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HEALTH A trip down memory lane Bus stop for Alzheimer’s patients

Cohasset Mariner (MA) - 11/28/2015

A recent call from Hingham police alerted residents to be on the lookout for an elderly woman dressed in bright clothes who was wandering, possibly barefoot. Thankfully, she was found safe, but the scenario is one feared by those who love or care for memory-impaired people. What to do when a disoriented person feels the urgent need to move: to go to work, to visit their children, just to go somewhere?

One solution to the problem is proving effective at Bridges by EPOCH, a memory care assisted living facility in Hingham. Two “bus stops to nowhere” are inside secure enclosed open-air garden courtyards.

On one side of the wooden “bus stop bench” there’s a STOP sign and on the other, a laminated map of Boston’s MBTA routes. A brown patio umbrella shields the bench where an Alzheimer’s patient might sit for a minute or two before a nurse comes to join him.

This “need to move” is most common with Alzheimer’s, said Alicia Seaver, EPOCH’s regional memory care specialist. “The bus stop is just a great diversionary tool. It’s a nice distraction and it’s empowering. Bus stops are good places to reminisce and take a trip down memory lane.”

The benches with their real signs and transit maps are a gentle way of redirecting and calming frustrated residents.

Seaver explained that the nurse may ask the patient about other times he’s traveled, what his favorite trip was, who was with him. After a few minutes of conversation, the patient’s agitation subsides. The nurse can help him focus on the present and forget the compulsion with a past activity.

Seaver helped open Bridges in 2012 and implemented the bus stops in 2013. Fifty-five people, including one couple, who suffer from either Alzheimer’s disease or related dementia, now live at Bridges.

“The street signs and MBTA maps had to be real,” she said. “Most of these residents are savvy about public transportation. Here they can be in a secured setting yet feel there’s a door open to the outside world. They don’t feel trapped or locked up. It’s good for their dignity and their integrity.”

“Just giving people an outlet helps,” added Nadine Shweiri, executive director of the Hingham campus.

“The bus stop idea is what we call a ‘fiblet’ in dealing with Alzheimer’s.”

“The experience allows someone with confused memories to act on the need to leave, but without actually leaving,” said Laura Holloway, a publicist for EPOCH. “You might call it a kind-hearted deception that helps everyone – the person wanting to leave and the caregiver who must help the person feel in control and still keep him safe.”

Shweiri recalled a recent incident. She spotted a resident wearing her coat and sitting on the bus stop bench. “I said to her, ‘It’s raining out. Can you let me drive you back home?’ We talked and within five minutes she had forgotten the bus.”

The bus stop idea would not work with residents who have other kinds of dementia, Shweiri said. “They have different levels of reality perception. These people would look at you and say there’s no way a bus is going to drive into this courtyard!”

Bridges is comprised of three well-lit and well-maintained buildings or “households” with 18 apartments or private rooms in each. Residents can bring their own furniture and decorations.

Programs offered depend upon their ability. Some patients are on Hospice care, yet others are still doing Zumba dance classes. “Some of the gentlemen’s eyes light up when instructors come in for that class,” Shweiri said. And even during last winter’s record-breaking snowfall, the courtyards were cleared daily so those patients who habitually run laps could get out there.

The average cost per resident for all-inclusive care and meals is about $250 per day.

Doors between households are not visibly locked, but are secured with key code access. The front desk is staffed from 8 a.m. to 8 p.m., when the outer doors are alarmed, she added. Every hour there’s an hourly check of all patients.

“Our basic concept is to avoid saying no and to redirect residents,” Shweiri said. “Treating people with dignity goes a long way.”

—Correspondent, Gail Besse Ryberg, is a regular contributor the Mariner.