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When I tell him that we are home, he refuses to believe me and continues to talk about wanting to go home. At bedtime, it often gets worse and I may spend a rather sleepless night because he will not settle down and relax. I have been giving him melatonin early in the evening to help him relax, and the neurologist has prescribed trazadone to help him sleep. But sometimes he gets so worked up, even the meds don’t help too much.

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I read once about a husband, who's wife did this. He said he would get her in the car and take her for a short drive and bring her home...it worked for him!
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I know this situation full well. My mother went through at least six prescriptions- and OTC melatonin and Benadryl- before we were able to find the one that keeps her settled in the early evening and through the night. We had to find a geriatric neurologist who was able to help. She still gets anxious but she will calm down considerably. I know very well how physically and emotionally it is on both of you. I was worn out every night
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I remember once when Dad wanted to go downstairs at his MC facility. (There was no 'downstairs'). I pushed him in his wheelchair all around the entire unit, which was shaped as a square (so there were 3 hallways, then the main area). By the time we got back to the main area, I said, "There, now isn't that better?" And he agreed. :)
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You are describing my situation fifteen years ago. My husband, Coy, developed obvious dementia in 2003, and very early on he wanted to go home. I spent a lot of effort and energy to convince him he was home. I'd point to a wall decoration and remind him that one of his friends gave that to us for our wedding. He nodded and named the friend. I reminded him of how long we searched before finding this perfect lamp. I showed him family photo albums. He acknowledged that they belonged to us. And then he'd go back to the door and wait for the bus to take him home.

What I know now is that people with damaged brains can believe two contradictory things at the same time. Coy could believe that all the things in the room belong to us, and that the room is a bus depot.

I learned that it is pointless and even harmful to reason with someone whose reasoning ability is gone. It is just frustrating for both of you, and generates negative feelings. I was trying to use logic with someone who was no longer logical.

I don't think I learned it soon enough to help in the early "I want to go home" stage, but I did learn eventually that things worked best if I could try to join Coy where he was, instead of expecting him to join me on the logical side of reality. Here is the approach I took later in his 10-year journey:

Why are you standing at the door?
I'm waiting for the bus to go home.
(Glancing at clock) Oh, I'm so sorry dear but there are no more buses tonight.
(Very disappointed) Oh no! I am so tired I just wanted to go to bed.
Well I know of a place you can sleep tonight, and we'll figure out the bus schedules tomorrow. I think you are going to like this place.
(Short wheelchair ride, at threshold of bedroom) This looks exactly like my bedroom at home!
I thought you would like it. I'll help you with your pajamas.

We were both satisfied.

Here is another responses that members have had some success with:

I can't take you home until they finish the work on the sewer system in the street. But aren't we lucky to have this nice place to stay while we are waiting? I bought some Girl Scout cookies today. Let's have a couple with a glass of milk."

No one is born knowing not to argue with someone who has dementia, and they don't issue manuals on the subject. I was lucky to find a local support group, online discussion boards, and books.
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I would let his neurologist know that the meds aren't working, perhaps they can adjust meds so you are both able to rest.

I am so sorry for what you are going through, for me everything is harder with sleep deprivation. I pray the Dr can help.
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