Reasons why a person with dementia may want ‘to go home’

By Micha Shalev
Photo Micha Shalev, Photo Submitted

 “I want to go home” is one of the most heartbreaking and confounding phrases people with dementia may say to their caregivers, but the meaning behind that phrase is almost always logical.

For the most part, “home” can refer to a place, time or even a person. For those whose vocabulary has deteriorated, “home” is shorthand for where we are comfortable – where our needs are met and where we are loved. “I want to go home” tends to be an expression of discomfort: The person doesn’t recognize where he or she is and/or is feeling distressed and uncomfortable. At this point in dementia, memories of the distant past are strongest and are often happy ones associated with good feelings. Wanting to go “home” is often an expression of longing for that security.

   For the most part if they say “I want to go home” they might mean:

1. They are too hot or too cold.
2. They are hungry or thirsty.
3. They have to go to the bathroom.
4. They are tired and need a place to rest.
5. They are discomfited by glare or too little light to see clearly.
6. They are disturbed by noise (even music).
7. They are disturbed by the tension or discord of “where I am”.
8. They feel unsafe.
9. They need a hug and reassurance.
10. And this is most important – They feel out of place and unaccepted.

The plaintive cry, ‘I want to go home!’ is one that strikes dread in the hearts of family and friends, particularly if a loved one with dementia recently moved into a care home. However, it is a fairly common challenge in the mid to late stages of dementia. Here’s a few ways to deal with it.

1. Learn about where “home” is. Encourage the person to talk about “home”.
2. Engage the person in dialogue.
3.  Offer to take the person home.

But first, two common questions to ask yourself:

Should I try taking them to see their old home?
It’s doubtful whether this will help. In fact, it might make them feel even more agitated or upset, especially if they’re confused about the reasons they moved. Plus, it might not even be this particular “home” that they’re yearning for. It could be somewhere they lived 50 years ago!

Another approach: You might say, “We can’t go home today, but look at these pictures I found. They can help us plan a trip back there sometime.” Then distract with the images.

But if you think a trip down memory lane might help them and clear up some confusion, it could be worth considering.

Should I lie?
Nobody wants to lie to a person with dementia but if all else fails, a therapeutic lie may be necessary. Remember, your aim is to help your loved one feel as calm and content as possible. If that means saying “We’ll go home after we’ve had lunch,” or “We’ve just missed the bus, let’s go later,” then you could decide it may be worth it.

Offering up rational responses, such as “But you are home!” or “This is your home” are ineffective for someone with dementia because their intellectual capacity to reason is gone.

Micha Shalev MHA CDP CDCM CADDCT is the co-owner of The Oasis at Dodge Park, Dodge Park Residential Care and The Adult Day Club at Dodge Park located at 101 and 102 Randolph Road in Worcester. He is holding a master degree in health care management and a graduate of the National Council of Certified Dementia Practitioners program, and well-known speaker covering Alzheimer’s and dementia training topics. He can be reached at 508-853-8180 or by e-mail at m.shalev@dodgepark.com. For more articles visit www.fiftyplusadvocate.com.