How to Calm a Person Living with Dementia Who is Wanting to Go Home

Strategies for Identifying Causes and Offering Comfort

If you’re caring for a person living with Alzheimers or another form of dementia, chances are you’ve heard the statement "I want to go home" before. Phrases like "I need to get out of here" or "I’m looking for my mom" are very common in dementia care, as they’re a symptom of a changing brain.

When dementia sets in, the brain undergoes chemical as well as physical changes. One of the first areas of the brain that gets damaged is the hippocampal region, the area of the brain that helps us keep a timeline of our life’s events and helps us orient ourselves in our surroundings. While the order and location of damage within the hippocampus varies by the type and form of brain change, it is one of the first parts of the brain to be affected in all types of dementia.

When enough of the hippocampal area has been damaged, destroyed, or chemically altered, the person will have a really hard time trying to hold on to the timeline of their life. Things we take for granted, such as knowing where you are, how you got there, or remembering the layout of your home, are no longer working properly.

To complicate things even further, the prefrontal cortex, the area of the brain that helps us to be reasonable and logical, gets damaged by dementia. In addition, a person’s language skills and ability to communicate decrease as well, leaving the person less able to express themselves.

While it can be frustrating for you as a caregiver (or care partner as we call them here at Positive Approach to Care®) to hear the person ask to go home while standing in the house they’ve lived in for many years, remember that blurting out "You are home!" isn’t going to help either one of you.

Instead, you may want to take a deep breath and try the tips below:

1. See If They Might Have an Unmet Need

All human beings have needs to meet, both physical and emotional in nature. Can you think of some of them? Take a look at the list below:

With a healthy brain, we can either meet those needs ourselves or ask for help. But if a person's brain has been affected by dementia, as explained above, they may not be aware of what is causing the discomfort, let alone be able to describe it.

So, if your person living with dementia says "I want to go home," what they might actually mean is that they're hungry, thirsty, or tired.

Now you may be wondering: Why does a person living with dementia that has an unmet need ask to go home or to see their mom? If you think through your own life and what your home and mom might mean to you, most likely it’s a place of comfort. A place where you can take a drink if you’re thirsty, get some food if you’re hungry, or have your mother help with pain that you might have. So when your person living with dementia is asking to go home, what they may really be expressing, is they’re looking for a place of comfort where their needs are met.

So, next time your person is asking to go home, take a look at the list of unmet needs above and think about what the day was like for them:

- Did they go to the bathroom? How long has it been?
- Did they get something to eat?
- Could they be in pain?
- Could their shirt have gotten wet and be causing them discomfort?
- Are they feeling bored or lonely?

Go through the list above and see if there’s an unmet need that you can help them satisfy.

2. Is the environment affecting the behavior?

While an unmet emotional or physical need may be the trigger for wanting to go home, there may be other causes too. If the environment the person finds themselves in does not feel friendly, familiar, functional, or forgiving, a person living with dementia might be quite uncomfortable.

What is the sensory or social situation? Are there smells or surfaces that might take them back to another time, such as the comfy sofa from their youth?

As you look around to see what might be causing distress, think about Teepa’s tips – separated into Fs and Ss to help you remember.

3. Be A Detective, Not a Judge

While it is understandable that one’s spontaneous reaction to "I want to go home" may be a response like "I don’t know what you want – you are home!," consider that if a person can no longer recognize their own surroundings, insisting they are home will not solve the situation.

Again, take a deep breath, and see if you can channel your frustration into curiosity instead. Put on your detective’s hat and see if you can get to the root of their request. So next time your person says "I want to go home," you may want to respond with "Oh, you have to get home. Now, do you need something there, or do you just want to be there?"

Notice Teepa Snow’s communication techniques in this response? Starting with a reflection, the first sentence mirrors back what the person has said. Not only does this help a person living with dementia keep a conversation going, it also signals that you heard them and you care.

Next follows a this-or-that style inquiry. By asking this type of question instead of an open-ended one, you’re offering options without being overwhelming, helping the person living with dementia keep a more fluent conversation.

Through curiosity, you might get a clue to an unmet need that you can fill, or another potential cause for their wish to return home. Plus, by empathizing with the person and showing interest in their worries, you meet them where they are and help protect the relationship that you two share.

Or as Teepa recently said: "You want to look for clues. We have to see clues within what they can give us because they can’t give us more than they can give us."

4. Consider Heading Outside

Conditions permitting, you may want to consider responding with "Okay, let’s head on out" next time they want to leave. By saying that, you’re giving the brain something new to look at, something new to listen to, and something new to experience.

And because they don’t want to be where they are, saying "let’s head on out" is a way to go "Oh, well, let’s see what’s on the other side of that door." Going out for a car ride, a little walk, or being willing to travel a little distance with someone can make a big difference. Take a phone with you in case you need it. It’s better to go with someone than trying to prevent someone who is wanting to get out.

Unfortunately, there are no black and white answers in dementia care, but these tips may be a starting point to help calm your person living with dementia that is looking to go home. Always remember to take a deep breath and a little break if you possibly can. You both need your safe and comfortable space to help protect your relationship on this journey of dementia.