When they want to go home and they are already home

Home is a feeling, and it has gone

He is not confused about the address. He is describing an absence. Home is the feeling of being somewhere safe where you know what happens next, and that feeling is exactly what memory loss removes, so a person can sit in their own drawing room and genuinely not be home.

Once you hear the sentence that way it stops being nonsense and starts being information. He is telling you he feels unsafe, or lost, or that something in the room is wrong. The bag by the door is the only way he has left to say it.

Often the home he means is not this one anyway. It is his mother’s house in the town he grew up in, fifty years ago, because that is where the feeling lives.

Do not prove him wrong

The instinct is to walk him round the house. Here is your chair. Here is the photograph of your wedding. Here is the tulsi you planted. It is reasonable and it does not work, because the problem was never evidence.

What it does do is turn a vague unease into a direct argument with the person he trusts most, and it usually ends with him more agitated than he started and you exhausted.

• Instead of "Papa, this IS your home", try "Tell me about home. What is it like there?"
• Let him talk. Ask who is there. You are looking for the year he is in, and it tells you who he is missing.
• Agree with the feeling, not the fact. "You want to go home. I know." is a whole complete answer.
• Then join him rather than steering him. Sit down. Make tea. Leaving is much harder from a chair with tea in front of it.

Delay is better than refusal

Saying no puts you between him and the door, and the door is where the argument becomes physical. A delay does not.

Not now, it is dark. Let us have tea first. The car is with your brother, he will bring it in the morning. Each of these is small, none of them is a fight, and the great majority of the time the wish has moved on by the time the tea is finished. This is not a trick you will feel proud of at first. It is the kindest available option and every experienced family uses it.

Look at the hour and the room

It happens in the late afternoon and early evening more than any other time, along with almost everything else that is hard. Tiredness and fading light take away the last of the ability to work out where things are.

Small physical changes help more than they should. Put the lights on before dusk rather than after, so the room never dims. Close the curtains, because a window turning into a black mirror at six o clock is genuinely frightening. Turn the television off, particularly the news, which is loud, urgent and full of places that are not here.

If he does leave

Plan for it once, calmly, in advance, rather than for the first time at nine at night in the rain.

Sew a label into the jackets he actually wears with a phone number on it. Tell the guard at the gate and the two shops at the corner, by name, that he may walk out and that they should call you rather than argue with him. Keep a recent photograph on your phone. Put a bell or a chime on the front door so you hear it open from another room.

And if you do find him outside, do not arrive angry, however frightened you were. Walk up beside him, greet him normally, and start walking together. A person who is confronted digs in. A person who is joined will usually walk with you.

Where else to look

These are other people’s pages, not ours. Our own published work and the neurologist who reviews it are on the research page.

• Cultural adaptation of Alzheimer’s disease assessment scale-cognitive subscale for use in India and validation of the Tamil version for South Indian population.
  The cultural adaptation of the same questionnaire for use in India.
• Hindi Version of Addenbrooke’s Cognitive Examination III: Distinguishing Cognitive Impairment Among Older Indians at the Lower Cut-Offs.
  A Hindi memory questionnaire validated for older adults in India.
• Alzheimer’s and Dementia Support, India
  The Alzheimer’s Association’s own pages for families in India.