Todays blog post was inspired by the article, ‘Home again, home again, diggidy-dig‘, published in The Monthly, and reminded me of the word Hiraeth (pronounced heer-eyeth) which is a Welsh word representing a profound, bittersweet longing, nostalgia or yearning for ‘home’.
This ‘home’ can be memories of an actual home, or of a time lost, and which is now unreachable. In some cases, maybe this ‘home’ never even existed, but is real in our memories. It goes beyond simple homesickness, embodying a deep, often spiritual, emotional attachment to one’s past, heritage, or idealized past.
I’ve previously written about Hiraeth and dementia, and its relevance to people with dementia, especially those locked away in segregated dementia units. Instead of the care sector and health care professionals (including medical doctors) recognising – and responding to the impact – and grief of being forced to move out of one’s home, and the nuances around the loss and grief people with dementia experience, and the longing for ‘home’, they instead continue to medicalise and pathologise normal human responses to distress. They refuse to ‘rethink dementia‘, and the gross and ongoing violations of our rights continue to be ignored.
Feeling “trapped” in a dementia unit is extremely common, and is a distressing experience for people living in secure institutional settings, made worse because people with dementia are segregated because of their diagnosis. The experience can cause apathy, depression, withdrawal, increased agitation, anger, ‘wandering‘ and many other distressing responses reducing the persons quality of life. These are all responses to grief. These responses stem from restrictive practices and other violations of human rights, and a loss of autonomy, and to the loss and grief people with dementia experience. They are rarely due to the dementia itself.
The excerpts below from the article ‘Home again, home again, diggidy-dig‘ really resonated with me, and inspired me to read more about homesickness, longing and its relevance to people with dementia, and to write this blog;
“As far back as I can remember, my mother has said this. At the end of any car journey, sometimes with a hand gesture like a magician revealing a rabbit, sometimes murmured to herself like a charm…“
“Home is the place you miss so much it makes you sick. Home again, home again, diggidy-dig.”
— Read the full article authored by Evie Wyld here www.themonthly.com.au/issue/2024/august/evie-wyld/home-again-home-again-diggidy-dig
Understanding Hiraeth
Hiraeth is a Welsh concept describing a profound form of longing for home. Unlike ordinary nostalgia, hiraeth refers to a complex emotional state involving yearning, grief, displacement, and the sense of belonging somewhere that is no longer accessible. It encompasses loss not only of a physical place but also of identity, community, culture, and the feeling of being “where one is meant to be.”
Scholars often describe hiraeth as a homesickness for a home that cannot be returned to, whether because the place has changed, the person has changed, or the circumstances preventing return are insurmountable. It therefore carries elements of mourning, existential dislocation, and emotional exile.
Institutionalisation as Forced Displacement
For many people living in residential aged care facilities or nursing homes—most often placed there against their wishes—the experience parallels the emotional landscape described by hiraeth.
Institutionalisation frequently involves sudden removal from one’s home, neighbourhood, social networks, and daily routines, which collectively form a person’s sense of self and belonging. Research consistently shows that this transition can produce intense distress, depression, and feelings of abandonment (Brownie & Nancarrow, 2013; Castle et al., 2020).
Unlike voluntary relocation, entry into nursing homes is often characterised by:
- Loss of autonomy and control
- Separation from familiar environments
- Disruption of identity and social roles
- Reduced connection with community life
These experiences create a form of social and spatial displacement, where individuals remain physically alive but experience a profound rupture from the life they previously inhabited.
Hiraeth as an Interpretive Lens for Distress
Applying the concept of hiraeth offers a deeper interpretation of behaviours and emotions commonly labelled in dementia and aged care settings as “agitation,” “wandering,” or “behavioural symptoms.”
Many actions interpreted clinically as symptoms may instead reflect expressions of longing for home, autonomy, and belonging. For example:
- Repeatedly asking to “go home”
- Attempting to leave the facility
- Distress when confined to institutional environments
- Persistent sadness or withdrawal
Within a biomedical framework these behaviours are frequently – and wrongly – classified under Behavioural and Psychological Symptoms of Dementia (BPSD). However, through the lens of hiraeth, they may be better understood as human responses to displacement, grief, and institutional confinement. This reframing aligns with critical perspectives that argue institutional environments often pathologise normal emotional reactions to loss and restriction.
Identity, Memory, and the Meaning of Home
The significance of hiraeth may be even more pronounced for people living with dementia. Memory loss does not necessarily erase emotional attachments to place or belonging. Studies demonstrate that emotional memory and place attachment often persist even when factual memory declines (Kontos, 2012).
Home is therefore not simply a physical building. It represents:
- personal history
- autonomy and privacy
- relationships and community
- familiarity and safety
When individuals are moved into institutional settings where routines are externally controlled, they may experience a profound sense of identity erosion. The repeated request to “go home,” commonly heard in nursing homes, may express this deeper existential longing.
Human Rights Implications
Interpreting distress through the concept of hiraeth also raises important human rights questions. International human rights frameworks—including the United Nations Convention on the Rights of Persons with Disabilities (CRPD)—emphasise the right to live independently and be included in the community (Article 19).
When people are placed in nursing homes due to lack of community supports rather than genuine choice, the resulting distress cannot be understood purely as a clinical issue. Instead, it reflects structural and policy failures that remove individuals from their homes and communities.
From this perspective, institutionalisation may generate:
- forced separation from community life
- loss of liberty and autonomy
- psychological harm associated with displacement
Understanding distress as hiraeth therefore reframes institutional suffering as a predictable outcome of segregation and loss of home, rather than simply a symptom of ageing or dementia.
Reframing Care Responses
Recognising the relevance of hiraeth has implications for care policy and practice. Instead of interpreting distress as pathology requiring medication or behavioural management, responses should focus on:
- enabling people to remain in their own homes for as long as possible
- developing community-based supports and rehabilitation
- designing environments that preserve autonomy and identity
- respecting the right to belonging and place
Such approaches align with disability rights frameworks that prioritise inclusion, autonomy, and community living over institutional care.
Conclusion
Hiraeth provides a powerful conceptual lens for understanding the distress experienced by people confined to nursing homes. Rather than viewing behaviours such as attempts to leave, expressions of sadness, or repeated requests to go home as clinical symptoms, they can be recognised as deeply human responses to displacement, loss, and the denial of belonging.
For many residents, institutionalisation represents not merely relocation but a form of emotional exile from home, community, and identity. Acknowledging this reality challenges prevailing biomedical interpretations of distress and underscores the urgent need for rights-based alternatives that allow people—particularly those living with dementia—to remain embedded in their communities and places of meaning.
