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02/06/2008Waiting for the bus that will never come
A German nursing home has come up with a novel way of dealing with want away Alzheimers patients by ostensibly granting their wish
Confused and disoriented, an elderly woman makes her way along the corridor of a nursing home.
"I have to get home. My husband will be back from work shortly and I've got to cook his supper," she says.
The two care assistants following her have heard it all before. They know the old woman's husband died years ago that the home she refers to no longer exists.
Nevertheless, they help by pointing her to a bus stop directly in front of the old people's home in the western city of Dusseldorf.
But the bus will never show up - the stop is a fake one.
More and more nursing homes for the elderly are using such phantom bus stops to prevent Alzheimers suffers from getting lost.
The old lady will probably spend about five minutes waiting for the bus before forgetting that she wanted to go home.
"After about 15 minutes another carer will go to her and tell her the bus has been cancelled or that she should come back with him because her daughter will be arriving shortly," says the nursing home manager, Richard Neureither.
"When relatives first hear of this their initial reaction is, 'they're making fun of the old people'," he says.
But he defends the unusual approach, saying it is necessary because the patients suffering from Alzheimers and other forms of dementia live in their own world.
Dealing with an alternate reality
"Using rational arguments won't prevent them from running away. You have to deal with them in the reality in which they live," says the home manager.
Some 82 people live the nursing centre that Neureither is in charge of, with around 70 of them suffering from dementia.
Their long-term memory functions perfectly, but the present is quickly forgotten. "Most are in the final stages of the illness. Their short-term memory is virtually nonexistent," says Neureither.
"They are not able to learn any more. If you leave their room and come back again in 15 minutes you can start all over again with the conversation you just had with them."
Their long-term memory is much better.
"They can remember exactly where they used to live. They know what different symbols mean, such us the sign for a bus stop," explains Neureither.
The idea for the phantom bus stops comes from Franz-Josef Goebel, chairman of the local aid organization Old Lions.
Better than alternative solutions
"The alternative would be to lock them up or pump them full of drugs to keep them quiet," he says.
As a rule, the home residents are there voluntarily and the carers are not allowed to detain them against their will, according to Neureither.
"They sometimes become aggressive if we try to hold them back and tell them they are not allowed to leave," he adds.
The fake bus stops present an opportunity to take the feelings of the residents into account. It enables them to behave like normal people.
The desire to escape is particularly strong among newcomers, who often demand to know what they are doing in the home and who is going to pay for them.
But despite the trick with the bus stop, there are still Alzheimers sufferers who manage to slip away undetected.
"If we can't find them then we have to alert the police," says Neureither. "It can be particularly dangerous if this happens in winter and they spend the night out in the cold."
There are more than 1 million dementia sufferers in Germany. The idea of the phantom bus stop has spread from Dusseldorf to nursing homes in Munich, Hamburg and at least four other cities.
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