The request to “go home,” often voiced by individuals with Alzheimer’s disease and related dementias, is distressing for both the patient and the caregiver. This persistent longing occurs even when the patient is physically in their own residence or a care facility. Caregivers frequently struggle with how to respond, often feeling frustrated or heartbroken by the perceived unhappiness of their loved one. Understanding that this request is rarely about the physical location is the first step toward a compassionate and effective communication approach. The strategies discussed here focus on validating the patient’s feelings to reduce anxiety and promote emotional security.
Why “Going Home” is an Emotional Need
The desire to “go home” is not a literal request to return to a specific building, but rather an expression of unmet emotional needs. Cognitive changes in the brain, particularly those affecting memory and orientation, lead to feelings of insecurity, confusion, and anxiety. The word “home” symbolizes the feelings the person seeks: safety, comfort, familiarity, and belonging.
For many with Alzheimer’s, the mind retreats to an earlier time when they felt most secure, such as a childhood residence or a time when life felt simpler. Their current surroundings may feel foreign or temporary, even if they have lived there for years, because the brain struggles to place the present environment in context. This disconnect triggers the distress that manifests as the desire to leave. The request may also signal underlying physical discomfort, such as hunger, pain, or tiredness, which the patient cannot articulate clearly.
Counterproductive Responses to Avoid
Caregivers frequently resort to logical explanations, which are ineffective when communicating with a person experiencing cognitive impairment. Trying to correct the patient’s reality by stating, “But you are home,” or “Your old house was sold years ago,” only increases confusion and agitation. Using logic forces the person to confront a reality their brain cannot process, causing them to feel dismissed, unheard, or trapped.
Arguing or rationalizing with the patient about why they cannot leave is counterproductive and escalates distress. The person with dementia operates from a different framework of reality, and factual details will not register or provide comfort. Such responses erode trust and lead to increased anxiety and a greater frequency of the request. The focus should be on the emotional message they are trying to convey, not the literal words.
Strategies for Validation and Comfort
The most effective communication method is Validation Therapy, which focuses on acknowledging and respecting the patient’s expressed feelings and reality. This technique prioritizes empathy over factual accuracy, aiming to reduce anxiety and maintain dignity. Caregivers should first attempt to identify the emotional root of the request, such as fear, loneliness, or a lack of familiarity.
The first step involves acknowledging and validating the feeling behind the words, showing that their distress is understood. Phrases like, “It sounds like you really miss your home,” or “That must be a difficult feeling to have,” validate their experience without confirming the logistics of going somewhere. A calm, low-toned voice, gentle eye contact, and appropriate physical touch reassure them that they are safe and heard.
Next, the caregiver can join the patient’s reality by asking open-ended questions about the “home” they are seeking. Asking, “Tell me about your home. What was your favorite room?” or “Who did you see when you were there?” shifts the focus from present distress to positive memories of the past. This technique, known as reminiscence, brings comfort and helps the patient reconnect with a time of security and happiness.
After validation and reminiscence, the caregiver can use compassionate redirection, sometimes called therapeutic fibbing, to gently shift the patient’s focus. This involves a non-confrontational distraction that respects their wish while moving toward a present activity. For example, the caregiver might agree and say, “We can leave right after we have a cup of tea and finish sorting these photos,” or “I just need your help with this puzzle before we go.” The goal is to delay departure and engage them in a pleasant task until the desire to leave subsides.
Shifting Focus Through Environmental Cues
Beyond immediate verbal responses, the physical environment can be modified to reduce the frequency of the “go home” request by increasing feelings of safety and familiarity. The use of familiar objects and personal items helps ground the individual in a recognizable reality. Displaying family photographs, a favorite blanket, or cherished heirlooms can evoke positive memories and create a sense of continuity and belonging.
The sensory environment plays a significant role in minimizing confusion and agitation. Overstimulation from excessive noise, such as a loud television or multiple conversations, can be overwhelming for a person with dementia. Creating quiet, uncluttered spaces with soft, non-glare lighting helps prevent disorientation and provides a calming atmosphere.
Incorporating sensory triggers associated with comfort can also be beneficial. Playing music from the patient’s youth can be soothing and trigger pleasant memories. Similarly, using familiar smells, such as the scent of a favorite flower, baked goods, or coffee, can evoke a sense of home and reduce anxiety. These adjustments work in tandem with verbal validation to address the emotional need for security that underlies the plea to “go home.”