Where's The Bus? Redirecting Alzheimer's Patients at a Nursing Home

  

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Faced with patients who would try to "escape" nursing homes for homes where they had lived many years ago, a German elder care organization found that missing Alzheimer's and dementia patients often were found at bus stops, as their still-functioning long term memory told them they could get home by taking a bus.

Rather than dealing with the police, a nursing home in Dusseldorf tried a radical approach: They installed a fake bus stop.

Residents were delighted with the autonomy they were given, and staff could intercept patients as they waited for a bus that would never come. The now-famous experiment was replicated at other nursing homes in Germany, and became a prime example of "redirecting," a strategy for dealing with Alzheimer's patients who cannot be reasoned with.

In a recent edition of the New York Times' New Old Age blog, a similar tale of redirecting is recounted. A woman in a nursing home is obsessed over the "theft" of a red box and gray suitcase, to the point that she cannot be distracted from her obsession. Family members and staff try to reason with her, but find that it is to no avail. Finally, a family member brings a red box and suitcase to her room and tells her that he's found them. She is once again at peace.

Those with Alzheimer's often cannot be "taught," as their often irrational behaviors are due to the loss of brain tissue. Rather than arguing with a loved one with Alzheimer's to no avail, experts recommend "redirecting" the situation to bring peace and comfort to the situation.

Here are some examples of redirection from the New York Times and a handout from the Alzheimer's Association:

- A loved one expresses a desire to go to a childhood home that's 3,000 miles away. Instead of listing the reasons why a multi-state trek is difficult or impossible, the caregiver says that the trip is OK but that he needs to get dressed first. Often, the small delay will be enough time that the original intent for getting dressed will be forgotten.

- If someone with Alzheimer's says they want to travel somewhere, often a short walk will satisfy their curiosity.

- If a person with Alzheimer's asks for a friend or relative who died years ago, don't remind them of the death. Say something like, "I'm sure he'll be here any minute," or "I'm sure he's fine."

As the Alzheimer's Association states, "Wait for an opportunity to redirect and always talk positively about the future. Remember, you can never win an argument with an Alzheimer’s patient."