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There is no hard and fast answer to addressing a problem behaviour.
The following information is provided as a tool to help the Caregiver find the solution that works for situation they are faced with.
For some unidentifiable reason, it's extremely common for a person with Alzheimer's to say that they want to go "home." And it's often not clear whether the person is speaking literally or figuratively.
- Sometimes, the solution can be as simple as taking the person for a quick drive or walk around the block, meanwhile playing along and pretending that you're in fact taking the person home.
- At other times, the person's "wanting to go home" can be a much more complex matter as it can be accompanied by bouts of agitation, anxiety, restlessness, and fear on the part of the person with dementia.
Wherever your situation may lie along this spectrum, a focus on the person's underlying feelings and emotions stated immediately above should take precedence over all else (with the exception of safety perhaps). In other words, try to address the underlying feelings, and not necessarily the explicit words "wanting to go home."
Physiological or Medical Causes
- Direct result of physical changes in brainIn
- Ability to recognize home as home - due to changes in perception, vision or hearing impairment
- Stress level to high ... too much activity or noise can make the person want to go home
- Feels bored ... not enough activity
- Recent move to new, unfamiliar place
- Feels insecure or frightened about the changes taking place in self or life
- "Home" means home of childhood - people with dementia may be searching for a home that no longer exists
- "Home" means a time when life was more comfortable
- Go for a walk or a drive... Getting out, even for a short time, is helpful. Upon returning home, the person often recognizes it as home.
- Respond to the emotion being expressed, e.g, "Are you feeling scared?" or "I know you are feeling lonely."
- Offer reassurance, e.g., "I will take care of you," or "Don't worry. You will have everything you need here."
- Look at a photo album with pictures of person's childhood ... The chance to reminisce about the past may ease the anxiety and trigger pleasant memories.
- Avoid asking a lot of direct questions that rely on memory and may cause anxiety.
- Try keeping a diary or log.
- Write down every time this behavior occurs.
- What time of day was it?
- What happened just before it began?
- Who was present?
- What was going on in the environment?
- Sometimes a pattern may emerge.
- If the person is particularly insecure or frightened at the same time every day, establish a very specific routine to help build security, and look for distractions to help get through that time of day.
- Examine routine for events or stresses that may be causing or encouraging wanting to go home.
- For example, in nursing homes or foster care, shift changes are often stressful times.
- Some people's anxiety about going home is triggered by noisy, confusing shift changes.
- Try to redirect the person's attention with an activity, food, music, dancing, a walk, or other exercise ... Often, after a while the person will forget about wanting to go home.
- Remove objects that remind a person of going home, e.g., hats, coats, purse, coat rack, etc.
- As A LAST RESORT, ask doctor about medications to calm the person, if the behavior is very frequent and agitated, and nothing else works.
Away from Home:
- Ask the person to assist in some way (e.g., help set table, sort laundry, greet people) to help him/her feel more useful, important.
- Keep outdoor clothing out of sight.
- Work out a telephone routine with family members, if a phone call is reassuring. This might involve a daily or occasional call at a time when staff know the family member will be home.
- Sometimes, merely giving the person the relative's phone number to keep in their pocket can be reassuring.
- Try a reassuring tape recorded message from a family member.
- It might tell a day care client when he/she will be picked up, and reassure that family knows where he/she is.
- It might help to tell a nursing home resident that he/she is loved and missed and that family will visit soon.
- However, for some people, a tape is more confusing than helpful.
- Try having the person carry a letter that provides a brief biography describing memorable events from his/her life ... For example, one such letter told when and where the woman was born, whom she married, names of her children, etc. For someone who can still read, this can be very reassuring
In a Long-Term Care Setting:
- Have family stay with the person the first day of a move into a long-term care setting. This is often a disorienting, frightening experience and family presence may be helpful.
- Try a large poster on a resident's wall or door from family that lovingly describe their last visit together and mentions that they will be coming again soon.
- Try a "visitor's book" that family and other visitors write in. Staff will need to reinforce this by reading it with or to the person. It can help convince a resident that he/she is still loved and visited, and is not forgotten.
- Try looking at the resident's room together and identifying personal possessions. (But don't argue or try to be too logical with the person if this approach doesn't work.)
- Have someone go for a walk outdoors with the person who is determined "to go home to mother's house."
- Eventually the person may tire or be distracted.
- If this behavior occurs in the evening, try suggesting that the person spend the night since it's late, and go home in the morning.
In a Day Care Setting:
- Try making lunch later in the afternoon.
- Some day care centers have found that the time after the meal is when people begin to get restless and want to go home.
- Have family members write short notes describing their own activities during the day, e.g, "I am going to lunch with Ann and will be here to pick you up at 2:30 p.m. Have a nice time. I love you. Your daughter, Joan."
- Try a note from the family member that instructs the person to remain at the day center until a specific time when he/she will be picked up. e.g. "Mother, please stay here until 2:30 p.m. when I will come to get you. Love, Joan"
- Wanting to go home is sometimes a phase that eventually passes as the illness progresses... It often seems to be one of the most frustrating and difficult behaviors for both family members and staff, and often requires a great deal of tact and creativity.
- Wanting to go home is often connected with the desire to see loved ones who are long dead.
- Don't contradict the person or try to reason about it, which may provoke pointless arguments or may cause unnecessary grieving if the person had forgotten the death.
- Instead, try to get the person to reminisce about the person or home which is being missed.
- Again, it can be helpful to help the person express the feelings of loss, fear, and/or insecurity, which he/she may be feeling
Alzheimer's Association (ADRDA) chapter newsletters
Mace, Nancy and Peter Rabins. The 36-Hour Day. Baltimore: The Johns Hopkins University Press, 1981.
Powell, Lenore and Katie Courtice. Alzheimer's Disease: A Guide for Families. Massachusetts: Addison-Wesley Publishing Company, 1983
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What is a Caregiver
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The Caregiver Code
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Protecting Yourself From Burnout
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How is Competency Defined?
Power of Attorney
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Communicating With Someone Who Has Alzheimer's
Your Approach Sets The Tone
Think Before You Speak
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Keeping a Dementia Journal
Making Caregiving Easier - Caregiver Notebook
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