How to talk to someone with dementia who wants to leave

She is standing in the front hall with her purse on her arm and her hand on the knob. You are behind her, and you are about to say the thing every daughter says first: "Mom, you live here." If you have searched for how to talk to someone with dementia who wants to leave, you already know that sentence does not work. This page is what to say instead, in the doorway, with your heart going, drawn from what the Alzheimer's Association, the National Institute on Aging, and the Family Caregiver Alliance publish for exactly this moment.

The rule: do not argue with the destination

The Alzheimer's Association's guidance for the middle stages of the disease is blunt on this. Avoid arguing. If the person says something you don't agree with, let it be. And: avoid criticizing or correcting; instead, listen and try to find the meaning in what the person says. The NIA says the same in its own words: be patient, try not to show frustration, and avoid arguing, and reassure the person that you are there to help.

Here is why. When your mother says she has to get home, she is not reporting a fact you can check. She is telling you how she feels: unsafe, unfinished, out of place. Correcting the fact leaves the feeling untouched and adds a new one, which is that the person in front of her thinks she is wrong. The Family Caregiver Alliance puts it this way: it is important to connect with the person on a feeling level, before you redirect. The Alzheimer's Association says to consider the feelings behind words or sounds, because sometimes the emotions being expressed are more important than what is being said.

So the order is: feeling first, then the errand, then the redirect. Never the correction.

Your body before your words

Before you say anything, get where she can see you. The Alzheimer's Association says to approach the person from the front and identify yourself. The NIA says to make eye contact and call the person by name, to be aware of your tone, volume, facial expressions, and body language, and to show a warm, loving, and matter-of-fact manner. Matter-of-fact is the phrase to keep. Not bright, not pleading, not scared. The voice you would use to tell a friend the kettle is on.

Do not block the door with your body. Standing between a frightened person and the exit tells her she is trapped, and nothing you say after that will land. Stand beside her, a little back, and let the door be there.

When she says "I have to get home"

When she says "I have to get to work"

This one deserves its own page, and it has one: "I have to get to work," and how to answer the reality she is in. The short version is the same order: the feeling of duty first ("you've always worked so hard"), then the errand ("let's get your things together"), then something in her hands. Do not tell her she retired twenty years ago. It is true, and it helps no one.

When she does not recognize her own house

Daughters search "mom doesn't recognize her house and wants to go home" more often than you would think, and the answer is not to prove the house to her. The deed does not help. What can help is making the room hers again in the ways her senses can still read: her afghan on the chair, her radio station, the smell of something she used to cook, the family photographs the NIA has in mind when it says to create a comforting home setting by reducing noise and clutter and keeping well-loved objects around the home. If she still wants to go, walk her out the door, around the yard, and back in the front, and let her come home.

What not to say

• "You live here. This is your house." A correction. It tells her she is wrong about the one thing she is sure of.
• "Dad died in 2011, remember?" If she is going home to him, this is a fresh grief every time you say it. Ask about him instead.
• "You can't go out, it's not safe." True, and it turns you into the person keeping her in. Delay the trip; do not forbid it.
• "Why are you doing this again?" She does not know. Neither would you.
• Anything in a raised voice. The NIA is specific: try to avoid appearing angry or tense. She will read the tone long after she has lost the words.

Simple questions, and time to answer

In the doorway you will be tempted to explain. Do not. The Alzheimer's Association recommends yes or no questions: "would you like some coffee?" rather than "what would you like to drink?". The Family Caregiver Alliance says to state your message clearly, in simple words and sentences, slowly and distinctly. The NIA says to allow more time for the person to respond and to try not to interrupt. Count to five after you speak. It is longer than you think.

And when it works, when she sits down with the tea and the purse slides off her arm, do not say "see?" Say nothing about the door at all. Talk about the towels.