Dementia Patients Wanting To Go Home

Why Would Seniors With Dementia Want To Go Home

Often, the mid and latestages of dementia exhibit challenging behaviors in our elderly loved ones. Thefear, anger, sadness, confusion, and paranoia that dementia patients experiencecan result in violent and aggressive actions.

Learn more about thereasons that may make the elderly with dementia express their desire to gohome.

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The classic line I always use is that this is the disease talking. It is not the person, Hashmi says. There is a lack of awareness in that moment. Its not your mom or dad or spouse saying that. Its the disease.

When you are faced with a loved ones aggression, Hashmi suggests employing these 4 Rs:

When theyre feeling calmer, Hashmi says, you can try asking yes/no questions to help determine whether an unmet need is causing the behavior. Ask: Are you hungry? Are you thirsty? Are you in pain? Are you tired?

When A Dementia Patient Asks To Go Home Try This Innovative And Effective Trick

By Elizabeth Morey

One of the most challenging things about taking care of someone who is suffering from dementiawhether you are that persons spouse, child, or professional caretakeris knowing how to diffuse a heated or frustrating situation. People with dementia often become angry or confused when they cant have what they want and continue to ask for it over and over again or lash out at their caretakers.

One of these difficult situations occurs when a dementia patient is uncomfortable in their current residence. It may be that he or she now lives in a care facility of some sort and longs to return to their home. Or it may be that he or she is living at home but is remembering a childhood home theyd like to go back to. In either case, it is generally impossible for caregivers to take the person home, leaving them unsure what to do or say to make the patient feel better.

What would you do in this situation? Lie about why you cant take them home? Tell them youll take them home later? Try to tell them the truth about why they cant go home? Ignore the request completely? None of these answers seems quite right, and yet, what else is there to do?

In an effort to improve care and quality of life for dementia patients , Teepa leads classes and seminars focused on difficult dementia-related situations like the one described above.

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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 its a place that comforts you.

When experiencing discomfort, you can stop at a location where you can receive something to drink if youre thirsty, some food if youre hungry, and get someones help. Therefore, if the person you care for has dementia and repeatedly expresses a desire to return home, its possible that what theyre really trying to say is that they want to be in a familiar environment where all of their requirements may be satisfied.

Hospital Visits During Covid

Due to COVID-19, hospitals continue to update appointment and visitor policies to comply with state department of health guidelines to protect the health and safety of patients, visitors and employees. For example, visitors may be required to wear a face mask or cloth face covering. Or, they may not be allowed to accompany patients in clinics, hospital departments or the emergency room, with exceptions in certain cases. Before you plan a visit, call or check the hospitals website for information on their policies. Get the latest public health information on the coronavirus at coronavirus.gov.

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Following A Partner Or Carer Around

Dementia makes people feel insecure and anxious. They may “shadow” their partner or carer as they need constant reassurance they’re not alone and they’re safe.

They may also ask for people who died many years ago, or ask to go home without realising they’re in their own home.

Try to:

• have the person with you if you’re doing chores such as ironing or cooking
• reassure them that they’re safe and secure if they’re asking to go home
• avoid telling them someone died years ago and talk to them about that period in their life instead

How To Respond To I Want To Go Home

Address the emotion behind their words. When responding to their request, its best to focus your response on providing comfort and reassurance. Listen for what they are feeling behind their request – do you think they are anxious? Afraid? Confused? As dementia progresses, people are less and less able to put their feelings into words, and how they feel tends to come out in behavior, including repetitive questions and statements, instead.

Approach them in a calm and soothing manner and validate and respond to the emotion instead. If you stay calm, it is more likely they will start calming down.

Put their feelings into words by saying something like You must be feeling worried or Its hard that this place is so unfamiliar or I can understand if youre feeling sad right now.

And then do whatever you can to offer comfort. If they like hugs or holding hands or sitting close or having their arm or back rubbed, do that. Give them a blanket or other comforting object.

Join them in their reality. Trying to use logic and reasoning to get them to understand their situation or to convince them of a reality that is not their own will likely only make them more upset. Dont say things like But you *are* home, dad or This is your home now.

Again, validate that you hear their desire by simply saying I know you want to go home, or I wish you could go home too. If they feel heard and understood, they are more likely to be able to calm down.

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How To Respond To Dementia Patient Who Says I Want To Go Home

The following suggestions will definitely help thecaregivers and attendants at the nursing homes and assisted living facilitiesto handle the situation of seniors with dementia. However, itll be a good ideaif you become creative and establish proper responses tailored to your lovedones history, preferences, and personality.

Remember: Your Needs As A Caregiver Matter Too

Dealing with dementia behaviors can quickly wear out a caregiver or family member, causing caregiver burnout.

If your loved ones dementia behaviors have progressed to the point where you cannot manage them alone, help is available. Senior care options like home care or memory care can help relieve some of the caregiving burden while also helping to keep your loved one safe.

If you are feeling resentment, anxiety, or depression, seek help. A caregiver support group, counselor, friend, or family member can offer camaraderie and advice.

Other families, other caregivers, are going through the same thing, Hashmi says. They have a lot of common challenges and common solutions to share. And often those are the most effective, because theyre going through exactly the same process.

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Hospital Emergencies: What You Can Do

A trip to the emergency room can tire and frighten a person with Alzheimers or other dementia. Here are some ways to cope:

• Ask a friend or family member to go with you or meet you in the ER. He or she can stay with the person while you answer questions.
• Be ready to explain the symptoms and events leading up to the ER visitpossibly more than once to different staff members.
• Tell ER staff that the person has dementia. Explain how best to talk with the person.
• Comfort the person. Stay calm and positive. How you are feeling will get absorbed by others.
• Be patient. It could be a long wait if the reason for your visit is not life-threatening.
• Recognize that results from the lab take time.
• Realize that just because you do not see staff at work does not mean they are not working.
• Be aware that emergency room staff have limited training in Alzheimers disease and related dementias, so try to help them better understand the person.
• Encourage hospital staff to see the person as an individual and not just another patient with dementia who is confused and disoriented from the disease.
• Do not assume the person will be admitted to the hospital.
• If the person must stay overnight in the hospital, try to have a friend or family member stay with him or her.

Do not leave the emergency room without a plan. If you are sent home, make sure you understand all instructions for follow-up care.

Reminiscing Can Provide Comfort

The next time your loved one talks about going “home,” remember that it may be a reference to the past. Try to respond with some questions of your own. For example, you can ask about your loved one’s childhood memories, or you can look at old family photographs together. Reminiscing about childhood and the home where the person grew up can be comforting.

You might also try using validation therapy. With this approach, you validate your loved one’s experiences and emotions by asking questions that help them process their feelings. This can help your loved one work through the loss of their sense of comfort. Some questions could include:

• What was your childhood house like?
• Do you miss it?
• What was the best thing about your family?
• What was your favorite home-cooked food?
• How did the kitchen smell?
• Did you share a bedroom with your siblings?

Try echoing your loved one’s feelings. For example, you could say, “You must wish you could be at home right now.” This can help the person feel like you understand what they’re feeling. That can be very comforting.

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Common Changes In Behaviour

In the middle to later stages of most types of dementia, a person may start to behave differently. This can be distressing for both the person with dementia and those who care for them.

Some common changes in behaviour include:

• repeating the same question or activity over and over again
• restlessness, like pacing up and down, wandering and fidgeting
• night-time waking and sleep disturbance
• following a partner or spouse around everywhere
• loss of self-confidence, which may show as apathy or disinterest in their usual activities

If you’re caring for someone who’s showing these behaviours, it’s important to try to understand why they’re behaving like this, which is not always easy.

You may find it reassuring to remember that these behaviours may be how someone is communicating their feelings. It may help to look at different ways of communicating with someone with dementia.

Sometimes these behaviours are not a dementia symptom. They can be a result of frustration with not being understood or with their environment, which they no longer find familiar but confusing.

Getting Our Approach Right

People may refuse help from some care staff but not others. This is likely to be to do with the quality of relationships and the type of approach. Refusing personal care from a particular staff member may be the persons way of saying I dont know who you are, I dont trust you, Im embarrassed or Youre going too fast. All of these messages can be addressed for example, we can:

• give clear explanations and repeat ourselves as necessary
• not ask for too much at one time
• work at building a closer relationship with the individual, showing that they are valued as a person and not just seen as a focus for a care task
• ensure that we are going at a pace with which the person feels comfortable and safe, not hurried or rushed
• ensure we are respecting their dignity and modesty as much as possible.

Refusing help is how some people communicate their need to believe that they are still independent. It is very important that we respect this and ensure that we help people to do everything that they can still do for themselves. It is often easier for a person to accept help with aspects of a task that they find difficult if they have a sense of achievement gained through completing some parts of the task on their own. For more on these ideas, look at the section on Communicating well.

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Comfort And Reassure Your Loved Ones To Validate Their Needs

In most cases, our olderadults say, I wish to go home to mean that theyre anxious, tense, scared andthat they need extra care and comfort.

The best way you canhandle the situation is by giving a calm response and in a positive manner. Bydoing so, youll be validating your loved ones feelings and needs. This will,in turn, make them feel more understood and comforted.

Responding to your olderadult with a soothing, relaxed, and calm manner helps them calm down as well.If your loved ones like hugs, give it to them. Others may feel good when givengentle strokes or touches on their shoulder or arm. Others will feel comfortedand supported if you sit down with them.

More Useful Links And Resources

To learn more, download our guide for people living with dementia. This version includes forms and worksheets you can fill in online and print.

To learn more, download our guide for caregivers. This version includes forms and worksheets you can fill in online and print.

Access a print version of the guide for people living with dementia: this can be printed and filled out by hand.

Access a print version of the guide for caregivers: this can be printed and filled out by hand.

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Handling A Seniors Pleas To Go Home

Members of the AgingCare Caregiver Forum often ask how to handle these requests 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, its 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. Its probable this person would become agitated and disoriented by yet another move and would still not consider it to be home. Unfortunately, this realization doesnt 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. Thats 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.

Common Causes Of Aggression

Aggression can stem from:

• Confusion. When a senior is feeling disoriented and scared, they may act out with aggression.
• Physical pain or another unmet need. When a senior cant verbalize or address needs such as hunger, thirst, or pain, its common for frustration to build, Hashmi says.
• Emotional pain. Sometimes, agitation can be a sign that someone with dementia feels lonely, depressed, or isolated.
• Discomfort with a specific task. Does aggression come out specifically at bath time, bedtime, or while your loved one is getting dressed? These tasks may be triggers for aggressive behavior.
• Reactions to medications. Has your loved one recently changed medications? Do they experience difficulties with medication management? This might be interfering with their dementia diagnosis, leading to aggression.
• Vision or hearing loss. Issues with vision or hearing can compound the typical disorientation of dementia and can cause seniors to act out in confusion or as a cry for help.
• Sundown syndrome. Does your loved one become aggressive around sunset in particular?
• Fear. People often are confrontational when approached or touched by someone they dont know. For seniors with dementia, who may not recognize caregivers, doctors, and community residents, many daily interactions can alert a fight or flight response.

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