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Wanting to Go Home
Practical suggestions for understanding problem behaviors
Possible Causes
Coping Strategies
- GENERAL:
- Go for a walk or drive. Getting out, even for a short time,
is helpful. Upon returning home, the person often recognizes it
as home.
- Respond to the emotion being expressed, e.g., "Are
you feeling scared?" or "I know you are feeling lonely."
- Offer reassurance, e.g., "I will take care of you,"
or "Don't worry. You will have everything you need here."
- Look at a photo album with pictures of person's
childhood. The chance to reminisce about the past may ease the
anxiety and trigger pleasant memories. Avoid asking a lot of
direct puestions that rely on memory and may cause anxiety.
- Try to redirect the person's attention with an activity,
food, music, dancing, a walk, or other exercise. Often, after a
while the person will forget about wanting to go home.
- Remove objects that remind person of going home, e.g.,
hats, coats, purse, coat rack, etc.
- Try keeping a diary or log. Write down every time this
behavior occurs. What time of day was it? What happened just
before it began? Who was present? What was going on in the
environment? Sometimes a pattern may emerge. If the person is
particularly insecure or frightened at the same time every day,
establish a very specific routine to help build security, and
look for distractions to help get through that time of day.
- Examine routine for events or stresses that may be
causing or encouraging wanting to go home. For example, in
nursing homes or foster care, shift changes are often stressful
times; Some people's anxiety about going home is triggered by
noisy, confusing shift changes.
- As A LAST RESORT, ask doctor about medications to calm
the person, if the behavior is very frequent and agitated, and
nothing else works.
- In a nursing home, adult day center, adult foster care home:
- Ask the person to assist staff in some way, (e.g., help set
table, sort laundry, greet people) to help him/her feel more
useful, important.
- Keep outdoor clothing out of sight.
- Work out a telephone routine with family members, if a phone
call is reassuring. This might involve a daily or occasional call
at a time when staff know the family member will be home.
Sometimes, merely giving the person the relative's phone number
to keep in their picket can be reassuring.
- Try a reassuring tape recorded message from a family member. It
might tell a day care client when he/she will be picked up, and
reassure that family knows where he/she is. It might help to tell
a nursing home resident that he/she is loved and missed and that
family will visit soon. However, for some people, a tape is more
confusing than helpful.
- Try having the person carry a letter that provides a brief
biography describing memorable events from his/her life. For
example, one such letter told when and where the woman was born,
whom she married, names of her children, etc. For someone who can
still read, this can be very reassuring.
- In a long term care setting:
- Have family stay with the person the first day of a move
into a long term care setting. This is often a disorienting,
frightening experience and family presence may be helpful.
- Try a large poster on a resident's wall or door from family
that lovingly describes their last visit together and mentions
that they will be coming again soon.
- Try a "visitors' book" that family and other visitors
write in. Staff will need to reinforce this by reading it with or
to the person. It can help convince a resident that he/she is
still loved and visited, and is not forgotten.
- Try looking at the resident's room together and identifying
personal possessions. (But don't argue or try to be too logical
with the person if this approach doesn't work.)
- Have someone go for a walk outdoors with the person who is
determined to "go home to mother's house." Eventually
the person may tire or be distracted.
- If this behavior occurs in the evening, try suggesting that the
person spend the night since it's late and go home in the morning.
- In a day care setting:
- Try making lunch later in the afternoon. Some day care
centers have found that the time after the meal is when people
begin to get restless and want to go home.
- Have family members write short notes describing their own
activities during the day, e.g., "I am going to lunch with
Ann and will be here to pick you up at 2:30 p.m. Have a nice time.
I love you. Your daughter, Joan."
Try a note from the family member that instructs the person to
remain at the day center until a specific time when he/she will
be picked up. "Mother, please stay here until 2:30 p.m. when
I will come to get you. Love, Jan."
OTHER CONSIDERATIONS
- Wanting to go home is sometimes a phase that eventually
passes as the illness progresses. It often seems to be one of the
most frustrating and difficult behaviors for both family members
and staff, and often requires a great deal of tact and creativity.
- Wanting to go home is often connected with the desire to
see loved ones who are long dead. Don't contradict the person or
try to reason about it, which may provoke pointless arguments or
may cause unnecessary grieving if the person had fogotten the
death. Instead, try to get the person to reminisce about the
person or home which is being missed. Again, it can be helpful to
help the person express the feelings of loss, fear, or insecurity,
which he/she may be feeling.
REFERENCES
- Alzheimer's Association (ADRDA) Chapter Newsletters
- Mace, Nancy and Peter Rabins. The 36-Hour Day. Baltimore:
The Johns Hopkins University Press, 1981
- Powell, Lenore and Katie Courtice. Alzheimer's Disease: A
Guide for Families. Massachusetts: Addison-Wesley Publishing
Company, 1983
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