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A lot of older folks with
confusion go through a stage of "wanting to go home."
No matter how often they're told they are at home, they don't
seem to recognize it as home. No matter how poor their memory,
the desire to "go home" crops up over and over, and
there's no diverting it.
No one can really get inside the thoughts and emotions of
someone with medium to later stages of a dementing illness. The
experts are probably getting fairly close to the truth when they
say the present is becoming more and more strange, unfamiliar
and frightening.
The desire to go home is probably the same desire you or I would
have if we found ourselves in a strange and unreasonable place.
We would want to go back to the home we remember as safe,
secure, and predictable. For the dementia patient this home is
most often the home of their childhood, where they were
surrounded by their parents and other loved ones. These are the
people they remember most clearly, as their more recent memories
are slowly eaten away.
The "home" they are usually looking for isn't any
particular house. Many would not recognize the house if you took
them there. It's the lost feelings of warmth, security, strength
and optimism of childhood and youth that they seem to yearn for.
So what do you do when the person you care for is obsessed with
wanting to go home?
First, try not to argue about whether your loved one is
"home." If he or she doesn't recognize it as
"home" at that moment, then for that moment it isn't
home.
Then, try diversion. Sometimes it actually works. Try going out
for a short walk, or a drive. There's a real chance that, on
coming back in the door, it may look like home again. For a
while.
Other diversions might be the chores that have to be finished
before doing anything else. Try to engage your loved one in
drying dishes, folding towels, dusting, making a sandwich or
tearing coupons from the paper. Often the engaged person will
forget about going home for a time.
Keep a photograph album handy for a diverting conversation.
Sometimes looking at pictures from their childhood and being
given the chance to reminisce will ease a feeling of anxiety.
Avoid asking questions about the picture or the past. Try to
make comments: "That looks like Uncle Harold. Grandmother
told me about the time he...."
A reassuring hug while you're doing these things can't hurt. A
neck rub or a back massage can be relaxing, reassuring and
diverting. We almost all like to be touched in these ways.
Put those things that are reminders about going home out of
sight. Hats, coats and purses can trigger the idea of going
home.
Sometimes the sight of the family car can trigger the need to
leave. If this is the case, try parking it out of sight. If you
must park on the street, ask the neighbor a few houses down if
you can park there.
If your elder with dementia is constantly bound and determined
to go home, one of the first things you must do is take
precautions against him or her wandering outside alone when you
aren't looking. Door alarms or deadbolts placed high on the
frame can reduce the chance of wandering. Even if your elder has
never wandered, and you don't think it's a danger, secure your
doors if he or she is ambulatory. The first time could be the
last deadly time.
Keep a log. You might find that certain times of the day are
worse than others. What is the common denominator about these
times? Is it near mealtimes (a snack might help). Is it during
times when the environment is noisier than usual? Is it later in
the day when shadows are creeping in? If you see a pattern, you
can take steps to lessen or avoid some of the triggers.
Routine is your friend. As much as possible try to do the same
thing at the same time of day, every day. The person with
dementia doesn't manage "spontaneous" very well, as
that usually demands a flexibility they no longer have. The need
for the safety of routine is why you will see the same thing, at
the same time, every single day on the activity chart in
an Alzheimer's residence. Sameness and predictability are
reassuring.
Wanting to go home is one of the most frustrating behaviors for
caregivers. It will eventually pass. In the meantime, if all
else fails, and as a last resort, ask the doctor about
medications for reducing anxiety. They can help immensely.
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