Think about how you woke up this morning. Somehow you have a part of your brain that allows you to wake up, go to bathroom, make coffee and sit in a chair before your brain even needs to rub two neurons together. That is the auto-pilot function of the brain. It takes very little energy to run and allows you to function.
Contrast that with being on vacation and waking up in a hotel room. Your brain can’t go on auto-pilot as you do at home. Everything needs you to think about what you are doing. And the coffee is not as good.
Dementia patients use that auto-pilot brain for a reason: because they must.
Dementia is a disease that impairs an individual’s ability to create new memories, and the ability to have sound judgment. When people struggle or cannot create new memories, moving to a new place or even going to an unfamiliar environment can be an extremely disorienting. For most people with dementia, like Alzheimer’s, keeping their environment and routine stable is critical for their health and well-being.
Often, early dementia is mistaken for “being old and set in their ways,” which is true, but not the whole truth. People with early dementia who are taken out of their place, find it difficult to know where they’re going, what they should be doing, or how they’re going to get home. So, to keep things stable, they shop at the same store, they go to the restaurant and order the same meal and they even have the same conversations over and over. That allows them to keep using those old memories and old patterns that have worked in the past.
It’s not unusual that families will first see dementia symptoms when they take grandma on vacation with them and she no longer has normal routines to lean on. She is in an unfamiliar environment and is not able to orient herself. I recall a family member who, on vacation, had an episode of confusion that he later laughed off as a “senior moment.” It was the first, but it wasn’t the last.
This sensation of feeling disoriented and in an unfamiliar environment may be the psychological “ground zero” of the most familiar phrase in dementia: “I want to go home.”
Home, in this case, is more than just a place. Home is feeling safe and being where you belong.
Home is being surrounded by the people you love and who love you.
Someone who has good judgment and a working memory may be able to understand the need of moving to a new apartment, for their safety. People with memory loss will only feel the discomfort of being in a place where they have no memories and are not able to function.
So what is there to be done?
Move early or late, but hang tight in the middle.
If you can convince your loved one to move to a safer environment in the early stages of dementia, you will have a greater chance that they will acclimate successfully. Get them to make new memories while they can make memories. Similarly, if dementia has progressed to beyond knowing where they are, there is less problem moving. The danger zone is when they have limited function and poor memory; that middle ground of being aware of just enough to be confused.
If you must move them, to do it carefully.
Being careful about the setup of a new place is key. If you can set up their new apartment to be as close to their old environment as possible, that will make the apartment feel more like home. You may not be able to do that for every room but choose the most lived-in rooms: bedroom, kitchen and living rooms tend to be the most important, with the bedroom being at the top of the list. We at HopeBridge have helped people re-home, and it takes quite a bit of coordination and planning to make it happen.
If you are taking someone you love with dementia to a new environment, the most important thing is being with them. You can keep them feeling safe and supported. Even if their brain can’t grasp what is happening around them, they can feel secure that they are not alone.