is a good chance that they still wouldn’t be pleased. This could be because they don’t remember the home or because it isn’t the home they are yearning for.
They aren’t interested in returning to the spot where they were living before moving into a senior living facility; rather, they are yearning to return to the house where they spent their childhood.
What to do if They’re Insistent?
No matter how much you try to comfort or refocus them, there will be instances when they will not let go of the thought of going home, no matter how hard you try to do so.
In the event that this occurs, you might be required to agree to take them home. Take a walk around with them (if applicable) and try to use these other strategies after you agree with them. If they are able to take a ride with you in the car, this could also be an option to take them to a place they would enjoy.
Experiment with different time intervals to see how long it takes until they will allow you to take them home without putting up a fight. Alternatively, you may offer that everyone goes to the ice cream shop, the drugstore, or the grocery store as a way to distract and redirect them.
Even if you are unable to physically remove them from the house or load them into the car, just going through the motions of getting ready to go can still be calming. This will appear to them both that you share their viewpoint and that you are contributing to the accomplishment of their objective.
In the meantime, the actions of getting ready provide you with more opportunities to divert your attention to something else and distract yourself from the preparations you are making.
It is essential to remember that not all the things you test will work well on the first attempt. And just because something is successful the first time, there is no guarantee that it will be successful the second time.
You’ll find that it’s easier to follow this strategy the more you do your best to maintain a calm demeanor while also retaining your flexibility and creative spirit.
The Bottom Line
The journey of providing care for someone with dementia can take an unexpected turn, and it requires a dedication to communication that is both flexible and sensitive. It is crucial to see why the person you care about wants to go home.
Therefore, prepare yourself by equipping yourself with education on why this question could be asked, and get acceptance of the situation. When we take the time to explore the possible reasons this question is being asked, we will be better prepared on how to handle this question when it arises.
References
- https://www.liftedcare.com/why-do-so-many-people-with-dementia-say-i-want-to-go-home/
- https://www.joincake.com/blog/how-to-respond-to-dementia-patient-who-wants-to-go-home/
- https://www.fivestarseniorliving.com/blog/what-it-means-when-a-person-with-dementia-says-i-want-to-go-home
- https://www.everystep.org/about/blog/i-want-to-go-home–3-ways-to-respond-as-a-caregiver-
- https://www.alzheimers.org.uk/blog/i-want-go-home-what-to-say-to-someone-in-dementia-care
- https://www.verywellhealth.com/when-alzheimers-patients-ask-to-go-home-97968
- https://seniorsathome.jfcs.org/dementia-i-want-to-go-home/
- https://teepasnow.com/blog/how-to-calm-a-person-living-with-dementia-who-is-wanting-to-go-home/
- https://www.agingcare.com/articles/what-to-do-when-elderly-parents-wants-to-leave-the-nursing-home-138005.htm
