Dementia patient wants to go home but is home: what to do

When a dementia patient wants to go home but is home, "home" is almost never the house. It's a feeling of being safe, in charge and somewhere familiar, often from decades ago. So don't tell her she's already there. Ask her about home, check whether she's hungry, tired, cold or needs the bathroom, and offer to go "later." Most of the time the urge passes within minutes once she feels heard and her attention moves to something else.

The same approach works when your mom is in memory care and asks every afternoon when you're taking her back. The stakes feel higher there, because you're the one who moved her. The words are mostly the same.

Why dementia patients want to go home when they are home

Picture waking from a nap in a room you half recognize. The furniture is close to right but the light is wrong, and a woman who calls you Mom looks too old to be your daughter. You'd want to go home too.

For many people with dementia, home is a time more than a place. It might be the house she grew up in, or the years when her kids were small and every day made sense. The Alzheimer's Association suggests going with her to wherever she is in time instead of pulling her back to the present, and that works here. If she says she needs to get back to the farm, ask what needs doing there this time of year.

A few things make the go-home loop worse. It often peaks in the late afternoon and evening, which is part of sundowning. The Alzheimer's Association lists tiredness, low light and shadows, and picking up on a caregiver's stress as common triggers. Unmet needs play a part too. Hunger, thirst, pain, constipation and a full bladder can all show up as restlessness she can't name.

It's also a safety signal. The Alzheimer's Association lists "trying or wanting to go home even when at home" as a warning sign that someone may wander.

What to do when a dementia patient wants to go home but is home

Work through these in order. Skip the ones that don't apply.

1. Don't argue about the address. "You've lived here for 40 years" contradicts what her brain is telling her, and she'll trust her brain over you.
2. Check the basics. Offer a drink and a snack. Ask if she needs the bathroom. Notice whether she's cold, wincing or worn out.
3. Ask about home. Talking about it often gives her some of the comfort she's looking for. Old photos help.
4. Offer "later." "After supper" or "first thing tomorrow" lets her agree without losing face, and by then the urge has usually passed.
5. Give her hands and legs something to do. A walk around the yard, folding laundry or sorting a drawer gives that restless energy somewhere to go.
6. If nothing works, go. Put coats on and walk around the block or drive for ten minutes. Come back in through a different door and say something warm about being back.
7. Calm the house before dark. Turn lamps on before the light fades, turn the TV off and play music from her teens and twenties.

What to say when she wants to go home

These lines take the feeling seriously and leave the facts alone. Rephrase them in your own words if they sound stiff coming from you.

Some of these lines bend the truth, like the one about the drive in the morning. Many caregivers find that a small fib spares her distress she can't do anything with. If you're uneasy about it, the guide on therapeutic lying explains how to tell a kind fib from one that takes something from her. Questions alone, like "What do you miss most?", carry a lot of weight if you'd rather not fib at all.

When a dementia patient in a care home wants to go home

It's a common thing to hear in memory care, especially in the first weeks. The Alzheimer's Association lists moving to a new residence or nursing home among the changes that set off agitation. Hearing "take me home" doesn't mean you chose the wrong place, or that she would be happier back in a house she couldn't safely live in.

Family Caregiver Alliance makes the same point. These requests usually express discomfort, not a literal plan. It suggests answering with questions like "Tell me about your home" instead of arguing.

Some things that help in the first few months:

• Ask staff when "go home" talk is worst. Plan your visits for her better hours, often late morning, and avoid shift change and the late afternoon.
• Keep visits short and frequent. Family Caregiver Alliance suggests that three visits of 20 minutes a week can work better than long, rare ones, since she may not remember whether you stayed five minutes or five hours.
• Bring something to do together: a photo album, nail polish, a treat, cards or a short walk around the building.
• Agree on a calling plan. If she calls ten times a day, you don't have to pick up every time. Choose one call at her best hour, ask staff to redirect her when she reaches for the phone, and let some calls go to voicemail.

Many caregivers describe the same afternoon pattern. Take Tom, whose mother called him at 4:30 every day her first month in memory care, crying and asking him to come get her. He started calling her at 11 a.m. instead, when she was cheerful, and asked the aides to start an activity with her around four. The late calls dropped to a couple a week. When they came, he asked her what she'd had for lunch, told her he'd be there Sunday, and said goodbye before the conversation could circle back.

When wanting to go home turns into leaving

At home, a parent who keeps asking to leave may eventually just go. The Alzheimer's Association estimates that six in ten people living with dementia will wander at least once, and many do it more than once.

Simple changes help. Put deadbolts on the outside doors and hang bells or a chime on them so you hear them open. Night lights help her find the bathroom instead of the front door. Keep a current photo of her on your phone, and get her an ID bracelet with your number. The guide on wandering at night covers alarms and other safety steps in more detail.

When to call the doctor

Asking to go home on most evenings for months is usually part of the disease. A sudden change is different. MedlinePlus explains that delirium usually starts over a few hours or days, and that older adults, people with dementia and people in the hospital are at higher risk. Infections such as UTIs, medication side effects, dehydration and pain are common causes.

For any question about what to do next, at any hour, the Alzheimer's Association 24/7 Helpline is 1-800-272-3900. If evenings are the hardest part, read the guide on sundowning as well.

Questions caregivers ask

Why do dementia patients always want to go home in the evening?

Late afternoon and evening are when sundowning tends to hit. She's tired from the day, the light is fading and shadows make rooms look strange. A steady daily routine, daylight and activity earlier in the day, and lamps on before dusk can make evenings easier. Plan the go-home routine for that window, with a snack and the same calming answer ready.

What if a dementia patient wants to leave the hospital?

Tell the nurses right away that she has dementia and that she's asking to go home. Hospital stays raise the risk of delirium, so ask the team whether that's part of what's happening. If you can, have a familiar person stay with her, especially in the evening, and bring her glasses, hearing aids and a photo or blanket from home. Don't promise she's leaving today unless the doctor has said so.

My dementia mom wants to go home and calls me all day. Do I have to answer?

No. Answering every call usually keeps the loop going for both of you. Set a time each day when you call her, and ask staff or her aide to help when she reaches for the phone at other times. When you do talk, keep it short and kind. Ask about her day, say when you'll visit next and end with "I love you" before the go-home question comes back around.