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She is experiencing sundowners and takes 0.5mg of Ativan in the mid-afternoon. We tell her we will go tomorrow morning and it doesn’t seem to alleviate the desire to go home. She becomes agitated, aggressive and mean spirited. Any advice? Thanks.

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One day take her there. Take photos that you can share with her if she requests again. They tend to dwell on things from their childhood days. Find old photos of her at her home that she can look at. My mom called police one day & they came to her home. She told them that (my brother) this stranger had kidnapped her & took her to his house. My brother had told the officers that she had Alzheimer's &they handles it well. They asked her about the dog which was hers. They pointed out her chair which she said was hers. They pointed to the family pictures on the wall & she said they were family. Mom calmed down & was okay with staying there. Familiar items & places are comforting in times of stress for them.
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It can be taxing to have to respond to this request over and over again. But, over time, she will stop asking or at least ask once a month instead of daily. Its the thing she is focusing on right now; something in her thoughts or activities reminded her of events or people from her hometown and the past. Once she finds something new to occupy her thoughts, she'll stop asking on her own. Just reassure her you care and heard her request, perhaps telling her you'll take a trip when (whatever might cause her to understand "later" in your lives). With my uncle, we'd say, "As soon as its safe, we'll do (whatever his latest request is). Remember, COVID is keeping us from traveling or keeping us from being around lots of other people.

Once you've given a reasonable explanation, change the subject or redirect her focus to something else. It can even be to ask her about an object in the room she cherishes. You can use this technique again and again in most cases because they don't remember what the conversation was yesterday and that you discussed that cherished object before.

If those methods don't work, tell her to get ready, you've got some preparations to make and you'll be back later. then leave and don't come back right away. If she's actually packed or something when you do return, tell her the trip has been postponed for reasons beyond your control and you're waiting for the travel issues to be resolved and then you'll go.

If she still gets uncooperative or mean-spirited, quietly leave. You don't have to put up with being mistreated just because she has dementia. Go do something you'll enjoy or visit someone who understands your plight.

I hope these suggestions help. You have a difficult role to play right now. My heart goes out to you. Remember, her attitude is not your fault and its really not even directed at you though it may feel that way. She has little control in her life or even her thoughts and sometimes realizes that and is afraid and frustrated. Its not your fault. You can't protect her from the things she's experiencing. You can only let her know she's loved and don't forget to take care of yourself.
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It's common for people with dementia to want to go "home." It's symbolic, meaning that they want to go back to a time when they were independent and happy. You are doing the right thing by not arguing or trying to reason about it. Speak with her doctor about it. She may have to try other medications or doses to calm her. My mother's doctor prescribed seratonin (it's very mild). In my mother's senior facility some of the women had stuffed animals and baby dolls. This seemed to help them at a certain phase. She'll go through many phases. This phase is likely to pass. Have a Plan B for her and yourself, if her mental and physical states decline to the point where you can no longer care for her by yourself. Sadly, with dementia, health is likely to decline.
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My psychiatrist relative once said patients who get enough medication to disconnect with reality but not enough to sleep can hallucinate. The hallucinations can make the patient agitated.
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cjljml: Since 'to go home' has an altered meaning to a patient with dementia (think of a non existent brick and mortar structure), you must use redirection. If the current dosage of Ativan needs to be changed, speak to your DW's neurologist.
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How about just saying "Let's plan a trip soon when you are feeling better, I can get off work, insert excuse here." Just be reassuring and keep postponing.
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Home is not necessarily where they used to live. Rather, they seem to want to go to somewhere that gives them comfort, security, protection, love. It’s more of a state of mind rather than an old address.
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I think that just about all of our loved ones ask to go home, at some point.

Here is a useful video that explains, very well, how to deal with it:

https://youtu.be/tYNxcXLwZjA
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I have seen this occur with a neighbor. She had gone out with her only daughter (which she did often) and when they returned home, she refused to get out of the car. The daughter begged, cajoled, screamed to no avail. I offered to help her out of the car. She thanked me, but was stoic and said she wasn't going . When I asked why she said that wasn't her home.
We could NOT get her to move! I advised her frustrated daughter to drive her around and when they returned I would welcome them home. The daughter reluctantly did so. And when they returned, I welcomed them home. And problem solved.
So after this lengthy story, I agree with others who suggested going for a ride "home".
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Ativan is not a choice drug for dementia patients. My mom was put on that in nursing home, switched to Seraquel and it has helped, they also added Depakote and my mom is less agitated, both drugs help with mood stabilization.
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lealonnie1 Aug 2022
My mother with dementia had great success with Ativan which helped her with agitation. Everyone is different so saying "Ativan is not a choice drug..." is a broad and general term that isn't accurate.
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Hi. I’m sorry you are dealing with this.
My father-in-law had this happen multiple times. His solution was to put her in the car and drive around the block. When she arrived she did not make the connection that this was not the home to where she was referring. She seemed pleased to be “home”, felt heard, and no battles.
I hope this helps you.
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You are doing all the right things.

Maybe you can actually take her by the house and take a photo of her in front.

Or get a picture of the house (either old or current). When she asks about the house bring her the photo, or ask her to tell you about it.
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Her request to go home is not what you think. You could take her to her childhood home and she wouldn’t recognize it. She might even ask “Why are we here”? This request is very common with Alzheimer’s. Her negative behavior seems to imply you’re not getting it, you’re not understanding her need. There can be many reasons for her wanting to go “home”. Something is bothering her and it’s not a need to go home. She may no longer recognize her environment and feel insecure. She may be recalling a happier time in her life. She may be anxious, scared, confused, or even tired. Ask her to talk about her childhood home. As a last resort, go for a short drive and when you return tell her “We’re home”.
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My mom, a very religious woman, went thru this recently. She would stand at the end of my driveway and wait for her ride home. Sometimes for hours. It was frustrating and upsetting to see her struggle like that. There really is no answer. My sister would keep a note in her pocket explaining she's at her house now, family dynamics and tell her we are keeping her safe. When she kept telling me she wanted to go home, I would take her for a ride in the car, stop at D.D. and get a tea, distract her till it passed. Sometimes we would have to medicate her to get her to calm down if the ride didn't help. She passed recently and it occurred to me she finally did get to go home and is at peace. God Bless
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I just would say “we will go soon” then they will forget and maybe ask you again.
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What you are describing is so very normal for folks with any of the dementias, as their long term memory stays in tack much longer than their short term, and often the thoughts of their childhood home holds such feelings as being safe and loved, so why not want to go back there?
It's best to try and redirect her like it sounds you're doing, but sometimes you also have to use what we like to call in our caregiver support group, little "fiblets."
And that may sound like when she asks next time, "well honey you know there's some work being done right now on the house and I just don't think it will be safe for us to go right now. Perhaps it's best to wait until the work is done."
You get the picture. You have to be able to say whatever it is that will keep her calm and less aggressive.
And you stay calm too when you're explaining things to her, as our loved ones feed off our moods and attitudes, so it's important that we keep calm best we can.
Usually this is a phase that will pass, so hang on and just keep redirecting.
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I agree, her meds need to be upped. Trying to explain that it was 60 yrs ago that she lived there will do no good because that is where her memories are now. IMO they go back in time because they start losing Longterm memory.

I had my Mom out with me somewhere. An old friend asked her how her other kids were doing. Mom said "kids! I have no kids" and gave the woman a look like she was nuts. My Mom had 4 children and I was standing next to her. Mom had me at 21. Married to Dad for 55 yrs. The last time she mentioned any of her kids was me and my baby brother and how we were making her feel like she was crazy. We were the two who lived the closest. My sister had passed and my other brother lived 8 hrs away. I really think she thought I was her Mom. And Dad, she seemed to forget Dad early on. And believe me, he was not a man you forgot easily.😏
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I think for my dad, who is in his mid 90's, he wants to go back to Seattle because that's where he lived when he was young and that's where his memory is these days. He talks about it every visit. He can talk all day about his childhood, remembers the route he used to go to walk to school (which I verified on a map), his time in the military in WWII, but says little about the 50 years he lived in our current city. He talks about his parents too. I believe it gives him a feeling of comfort.
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Since dementia affects short term memory first, when someone wants to go "home", if you ask them to describe " home", you will get an idea of where their memory is at at that point. My husband, who has dementia, has been in the mid nineties for a couple of months. Fortunately, those were good years for us.
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"Go home" can also be tired, need to rest/lie down, be soothed.

Does music help? A peaceful sceanary DVD? Looking at old happy memory photos?
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Carelyn73 Aug 2022
You are right. Do an internet search on the phrase, “I want to go home” and you’ll get a title wave of information on what it really means. It seems to be textbook dementia and I hear it from my husband a lot! The first thing I do, as you suggest, is to ask if he is cold, tired, hungry or needs the bathroom. It’s often just that simple. He doesn’t actually want his childhood home, he wants to feel the comfort he remembers from that home. If he persists I tell him that the home was sold or rented and that there is a young family with children living there so we mustn’t disturb them. Then I change the subject.

Good luck. This can recur for a long time, until it doesn’t anymore!
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Ask doctor if you can increase the Ativan. And accept that this is the way she is now. You could change your answers occasionally, like “we are home,” or we’re going next week,” or whatever you think of. It doesn’t matter what you say because her mind can’t grasp it and she won’t remember any of it.
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