The phrase, “I want to go home,” is one of the most frequently encountered and emotionally challenging situations for people caring for someone with dementia. When a person with memory impairment expresses this desire, it can cause distress, confusion, and frustration for the caregiver, even if the person is already in their own residence or a long-term care facility. This statement rarely represents a literal desire to travel to a physical structure. Instead, it is an expression of a deeper search for comfort, security, or familiarity. Understanding this underlying emotional need reframes the interaction and provides a path for a compassionate response.
Deciphering the Underlying Need
The request to “go home” is often a symbolic communication arising from cognitive changes dementia causes in the brain’s memory centers. Damage to these areas can cause a person to struggle with the timeline of their life, leading to confusion about their current location or the people around them. This disorientation frequently triggers feelings of anxiety, fear, and loneliness because the environment no longer feels familiar or safe.
The word “home” can represent a time in the past when the person felt more in control of their life, or it may symbolize the security of a childhood residence. For example, a person may be experiencing “time-shifting,” believing they need to return to their family home to perform a duty, such as picking up their children from school. This behavior is a form of flight response, a reaction to high levels of anxiety.
This vocalized need may also be an attempt to communicate an unfulfilled basic physical requirement. The inability to clearly express a need, such as hunger, thirst, pain, or the need to use the restroom, can manifest as emotional distress and the desire to seek the comfort associated with “home.” The request acts as a generalized call for help, signaling that something in the current environment is not comfortable or functional for them. Identifying patterns, such as the request occurring at a specific time of day or during periods of increased noise, can help pinpoint the genuine trigger.
Immediate Verbal Response Strategies
When faced with this plea, the most effective approach is to avoid correcting the person’s perception of reality or engaging in logical debate. Explaining that they are already home or attempting to reason will only increase their agitation and distress, as they are unable to process that information logically. The goal is to acknowledge the emotional message behind the words, which is a longing for comfort and safety.
The first step is validation, a therapeutic communication technique that acknowledges and respects the person’s feelings without agreeing to the literal statement. Statements like, “It sounds like you really miss home,” or “Tell me more about what your home was like,” validate the emotion while shifting the focus to a positive memory. This empathetic response allows the caregiver to enter the person’s reality, communicating that their feelings are heard.
Following validation, the conversation can be gently redirected using a technique sometimes called therapeutic “fudging.” This involves joining the person’s reality and then subtly diverting the topic to something related and pleasant. For instance, if they state they need to go home to make dinner, a response could be, “That sounds like a wonderful idea; what was your best recipe? We can’t leave right now, but maybe we could look at a recipe book together.” This strategy shifts the focus from the impossible task of leaving to an enjoyable activity.
The language used must be simple, delivered in a calm and soothing voice, reflecting non-verbal communication that reinforces a sense of security. Asking open-ended questions about their memories of home, such as, “What was the first thing you did when you walked in the door?” can encourage reminiscence and distract from the immediate goal of departure. Maintaining a relaxed posture and making eye contact at their level is essential to foster trust.
Shifting Focus Through Activity and Environment
After the initial verbal exchange, redirecting the person’s attention through a comforting activity can help de-escalate the situation and address the underlying need for security. Changing the physical environment is an effective method to break the cycle of fixation on leaving. Moving to a different room, stepping outside for a brief walk, or simply adjusting the lighting can provide a sensory change that resets their emotional state.
Introducing a meaningful task gives the person a sense of purpose and accomplishment, which helps alleviate feelings of boredom or restlessness that often trigger agitation. Simple activities that connect to past life roles are most successful, such as folding towels, sorting buttons, or watering plants. Even a short engagement, like listening to familiar music or looking through a photo album, can redirect anxiety.
It is prudent to quickly perform a check for unmet physical needs, as these often drive the distress. Offering a favorite snack or a drink can address hunger or thirst, while a gentle inquiry about pain can reveal a physical trigger for the agitation. A non-verbal approach, like a gentle, welcomed touch on the hand or shoulder, can also communicate support and reduce anxiety when words prove insufficient. By focusing on comfort, security, and engagement, caregivers can transform a difficult request into a moment of connection.