“I want to go home.”
Nearly every dementia caregiver has heard this heartbreaking plea from their loved one. They may already be at home or they may be struggling to accept their new surroundings after a move to long-term care, but this simple statement is still jarring. Home means different things for different people, but dementia tends to take this concept to a new and confusing extreme.
How Dementia Skews a Senior’s Perception of Time and Place
It’s fairly well accepted by dementia experts that the “home” most elders wish to return to is their childhood home. In the later stages of Alzheimer’s disease, for instance, it is thought that a senior may tap into remaining memories from long ago and revert to a younger period in their minds. The passage of time becomes confusing and overwhelming, so they seem to crave the familiarity of their family home or call out for long-deceased family members and friends as a source of comfort.
Remember that not every case of dementia is the same. My parents each had different forms of cognitive impairment, but fortunately, they never asked me to go home. However, since I was a daily visitor at the nursing home where they both resided, I did hear this plea from many other residents. I didn’t even know some of the people, but it was upsetting nonetheless. Of course, most of these people had Alzheimer’s disease.
Handling a Senior’s Pleas to Go Home
Many people initially take this desire at face value, especially from loved ones who are living in long-term care facilities. But, it’s important to understand that giving in to these appeals is not guaranteed to be successful.
Many families struggle with the decision to move their loved ones out of senior living and in with them, but this rarely pans out. Although the move makes sense logically, elders in the middle and late stages of dementia do not handle change well. It’s probable this person would become agitated and disoriented by yet another move and would still not consider it to be “home.” Unfortunately, this realization doesn’t make navigating such a heartbreaking routine any easier.
Caregivers and staff can gently remind a senior, “This is your home,” each time their anxiety increases. That’s okay, but it may not help much. If the person gets upset by hearing this, then drop it. Correcting or arguing with them will only make the situation worse. This is when you need to take a deep breath and accept that you will continually hear this plea. Expect it. Absorb it. Plan ahead. Then, begin using the distraction and redirection routine.
Validation and redirection are a dementia caregiver’s secret weapons. What this means is that, once the plea begins, you acknowledge their request and validate their feelings. Then you gently guide their attention to a different object, activity or topic of interest. If there is something in their immediate environment that is prompting this desire to go home, try moving to a different room or area to eliminate this stimulus.
How long will this distraction last? Maybe a minute or two, maybe an hour. It may not work at all, but it’s a start. If the first attempt doesn’t work, then try something else. Just remember to be respectful and understanding. Bring out a photo album, put on their favorite old movie, take them to an activity or class at the facility or play some soothing music. Ask them about their childhood, their career, time at school or starting a family of their own. Mastering redirection requires a lot of trial and error, so be patient and take note of what works and what doesn’t.
Here’s a tip for family caregivers whose aging loved ones are still living with them: If your elder asks to “go home,” try to determine if they have any immediate needs that must be met (e.g. hunger, thirst, pain), and then attempt the same distraction or relearning techniques. Some people go as far as taking their loved ones for a drive around the block and then re-entering the house. This approach can work for a while, but it depends on the elder and their level of cognition.
There Is No Reason to Feel Guilty
No matter what you do, you will likely hear this plea again no matter what you do or say. This will hurt your heart, but understanding that the home the person wants likely no longer exists can help minimize the guilt you feel. Even if you were to pack your loved one up and take them to their last home, they probably wouldn’t be satisfied because they may not remember it or it’s not really the home they are longing for. Deep down, they want to go to their childhood home from decades ago, not the place where they were living before their move to a senior living facility.
So, arm yourself with understanding and acceptance. This is yet another dementia-related behavior that simply cannot be fixed. Distraction and redirection can sometimes help keep this demand at bay for a while, but the pleas will continue until they are replaced with another obsession or behavior. Sometimes we just have to try our best and deal with it.
Aging Care 2020