Activities for Elders: Articles for the Elderly

When Someone With Dementia Says:

"I Want to Go Home"

One of the hardest things is to hear someone with Alzheimer’s or another dementia to say "I want to go home.” After this major question others more practical will follow. "Where's my purse? Have we paid yet? Should we take a bus? Do you know where can I find a bus pass? I feel better so why we don’t go home?"

Most of the residents cannot accept the fact that they are living in care homes. They believe that they are in hospital/institution, in prison or somewhere else. They don’t recognize or they don’t want to accept that the care home is their new home.

"I want to go home" isn't usually meant literally by someone with moderate or late-stage Alzheimer's. It’s the memory that missing and not the actual home.

Don't argue, "But you are home!" For one thing, the "home" being spoken of may not be the same place you're thinking of. One of the residents in a care home in America, was referring to "going home pretty soon," The family later have learned that he doesn't mean the house where he lives now or the town where he lived for 40 years. He's referring to his birthplace, where he hasn't lived since college. His long-term memory and emotions have conspired to have made that place the representation of a feeling of deep security.

Arguing with someone with dementia, as you already know, is counterproductive.

Hear "home" as a feeling you need to read. When people with mid- or late-stage dementia live in a facility or are hospitalized say, "I want to go home," what they're really saying is, "I'm uneasy," or "I'm scared." To all of us, the very concept of home is a mood that's soothing, familiar, and safe. Doesn't matter whether the "home" in the person's head is a childhood home, the home where they raised their family, or the place they live now – or all of them co-mingled as a just particular, satisfying kind of feeling, rather than a place.
Don't be overly distressed. Hearing "I want to go home" can provoke lots of emotions in family members: Worry that "she hates it here." Guilt at having placed her there. But remember that by mid-stage Alzheimer's, the person is not very capable of manipulating you, if for no other reason than within a short time she will have forgotten what she said (unless you provoke and prolong by arguing over the geography of home

Home is where the heart is. Dementing illnesses strip safety away. Little by little and sometimes in large chunks the familiar becomes unfamiliar. The little things a person unconsciously counts on to clue them in to where they are, who they are, how they should act and what they should expect disappears. Home is the place where I don’t have to worry, where I can rest, relax, breathe deeply and know everything is alright.

Unfortunately, when you are losing your mind everything is NOT alright no matter what anyone says to convince you otherwise.

Families resort to all kinds of tricks to deal with this and sometimes that works. Sometimes going for a drive around the block and going through the familiar action of walking up to and opening the front door to one’s house is enough to trigger the feeling of “at home” for a confused patient. An old favorite dessert or a piece of music can do the same thing.

But when all else fails—the usual tricks, the false reassurance, the distractions—it’s time to get honest.

Things aren’t the same anymore. Neither one of you is in familiar territory anymore and it does feel terrible.

But home isn’t just where things feel familiar. “Home is where they have to take you in.” “Home is where everyone knows your name.” Home is where you know you are loved.

Remind the patient (and yourself) that you still have love, the ability to show you care and the ability to receive it. Even the most demented patient is capable of holding your hand and vice versa. So hold hands together, be together and claim a moment of comfort.

Better: Give a hug. Meet that emotional need (fear, uncertainty). Be positive, not negative: "The weather's too bad to go out now, maybe later." Or, "Why don't we listen to some music first?" Shift the attention to a happier ending.

What does “home” mean?

What if dementia means you never feel like you are at home? Home is not just a physical place, but an emotional and spiritual one. If home is a place filled with your memories and hopefully a feeling of safety and with dementia you are losing your memories and everything feels unsafe, maybe there is no place you can call "home." Maybe when someone with dementia says "I want to go home" they may be telling us how unsure they are of life and everything they once knew.

Home could mean one’s birthplace
Their childhood home
A relatives home where memorable events took place
The home where their children were raised
Their most recent home
The job they so loved
Home as in Heaven
A change as in state of mind
Take me away from the noisy TV or music
Take me to my room where it’s quiet
Take me to that place where I feel safe
Take me to that place where I feel loved

VALIDATION THERAPY

A very popular form of conversation with dementia persons is the use of a program called validation therapy. The idea behind validation therapy is to "validate" or accept the values, beliefs and "Reality" of the dementia person - even if it has no basis in your reality.

Here is an example of how a validation therapy conversation might work.

John: "I have to find my car keys."
Me: "Your car keys..." ( I don't tell him he doesn't have a car or he hasn't driven for years)
John: "Yes, I need to get home - lot's of work to do, you know!"

Me: "You are busy today?" (I don't tell him that is flat has been sold)

Mary: I want to go home!

Me: Who is home? (I am not saying this is your home)

Mary: My mum and she is waiting for me.

Me: What’s your mother’s name? (I am not saying your mother is dead)

The key is to "agree" with what they want but by conversation and "steering" get them to do something else without them realizing they are actually being redirected. This is both validation and redirection therapy.

Does this always work? NO! But it has a pretty high success rate because it is so non-confrontational. If you can avoid direct confrontation, you will be much happier and so will the dementia person. I know that sometimes a direct confrontation is needed; but I see those confrontations occur far more often than they need to.

Does knowing this make hearing

"I want to go home" any easier?

I hope so.