Yes, it can be truly difficult and painful, owing to the fact that there is no resolution. At the end of the day, the term 'comfort' becomes paramount. I referred, on another post, to the time when I was a small child, subject to very nasty nightmares, I was terrified. My father would come to me and take hold of my hand and remain with me, sometimes for half the night, despite him having to arise the next morning for work. That simple act, of consoling a frightened child, in this case myself and my own father, was all that might be done and it was the right thing to do. With dementia, the same approach is really required. The person-centred approach, that of comforting, when all else is beyond one's reach. We can discuss dementia and frontal lobes and the hippocampus or neuronal syapses, beta-amyloid, sleep patterns, genetics and so on and so forth. All highly relevant and fascinating in study and research and without question, important.
"Going home", the meaning behind which, if made crystal clear by the one requesting it, would make things so much easier, but dementia clouds the issue in a quite profound way. So, you cannot really address the question with a mind which is based upon logic, or suspicion (what do they mean?) because there is always that risk of exacerbating the problem. Therefore, there are times when you say nothing, simply hold a hand, give a hug, make a cup of tea - but YOU ARE THERE, that is important too - being there. And you hang on every word and pay attention to every 'look' of an eye, in order to strive to be as one with your loved one. Not at all easy, we have family to care for, jobs to go to and so on.
We can express emotion or anxiety, we can say "I want to go home" after a bad experience, or we are tired and seek the solace of our own bed. That is clear and concise. With dementia, that faculty we know is not there, the means or capacity to structure a thought which runs its course, is not there. The damaged brain cannot relate to the undamaged brain, because it makes no sense. This is why so often, a request (in the Care Home) can bring about a totally contrary response. "Do you need the bathroom XX?" "Don't be silly! You know I don't do that!!" Or a chicken lunch is seen and believed to be a fish lunch - no matter how hard you strive to convince, which is usually a huge mistake. Fear and anxiety are very real companions in dementia. But, I have found personally, that even in quite difficult situations (agitation or aggression) the application of 'comfort' over and above say distraction or 'white lies', can prove worthwhile. Every single case is as different as every single individual who walks upon this Earth and with that extraordinary creation, which we term 'the brain', having been in some way compromised by a disease, the challenge in terms of 'communication' is immense --- but not hopeless. And that feeling of 'letting down' comes about due to the fact that you have no choice, but above all you cannot rectify the nature of a dementia which inhabits your loved one, your mother, and in so doing, 'owns' her in a particular way. Therein lies an enormous challenge. But as has been stated before and as has been seen many, many times before, a simple taking hold of a hand can convey much much more than a thousand words and it requires no explanation.