A dementia patient wants to go home, yet they are already at home? Read tips for families on understanding the feeling and calming them without arguing.
As late afternoon approaches, you see your mother putting on her coat, slipping her handbag over her arm and waiting by the door. "Come on, take me home, the children will be back from school," she says. Yet she is standing in the living room of the house she has lived in for forty years, and "the children" grew up long ago and set up homes of their own. However much you explain, she insists, "This isn't my home"; and the more you insist, the more restless she becomes. This is one of the situations caregivers face most often and find hardest: a dementia patient wants to go home, even though they are already at home. In this article I look at what may lie behind this wish, how you can respond without getting into an argument and how both the patient and you can be protected during this process. For a medical assessment of changes in behaviour, it is always necessary to consult the doctor who follows the patient's care.
A Dementia Patient Wants to Go Home: What Does This Wish Express?
In dementia, the word "home" often describes a feeling rather than an address. The home the person is looking for is not four walls; it is a time when they felt safe, capable and at ease with what was familiar. That is why saying "But this is your home" does not reach the real source of the problem.
There may be different reasons behind this wish:
- Going back in time: In their mind, the person may be living in their youth or childhood. The home they are looking for is the house in the village where they were born, or in the neighbourhood where they lived when they first married.
- A sense of strangeness: As memory loss progresses, the furniture and rooms of their own home, and even family members, may start to feel unfamiliar. This gives rise to the feeling "I'm not where I belong."
- Insecurity and anxiety: In a setting they do not fully understand, the person wants to return to a place where they felt safe. "I want to go home" often means "I'm frightened, comfort me."
- Longing for a task or a role: Sentences such as "The children will be back from school", "I need to feed the animals" or "I'm late for work" may show that the person is searching for the sense of responsibility and worth they once had.
- Physical discomfort: When the person cannot name needs such as hunger, thirst, needing the toilet, pain, tiredness or feeling cold, these can show up as restlessness and the urge to "leave".
- Environmental stimuli: A noisy setting, lots of visitors, a loud television or dim lighting can increase confusion.
Let's say an eighty-year-old father who spent his life farming in a village has been living for a few years with his son in the city. Every evening, shortly before the call to prayer, he gets up and looks for his shoes: "I haven't watered the cows, I need to go to the village." Each time, his son explains that the village house has been sold and the animals are long gone; and each time, the father grows angrier. One evening, instead of arguing, his son asks, "What were the cows called, Dad?" For half an hour the father talks about his animals, the barn and the morning milking; then he calms down and drinks his tea. What is being sought in this example is not the village, but the life in which the father was once responsible, capable and needed.
That is why, when a dementia patient wants to go home, the first question should not be "How do I persuade them?" but "What do they need right now?"
Restlessness That Increases in the Evening
Many families notice that this wish intensifies particularly in the late afternoon and evening. This is sometimes referred to as "sundowning". The fading light, the tiredness that builds up over the day, the increased activity in the house and the shadows becoming less distinct can heighten anxiety and confusion in a person with dementia.
During these hours, as restlessness at home increases, the caregiver's own tiredness is also at its peak; dinner is being prepared, children are coming home, people are returning from work. This is why tension can easily escalate on both sides. Planning the evening hours in advance, for example switching the lights on early, closing the curtains, putting on calm music and scheduling a familiar, quiet activity for these hours, can help reduce restlessness. The routine during the day also affects the evenings. Sitting by a window that gets daylight in the morning, taking short walks to the extent the doctor considers appropriate, not sleeping too long in the afternoon and not leaving the evening meal too late can ease evening restlessness in some patients. Noting in a small notebook for a few weeks at what times and in what situations the restlessness increases can also help you see patterns and give the doctor clearer information.
If there is a sudden and marked change in behaviour, for example if confusion increases noticeably over a few days, remember that an infection, pain or another medical cause may lie behind it, and consult a doctor without delay.
A Dementia Patient Wants to Go Home: How to Respond Without Arguing
In this situation, families' first reflex is usually to remind the person of the facts: "Mum, this is your home, look, this is your armchair." But because reality works differently in the patient's mind, this argument usually makes them more anxious and angry. What helps more is to respond to the feeling.
1. Notice the feeling and name it
A sentence such as "You want to go home; I think you're not feeling comfortable here" helps the patient feel understood. When people feel understood, they are more open to calming down.
2. Ask about home and let them tell you
Questions such as "What was your home like? Did it have a garden?" make room for the patient to describe the place they are longing for. Often, talking about it softens the urge to leave; meanwhile, the patient holds on to memories in which they feel safe.
3. Gently redirect
While they are talking, or once they have calmed down a little, you can turn their attention to another activity: "Shall we have a cup of tea together before we set off?", "Would you help me fold this washing?" Small, familiar tasks that make use of their hands also support their sense of being valued.
4. Make use of familiar objects
Old photo albums, a favourite song, their own tablecloth or an old possession can strengthen the feeling of "being at home". Some families prepare a "memory box" for the patient; opening this box together in restless moments can help.
5. Consider a short walk
Sometimes stepping out of the door for a short turn in front of the apartment block or in the garden meets the need to "go home". On the way back, saying "Come on, let's go inside" can help the patient recognise their own home again. Of course, this should take place in a safe setting and with you accompanying them.
What to Say, and What Not to Say, to a Person With Dementia
The sentences below are fictional examples; the aim is to see the difference between attitudes that argue with the patient and those that accompany their feelings.
Sentences you might do well to avoid:
- "How many times do I have to tell you, this is your home!" (It shames the patient and increases their anxiety.)
- "Your mother and father died forty years ago, who are you going to go to?" (The patient may grieve again as if hearing about the loss for the first time.)
- "Your memory has really gone." (It damages their dignity and can lead to anger.)
- "Just stay where you are." (It deepens the feeling of loss of control and helplessness.)
Sentences you could try saying:
- "You miss home, don't you? Tell me, what kind of home was it?"
- "I'm here, I'm with you, you're safe."
- "It's about to get dark; shall we talk about it tomorrow morning? Let's have some soup together now."
- "Would you help me? You've always been so good at this."
Some families use small, harmless redirections to help the patient calm down, such as "Dad says he'll come and fetch you tomorrow." Whether or not to use sentences like this is a decision each family makes according to its own values and the patient's condition. What matters is reducing the patient's anxiety and protecting their dignity; trying to force them to accept the facts usually serves neither of these aims.
When a loved one with dementia wants to go home, what they are looking for is often not an address but someone beside whom they feel safe.
Safety: Precautions Against the Risk of Getting Lost
The wish to "go home" can sometimes turn into actually leaving the house and walking off. A person with dementia going missing is a very frightening experience for families. Some general precautions can help reduce this risk:
- The patient carrying a card or wristband with their name and a relative's phone number
- Securing doors so that the patient does not easily notice how to open them, while still allowing them to be opened in an emergency
- Letting neighbours, the building caretaker and local shopkeepers know about the situation
- Keeping an up-to-date photograph of the patient ready in the family
- Knowing the patient's restless times of day and increasing supervision during those hours
If the patient goes missing, call 112 (emergency services) without delay. It is also useful to talk about safety measures and the patient's general condition with your doctor and, if necessary, with social workers.
The Caregiver's Burden and Feelings
Answering the same question many times a day and facing the same restlessness every evening wears the caregiver down deeply. The question "Doesn't she recognise me any more?" is heartbreaking. Sometimes anger, sometimes deep sadness, and sometimes feeling as though you have lost the person while they are still alive, in other words anticipatory grief, can be experienced. I have discussed the effects of caring for a person with dementia on the family more broadly in the article on supporting a relative with dementia.
When the same scene repeats every evening, the thought "I want to run away too" may sometimes cross the caregiver's mind as well. These feelings do not show that you are not a good caregiver; they show that you are carrying a very heavy burden. Sharing the care within the family, having another family member present during the hours that are hardest for you, and opening up small breathing spaces for yourself are necessary for long-term care to be sustainable.
Grandchildren and other children at home can also be affected by this situation. For a child who sees their grandmother not recognising them or crying to "go home", an explanation suited to their age, such as "Grandma's memory has become ill; sometimes she thinks she's in a different time. It's not your fault, and she still loves you", reduces the child's fear and hurt.
In a patient diagnosed with early-onset dementia in their fifties or sixties, the wish to "go home" can sometimes reflect a longing for their job, their former role or their independence. In this case it is especially important to make room for the person to take part in the tasks they are still able to do.
When Should You Seek Professional Support?
Changes in behaviour are to be expected as dementia progresses; but in some situations it is necessary to seek medical and psychological support:
- A sudden, marked increase in restlessness or confusion (consult a doctor)
- The patient frequently leaving the house and an increasing risk of getting lost
- Intense anxiety, crying, aggression or sleeplessness making daily care very difficult
- The caregiver constantly feeling burnt out, angry, hopeless or helpless
- The caregiver neglecting their own health completely
An assessment by a neurologist or psychiatrist is important for managing behavioural symptoms; decisions about medical treatment should always be made together with the doctor. If, as a caregiver, you are having thoughts of ending your life or of wanting to die, do not carry this alone; in an emergency, call 112.
How Is the Family of a Person With Dementia Supported in Therapy?
Psychological support does not change the course of dementia; but it can help the caregiver carry this process feeling less alone and less guilty. Topics frequently worked on in therapy include anticipatory grief, guilt and anger, sharing the burden of care among siblings, setting boundaries and self-care.
In a cognitive behavioural approach, thoughts such as "I'm a bad son because I got angry with him" are identified and a more compassionate inner voice can be developed. Calming methods that can be used in difficult moments and problem-solving skills are also areas of work. For family members who find it hard to leave the house because of caregiving, online therapy can be a way to make time for yourself without leaving the patient alone. For more suggestions on everyday communication with a person with dementia, you can also look at the article on how to talk to someone with Alzheimer's.
Frequently Asked Questions
Should I keep reminding a person with dementia that they are at home?
Generally, no. Insisting can increase the patient's anxiety and anger. Responding to their feeling, making room for them to talk about their home and gently redirecting their attention to another activity is usually more calming.
Why does the wish to go home always increase in the evening?
In the evening, the fading light, the tiredness that builds up over the day and the activity in the house can increase confusion in people with dementia. Switching on the lights early in the evening, calming the environment and creating a familiar routine can help.
What should I say if the patient asks for their mother or father who has died?
Reminding them of the loss every time can make them grieve all over again. Instead, acknowledging that they miss them and asking about their memories ("What was your mother like?") is usually a more compassionate approach.
How do I protect myself as a caregiver during this process?
It is important to share the care, take regular breaks, keep up with your own health check-ups and find a space where you can talk about your feelings. If you are experiencing signs of burnout, getting support from a professional can be helpful.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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