How do I deal with my husband's delusions and wanting to go home without an argument?

A fellow caregiver asked...

My husband was diagnosed with AD 5 years ago. We moved to a condo 10 months ago because our house was too much for me to keep up and I find he is going downhill much faster now than in the past. Anyone else find this? Also, every night he imagines he is the leader of a large organization and has to make plans for the "members" which is something he did do 10 years ago. He also wants to go home each night...not to our last home but to one he lived in as a child. How do I deal with this? Everything I've tried just leads to arguing and anger on his part and then on mine. I don't have any help with him and I really feel like he is velcroed to me as we are together 24/7!

Expert Answer

Helene Bergman, LMSW, is a certified geriatric care manager (C-ASWCM) and owner of Elder Care Alternatives, a professional geriatric care management business in New York City. She consults with nursing homes and daycare programs to develop specialized programs for Alzheimer's patients.

Disorientation for an Alzheimer patient is often reflected in "I want to go home" statements. The short term memory loss has advanced to the point where they may not remember their present setting but instead retrieve the memory of where they lived from long ago. Thus, they feel afraid and in a strange setting and yearn for the comfort of their 'home'. They may even ask for their parents despite the reality that they died over 30 years ago. Reorienting your husband at the moment he exhibits these behaviors may or may not be effective. He may get, as you said, argumentative. An alternative response for a caregiver is to provide reassurance.......that he is safe where he is, that you are with him, that he will not be abandoned....and that you will take him 'home' in the morning when you get transportation. That is usually supportive enough to ease his anxiety.

His delusion (or misperception of reality) that he is CEO of the organization is another reflection of both his memory loss and disorientation. If his delusion is not harmful, it is often recommended that a caregiver support it.......and let him feel that the plans he will make for the organization are helpful. Often Day Care Programs will use this strategy with participants and let them perform 'voluntary' roles. It gives them a better sense of self esteem and dignity.

Caregivers need to try different techniques and strategies to see what works. Every individual is different with his/her dementia and the goal is to ease their distress or agitation.