"I Want to Go Home"

So, in this blog we are going to talk about what it means when a person with dementia says "I want to go home" and tips for how to respond.  

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Now, the statement" I want to go home" or the question "when are you going to take me home?  can really throw some people off, especially when the person IS already home. And, using something like reasoning and logic often isn't effective, right? But, it is often a sure way to either increase anxiety, agitation, or start an argument.

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So let's talk about it.  

Why do people with dementia want to go home? We can start by thinking about reasons you may want to go home. Have you ever been somewhere and all you could think is "man, I'm ready to go home"?  I know I have!

Let's think about some reasons you may have wanted to go home...maybe you were

• Tired

• Bored

• Lonely

• Uncomfortable

• Just not having a good time

• Overstimulated (ex: too much noise)

• Situation was too demanding

• Don't see the point

• Feel like you've been there long enough

• Somethings got you upset or feeling anxious

• Have something you would like to or would rather do at home

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I'm sure you could think of a couple more reasons yourself as well...

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So, when a person with dementia tells you they "want to go home," we must remember that they are human first and as humans we are typically experiencing some type of triggering feeling that is making us want to go home.  

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Now, where is home? Why would someone want to go home, especially if they are already home? So home is not always a place, it's a feeling. I say not always because for some people it is just that — it's a place there are referring to. For some people they really do mean their house. For others they are simply referring to their room. Others could be referring to a heavenly place and others could be referring to a place from their childhood. It's important to know what your person is referring to when they mean home, but more importantly, it's crucial to understand what home represents and why they are wanting to seek it.  

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Does that make sense?

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So when you think of home, what do you think of?

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Maybe peace, comfort, familiarity, pleasant memories, love, safety....maybe some other things come to mind when you think of home.  

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So again, what we want to do is try to understand and acknowledge the feeling behind their desire to go home.

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We don't have to do this by lying to them....for example if it's not true that they are going "home" you don't have to say, "your daughter will be here to pick you up in a little while." Now, lying isn't always a bad thing. There are what some people call therapeutic lies or what I like to call opportunities to F.I.B..which stands for fill in the blanks...but some people can pick up on your lies and if you don't have to lie, it's usually better.  

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We also don't have to do this by using reasoning or logic: "Mom, this is your home now. We sold your house two years ago, remember?" Or "But dad, this is your house..." Followed by a grand tour of their items in efforts to trigger their memory and convince them they are already home. It's usually not that helpful and it can be really confusing.

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So, what we want to do is appeal to the unmet need, which is the most challenging part, right? Sometimes it takes tuning in to random things they may have said or done throughout the day or maybe what happened right before them asking to go home...to give us a clue about what they may feel like their missing

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But, one way we can appeal to the unmet need without knowing right away what it might be is by validating their feelings. The easiest way to do this is to repeat back what they have said to us in the form of a question. So, if the person says "I want to go home." You say, "You want go home?" or if the person says, "When are you going to take me home." You say, "You want to know when I am going to take you home?" This is the first step to letting someone know they have been heard.  After they respond, the conversation can take a number of different pathways.

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Now, I personally don't like to provide scripts on this because if your partner replies outside of the script oftentimes care partners have a difficult time improvising and navigating the conversation, which usually leads to them reverting back to old habits which is either lying or trying to use reasoning, which may not end too well.  

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So, where do we go after repeating back what they have said in the form of a question?

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No. 1: Be present.

That means stop what you're doing and join your partner in their moment. Remember, there is something going on that is triggering their desire to go home.

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No. 2: Talk in a calm, relaxed manner.

You don't want to sound irritated or bothered by the request.

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No. 3: Try Asking a simple question

For example: "What's wrong?" or "Where is home?" These two questions can lead you down a path to greater understanding and can be fun to dive in deep and find opportunities to shift the conversation in different directions. It also gives you deeper insight into what you should do next.

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Maybe they just need to be reassured and comforted – a hug, holding hands, a soft blanket, a doll or stuffed animal...maybe they are hot or cold or in some other way uncomfortable. Maybe they are feeling lonely and just want someone to talk to or be in their presence. Maybe they are bored and need to find purpose and feel useful, so you could have them help you with something. Maybe they need to get out the house – so you could take them for a car ride, to a park, stop for some ice cream, bring them with you on an errand — things like that.

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Now, asking questions and diving deep works really well for some people, but others...oh boy, some people will get really irritated if you start asking too many questions. Some people are just not into that "talk talk talk talk" stuff and this may happen even more as language and comprehension becomes more difficult.

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So, you can ask a question, but keep it simple and gage their response. Does your question just cause more irritation? If so, switch it up and divert the conversation to something more interactive like a snack, their favorite music, going for a walk, looking at pictures, engaging in an activity together — things like that.  

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Once you are able to move beyond them being adamant about going home, please don't bring home back up. Stay in the moment that the interaction has brought you to. So for example, you can start with home, but don't end with home. What do I mean by that? So, if the conversation is going good and you are now onto talking their favorite food — something that is not directly related to home. Don't then say, "So, tell me about your home?" It could end up being a master reset button and you may have to start from scratch. The point is not to talk about home per say. The point is to address their need and desire for home and find an opportunity to shift that desire into satisfaction being where they currently are in the present moment. Whether that be by reminiscing about the past to eventually things not directly related to home or by being comforted in the here and now or by feeling useful in the here and now...or whatever they are needing to be okay where they are.  

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Does that make sense?

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I don't want you to feel like you need a script or like there's a right or wrong way to approach your partner wanting to go home because there's really not. The goal, above all else, is to validate their feelings, comfort them, and help them fill that unmet need. As the saying goes, there's more than one way to milk a cow, okay? So, open yourself up to trial and error. Keep a journal of you successful and not so successful interactions. This may be really helpful in helping you navigate the request to go home in future interactions.  

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As dementia care partners, we want to try to create as many positive experiences as we can for both ourselves and our partners. So if you can keep that in the forefront of your mind and just try your best, you've done enough, okay? Please try not to be too hard on yourself if the interaction goes left — it sometimes happens. Try again next time, okay.  

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