Radiolab - The Bus Stop

Episode Date: March 23, 2010

There’s a common problem faced by Alzheimer's and Dementia patients all over the world: lost in their memories, they sometimes get disoriented, and wander off. In this podcast, Lulu Miller talks to a nursing home in Düsseldorf, Germany that came up with a novel solution.

Wait, you're listening. Okay. All right. All right. You're listening to Radio Lab. Radio Lab. Shorts. From.

W. N. Y. C. C. C? Yes. And NPR. Hey, I'm Chad Abumrod. I'm Robert Krollwich.

This is Radio Lab, the podcast. Yep. And today we thought we would. We would tell a lie. Right. That's what we're going to. We're going to, we're going to. you know what?

I think we should get on with that. Yes. This one comes to us from our producer Lulu Miller. All right, so I'm going to tell you a story. Takes place in Germany. Good night. At an old folks home.

Hello. And that's not where we are right now, but we brought two of the people who work at the home into a studio. We have to close the door. Yeah, it sounds like you're having a party over there. So the story really belongs to this guy, Richard Neu Reiter.

He's the director of the home, which is called Benrath Senior Center. But we've also brought Regina in, who also works at the home, who speaks more English. I just helped Mr. Neue Riter. Shall we do it like this? Yeah. Okay.

So, Mr. Neu-Wrightther has a problem. It's a problem most nursing homes face. Which is that many people who develop dementia or Alzheimer's, They'll become disoriented and confused and suddenly think, Where am I? Where am I? This is not my world. And I have to go back to my house.

My children are waiting for me. And usually, you know, nurses will intercept them. Relax. You are living here. But occasionally, people somehow slip out the front door. Yeah. Escapes, they happen. And then they wander.

They had one woman make it onto a bus. And she escaped about. She eventually made it to a town about 20 miles away. Yeah. They've had people turn up at grocery stores, wandering in the forest. They've even had people make it all the way back to their old houses and find new people living there. Yeah.

And for the people who work at the home, says Regine. You get crazy not knowing where is the person and where did she go. Test, test, test. This is something we all know about. Do you guys know I'm working on this story about the valve? And while reporting this piece, I was checking in with my parents about some stories like this. What happened to my grandpa? Well.

And they told me when I'd never heard. One morning. This was in February. Yes, this was on a very, very, very frigid cold morning. My grandpa got up. Five in the morning. Left the house and walked to the train station. He probably got the earliest tea.

Took it all the way out to Cambridge because he thought he had to teach a class at Harvard. Did he used to teach at Harvard? No, but he'd given lectures there. So anyway. It's pitch dark. early in the morning, frigid Boston weather. And he was only in his long underwear with his coat and hat and scarf on over that.

He didn't even have shoes on. He was just wearing his slippers. He was picked up by the police because he was, you know... Hypothermic. Yeah. He was hypothermic? I mean, when they brought him into the hospital,

his temperature was too low. I did not know that. It was the moment when I knew that, you know, that everything was going to have to change, that he would have to move into a place that had a floor for people who were suffering. A locked floor. That's what it meant. So that essentially is the problem.

Some people have to be locked in. Which just feels cruel. Yeah. It's horrible. Yeah. It is. And then? In walks a fellow named Misty.

Mr. Goobel. No, no, no. Gobe. Not gube. Gube. Gobe. Gobe. Oh, really?

Oh, okay. Try to make it more like Goebe. Gubel. Yeah, power. Okay. Mr. Gube. No.

No? Goobel. No. Okay, we'll just like, we'll just use you saying it. We'll just, you're Mr. Mr. Gubel. Okay, so. Mr. Gub.

Was an older gentleman. He sat on an advisory board of the senior center. And one day he came up with this idea. That's Richard Noiriter again. And it's one of these ideas that's so out there and yet so simple that you think it just couldn't possibly work. When Mr. Goubel came into the office of Richard and presented his idea, Richard was just laughing.

But it came also the first night to do. He thought it's very funny. What a funny idea. Well, what is it already? What's the idea? Well, Mr. Goebel thought that right in front of the home, they should build a bus stop. The bus stop.

What? Build a bus stop? I don't understand. What would that do? Well, think about what a bus stop is. When you see a bus stop, it's the first step into the white world. From a little bus stop, you get anywhere. Yeah.

Regine says that in a lot of these wandering cases, the first place people often head is to a bus stop. And so back to our friend Mr. Gruby. He thought what they should do is build a bus stop right in front of the home that has just one crucially odd feature. There's no bus coming. No bus? Never. It's a bus stop to nowhere.

So his thought was it would be a way of catching people who happened to wander. They'd see the bus stop go and sit on it, waiting for a bus stop. bus that would never come, and then eventually a staff member could see them and bring them back. So while Richard's first thought was, this is ridiculous. Second thought was maybe not that bad. So they bolted in a bench, made of iron, put up a sign, in yellow and green, just like every government issued bus stop. And when you get out of the home, you see it immediately.

And the staff. Say Richard and Regine just thought this was a stupid idea. It's not appropriate or it's even cynical. And most of all that it probably just wouldn't work. Yeah. And at first, it looked like they were right. One by one. The neighbors, you know, normal people, they said, oh, new bus stop.

And they waited there for the bus. And so one by one, Richard would have to run out and explain. It's not for you. What's for the sin there was this period of adjustment. And then one day, an actual patient from the home, started having an episode. She was very troubled. In her mind, she was a little girl, and she needed to get home to her parents. My mother waits for me.

I have to go home, home, home very quick. The nurses talk to her and try to calm her down, but she began to cry. So they thought, well, let's just let her walk out. It was fall. It was rather cold. So she went to the bus stop in her coat, in her head. And she sat there very patient, and she waited for the bus. In the fresh air, sun shining. And eventually a nurse came over and sat with her.

And they waited together side by side. And eventually she forgot why she was there. The nurse said, We go in and have a cup of tea together, and then she came back and everything was fine. She was relaxed. She was in the present time, not longer in the past time. It's been two years since the bench first went up, and Richard and Regine say they use it all the time. Every couple of days.

Sometimes the nurses will take someone who's upset and wants to go home. The nurses say, let's go to the bus stop, let's see what we will do and how we plan this. day. Or sometimes the nurses, they don't see that somebody escapes and they say, oh, where is Mrs. Smith? And then they look out of the, oh, she's waiting for the bus and then somebody go there. But one thing is always the same. When the people get to the bus stop, the mood is very dark. I'm feeling so lonely. I want to go home. And also urgent. My parents wait for me, my children wait for me. I have to go there quick, quick, quick. But then, after a while, as they're sitting there thinking their escape is on the way

that urgent feeling disappears do you know why or can I guess can you describe it disappearing like does it go away slowly or suddenly how can't they then so things

get that then so or so you must understand which stadiums the demands the people have it's not be a unlike Richard says It's like another thought comes up and then you forget what you wanted. You know, it's like fish is coming up to the surface of the water and then going down again and disappearing.

Thoughts come up and they disappear. And you don't know that they have ever been there. Oh. Yeah. You forget. Which is, it's interesting. The forgetting is both the problem and the solution. Yeah.

But Lulu, I mean, isn't this maybe a little bit cruel? Because it is a lie that's happening here. I mean, they are lying to these people. Well, sure, it's definitely a lie. There's no way around that. But what's the alternative? I mean, take that woman at the bus stop. What are you supposed to say to her?

I know that you're utterly convinced of this, but actually you're not a little girl. You live in a nursing home. As you can imagine, these kinds of conversations don't go well. They say sometimes they have to restrain the people. Hold them back, call the police. They don't accept it because it's not their world. It's too completely different worlds.

And so they say, why not just allow that other world to be true for just a beat and then gently coax them back? That's the aim of the whole thing. to lead those memories very gently into this now, this today. And this idea has sort of spread at the nursing home. It changed the atmosphere in the home. Now they try to do this sort of time shifting in all different ways. Sounds a little bit complicated, but it isn't.

Like, for example, they had this guy who's a baker who always used to want to get up at 2 o'clock in the morning. And they used to say, no, you know, go back to bed. We're working. But now they just say, okay. And they let him get up every day at 2 o'clock. They take him to the kitchen and let him bake. And then he says, well, I'm always in time and I'm proud. I never miss an hour of my work.

And the interesting part for me is that I think about my grandpa wandering through the cold in his slippers. And here's this way in which people can be somewhat lost in their memories. and yet exist in the present. Safely. Safely. That's our producer Lulu Miller. With the music choice, if you want to know anything more

about the Benrath Senior Center in Dusseldorf, Germany, check our website, radio lab.org. I'm Chad Aboumrod. I'm Robert Crulwich. Thanks for listening. Message 2.

This is Bob Hilkeye, a radio lab listener from Oshkosh, Wisconsin. The radio lab podcast is funded in part by the National Science Foundation and the Sloan Foundation. Hi. End of message.