Ask Miriam – October 2020
Dear Miriam,
My father, who has Alzheimer’s disease, came to live with my family and me six months ago, right before the COVID-19 shutdown. My husband works outside the house during the day, but I am home and working part-time. Our kids are grown and only one lives nearby. It’s been a big adjustment having my father here, but the worst part is when he doesn’t seem to know where he is and wants to “go home.” Miriam, we already sold his house and, besides, it’s not safe for him to live on his own anymore. Sometimes he starts taking his clothes out of the dresser and asking for a suitcase. When I tell him, “this is your home,” he just gets angry at me and tells me I don’t understand. Sometimes he walks out of the house in a huff and says he’s going to call a taxi (he doesn’t even use a cell phone!), and I have to follow him at a distance to make sure he doesn’t get lost. How can I convince him that he IS home?
—At a Loss
Dear At a Loss,
It sounds like you have a lot on your shoulders right now and dealing with the symptoms of dementia on top of everything else in your life can be stressful. I hope it will help you to know that it is very common for people with Alzheimer’s to be confused about where they live, sometimes thinking that they live in a past home. Perhaps, when they say they want to go home, they are simply seeking a safe place in the midst of world that has grown confusing for them. It is also quite common for this type of behavior to take place in the early evenings, a time during which sundowning is common. Sundowning typically consists of increased agitation, confusion, and the desire to go someplace.
There are several useful ways you can respond to your father. Unfortunately, reason and logic may not work anymore. Rather than arguing or trying to convince him that he is actually already home, try using a delaying tactic. For instance, let him know you will help him find a suitcase and pack, but that first it’s time for a snack, or dinner, or a chore that needs to be done. People with Alzheimer’s usually have short-term memory loss and it is possible that after the chore or snack has taken place, he won’t remember that he was going to leave. Of course, he may repeat himself, either later that night or the next night, and you can use the same tactic again (and he likely will not remember that you previously said the same thing). You can also agree with his statement that it’s not his house that he is in, and respond to him along the lines of “oh, we’re just visiting here, we’ll go home in a little while” or “we’re housesitting for a few days for a friend, we’ll go home soon.” These are called therapeutic fibs and they are helpful in reducing conflict. There is nothing your father can do about the fact that his brain won’t let him understand that he is really at home, so confronting him can only lead to increased levels of tension and anxiety.
The most important thing you can do in caring for your father is to provide a safe, calm environment. Be his ally, agree with him, use distraction, and try redirecting him to other activities, such as a favorite television show or task. I know it’s not easy and can take some creative thinking! For more ideas, please contact our Helpline at 844-435-7259. You can also write directly to Miriam with your questions at askmiriam@alzla.org.