What to do if a Person with Dementia Begs to Go Home?
If a person wants to go home, we first need to understand where home is and then we need to understand the reason that this person wants to go home. Using Validation, a method created by Naomi Feil for communicating with people who have dementia, we can learn which home the person would like to go to and the reason they want to go home.
I Must Go Home
A 90-year-old woman with memory loss bangs on the locked door pleading to let her go home. It could be the door at a senior facility, or it could be the door of her own home.
How do you react?
Methods Often Used When Someone Wants to Go Home:
Do you try to get her attention away from the door by telling her that there is an activity going on or it’s time to get something to eat?
Does it help? If so, for how long?
In most cases, the individual will be back at that door again sometime soon. Redirection may be a temporary solution, but not a long-term one.
Do you tell her that a relative will soon come to take her home just to get her away from the door? This again is a tactic that may only bring a temporary solution, but unfortunately, a therapeutic lie may lead to distrust since the woman may understand that no one is coming for her. In the Validation Method, we do not lie. We want to build a relationship of trust so the person we are validating will feel safe to open up and talk to us.
Reality Orientation: Do you correct the woman and remind her she is in a facility or that she is actually home? If this woman can no longer track time, Reality Orientation may make the woman more distressed because in her mind she is somewhere else.
The Validation Option
In this type of situation, we could first use one of the Validation techniques called Open Questions. We can ask who, what, where, when or how (not why) questions to try to understand the woman’s situation better.
Where is your home?
Who is at home?
If the woman answers that her children or her parents are at home, then we can understand which “home” in her past this woman wants to go to. If we don’t ask questions and try to understand what this woman is thinking and feeling, we have no idea of what “home” means to her.
Using an opposite question is also a good technique in this type of situation to understand the reason it is so important for this woman to go “home” now.
What will happen if you don’t go home?
The answer to this question can help us understand the woman’s reason for being anxious to get home. She may answer:
My parents will be worried
My children need to eat
Now we know which home this woman needs to go to and we also know why it is important for her to go home now.
Perhaps every day at around this same time in the afternoon, this woman goes to the door because she remembers she needs to prepare lunch for her children when they come home from school.
Or perhaps this woman just finished an art project at the facility, and she wants to bring it home to show her parents?
Each person is different, and each person may have a totally different reason for being at the door asking to go home. By asking open questions and listening, we can try to understand each individual and their reason for wanting to go home.
Validating – Listen and Explore
Now that we understand which home the woman is thinking of and the reason why she wants to go home, we can use Validation to explore more about her need to go home.
My Children Need to Eat
If the woman wants to go home to feed her children, we can ask her which of her dishes her family likes the most. This may allow this woman to talk about her cooking, maybe tell us who taught her to cook or what ingredients are in the dish. We can also explore more by asking which foods the family doesn’t like or which dish is her personal favorite.
Many times just allowing the woman to talk about her role as mother and cook and our appreciating what a good mother and cook she is, may be enough for this woman to no longer have the need to go home.
Perhaps being a mother and cook were very important roles for this woman. Now that she is in a facility or no longer useful at home, she has needs that are no longer being fulfilled. This woman needs to feel useful and to feel needed. As a mother, she fulfilled these needs. This may be the real reason the woman wants to go home, to return to a time when she felt useful and needed.
Perhaps we could also find something this woman could do at the facility or at home to make her feel more useful. Depending on her abilities, maybe she could help make a meal. Imagine how proud she would be knowing she helped when the meal was served. This woman may be able to help by slicing bananas with a plastic knife for a fruit salad or help knead dough to make bread. This woman may also help fold laundry, pair socks, or sort silverware. There are endless possibilities. We need to discover what works best for this woman’s abilities.
My Parents Will be Worried
If the woman wanted to go home to her parents, we could ask questions about her parents. Who was she closer to her father or mother? How did her parents meet? Did her parents support her? Were they strict? Did she feel love at home?
This can help us understand if the woman wants to go home because she is afraid her parents will be angry or if perhaps she misses their love.
Sometimes being in a facility can be very lonely, especially during this past year and a half when family were rarely allowed to visit. This woman may feel alone and missing a time when she felt loved and comforted by her parents. She may want to go home because she wants to return to a time in her childhood when she felt secure and loved all the time.
Depending on Covid-19 restrictions, we could use touch to help this woman feel more secure and cared for. We could also ask the family to bring photos of her parents to have in her room so she could look at the photos and remember them. This will also allow those caring for the woman to ask about the photos, so the woman can continue to talk about her parents. If this woman feels loved and secure, she may not have to bang on the door anymore and ask to go home.
It is important to take the time to understand and empathize with someone who wants to go home in order to understand what they are thinking and feeling. Validation allows us to do this and can help change the behavior rather than other methods that try to stop or ignore the behavior.
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