One of the first things my (95-year old) mother lost when she started developing dementia (probably several types, maybe started as vascular) was knowledge/memory of where she was geographically - what town, what street, where the building was in relation to other buildings, how to get around in unfamiliar buildings, how to get from Place A to Place B. Last year, I moved her from New England, where she'd spent almost her whole life, to Southern California, where I live - from one memory care ALF to another. (Managing care from 2500 miles away wasn't working.) Much of the time she doesn't immediately believe that she's in SoCal, so I walk her outside and show her hibiscus flowers and palm trees. Today she couldn't get through her head that she's on the West Coast ... says she's an East Coast girl and feels out of place here. Nothing I can do about that feeling ... I'm very familiar with it, having taken years to adjust to having the ocean to the west and the landmass to the east, and somewhat to the subtle change of seasons. So I assure her she isn't nuts to feel that way. The problem is that not knowing where she is really disturbs her -- and she has enough insight to know what disturbs her. She recognizes her room, much of the time, but can't remember the name of the ALF, or the town, or what state she's in, or if California is east or west (and gets so upset that she wonders if we're still in the US). She wonders how far away I live and what route I take to drive. It's the not-knowing that drives her nuts and I think is one of the reasons she wants to "go home" - which, when I ask her, is the city she grew up in, rather than the town she lived in for 60 years. She lies on her bed and figuratively gnaws on herself trying to figure it all out. And she still is at the stage of wanting to know reality (except I don't tell her her mother died 25 years ago). I have quite a few books of strategies for dementia care, but none of them address how to help someone who gets anxious about not knowing her geographic location and relationship to the rest of the town, state, country, etc. I just gave her an outline map of the US. I have a folder labeled "Answers to Ruth's Questions" with Q and A lists in it that she and I developed together, which she does read and finds helpful; one page in it is "Where am I?" I try to distract her and get her out of her room or doing some activity ... but that doesn't help when I'm not there. Has anyone dealt with this? Any suggestions?