The Bus Stop

The Bus Stop

By Jenna Fariss, Colorado Springs LIVING WELL Magazine

“Well, it’s been lovely having dinner with you people, but it’s time for me to go home now” was the sentence Deborah had to hear coming out of her mother’s mouth night after night at the dinner table. The thing was, Ruth lived at home with her daughter and her family. It was always the same response, “But Mom, you live here.” And Ruth would constantly reply, “No, I don’t!” and angrily leave the table. Sometimes Ruth would make it back to her room upstairs, but on a few occasions, she left the house to go look for the bus stop to go “home.”

Deborah thought she was doing what was best; keeping Mom at her house and taking care of her as long as possible, but after neighbors began noticing Ruth’s wandering habits, their concern grew. One couple offered Deborah advice of putting Ruth in a nursing home, but Deborah admitted that she could not deal with the guilt that would be associated with that. She loved her mother and wanted what was best for her and putting her “away” was the last thing she could think of.

As Ruth’s dementia progressed, her safety along with the rest of the families’ became a bigger concern. Ruth was constantly paranoid. At one point, she thought Deborah’s husband, Mike, was her husband and that he was having an affair with another woman. She no longer recognized Deborah as her daughter. Ruth would get angry at Deborah when she would see them kiss, so they were no longer able to be affectionate in their own home. This began to wear on their marriage.

One night, after everyone was in bed asleep, there was a knock at the door. It was a police officer escorting Ruth back to the house because this time, she had wondered away to a convenience store and was trying to buy food with her library card. Deborah was mortified and heartbroken.  The next day Mike and Deborah contacted their local Alzheimer’s Association. The representative asked them a few simple questions to get them headed in the right direction to find the perfect place for Ruth that would meet all of her needs. They set up tours of the local senior retirement communities around their city. This was a new experience to them and definitely a learning curve.

After viewing five communities and feeling extremely overwhelmed, it was time to narrow them down to their top two. They invited Ruth to join them to help make the final decision. Ruth was very opposed to the thought of moving away from home even though she was not exactly sure where that was. After speaking to the community representatives, they decided that memory care would be the best placement for Ruth. It was hard for Deborah to understand that, but after they explained that Ruth is an elopement risk and she would need a secured environment to keep her safe, she felt better.

The decision was made. They chose a community that Ruth would call her new home. They set up an assessment where the nurse from the community came to their house to ask her a bunch of questions about her health and everyday life, such as how many times a week do you like to bathe?

They set up a move-in date. The room came unfurnished, so they her furniture from her previous home to fill the unfamiliar space. Ruth helped decide where to hang pictures, but you could tell her uncertainty was developing into pure anxiety. Deborah and Mike decided that they were going to say goodbye and leave Ruth in her new home. Ruth walked them to the door and they typed in the code, the light turned green, they embraced one more time, and slipped through the door.

Ruth was exhausted from the emotional aspect the move brought to her. She slept soundly all night and was greeted by a caregiver in the morning. The kind lady helped her get out of bed, get dressed, and get ready for the day while allowing Ruth to maintain as much independence as possible. Ruth was very confused during this entire process, but the caregiver calmly reassured her every step of the way. She took Ruth down to the dining room, where she was seated at a table with two ladies and a man. They were all talking to each other, but if you listened closely, they were all talking about different topics and nothing was connecting, but the important thing was, they were all happy.

After breakfast the caregivers gathered the residents in a circle and read them the morning paper.  Ruth began asking around, “Where is my daughter? When is she coming to pick me up? When am I going home?” The caregivers reassured her that everything was going to be all right, but Ruth became increasing angry. She was confused and was not getting the information that she wanted to hear.

Around 3 in the afternoon, Ruth started to show signs of sundowning, or sundown syndrome.  This is when there is an increase or occurrence in one or more abnormal behaviors in the circadian rhythm. Sundowning behaviors can sometimes exhibit as crying, sadness, aggression, combativeness, confusion, and many more. After wandering, sundowning is the second most common type of disruptive behavior in people with dementia living in communities. Ruth was ready to go home. She went to all of the doors trying to get out, explaining that she needed to get to the bus stop to take the bus home to cook dinner for her mom and dad. Instead of bringing Ruth into reality and telling her that her parents died a long time ago, they joined her world and directed her to a location in the Memory Care Unit where they have designated as “The Bus Stop.” That is where they bring residents to sit and wait who need to get home. The caregivers even went as far as printing out fake bus tickets to hand to the residents. Having that small piece of paper in hand, sitting at a place called a bus stop, is all the reassurance they need at that moment in time to let them know that everything is going to be okay.

If you or a loved one has questions about memory loss, you are not alone. Please visit the Alzheimer’s Association website at alz.org or give them a call at 1-800-272-3900.