People living with dementia sometimes tell us they want to go home. And sometimes we respond by saying, “But you are home!”
It’s true: They are home, whether that’s in the house they’ve lived in for the past 40 years or a residential facility they moved into when they needed a more supportive place to live. But their home doesn’t feel like home. Maybe it doesn’t even look like home.
Because of changes in the hippocampus—the part of the brain that’s responsible for helping us identify familiar surroundings vs. unfamiliar surroundings—the person living with dementia doesn’t recognize that sofa in the living room or remember how to get to the bathroom anymore.
Not too long ago, care partners were taught to use something called Reality Orientation in such situations. Reality Orientation is simple enough: Tell the person where they are, what’s real and what’s not real, and then expect them to behave accordingly.
The problem with that approach is that we don’t recognize or acknowledge where that person is in their own mind. In other words, they simply do not believe that they’re home because this doesn’t look or feel like home. And telling them that it IS home will not be an effective strategy.
So how, then, do we respond? Here are a few tips:
- First, acknowledge their reality, as well as their distress. “Oh, so you’re wanting to go home.” The person needs to know you understand what they’re saying.
- Second, try to engage them on the subject, but in a way that will distract them from that distress. For example, “Tell me more about home. What does your home look like?”
- Then, continue to use follow-up statements or questions. “Oh, so your home had a swing set in the backyard for the kids?”
By validating the person’s emotion—what they’re experiencing right at that moment—and then using reflective statements and questions to allow them to talk about that subject in a wider context, you can reduce their distress and create a meaningful moment to engage.
Rosemary Apol-Hoezee, RN, MPH, CPRHM
Dementia Specialist
If you’re struggling to communicate and connect with a loved one living with dementia, you’re not alone. Support is available through the Dementia Institute. Learn more about our Family & Friends Caregiver Course at the link below.