I’m not getting off this bus.

“I won’t, I know it’s a trick, I want to go home and I won’t get off this bus until it takes me there,” she said.

This was, by far, the most challenging encounter I’ve had with a person with dementia. She had just come back from a doctor’s appointment, and the bus was parked outside of our Clare Bridge. This, however, was not where she wanted to be. “I’m not going in there. I’m not getting off this bus,” she said, sitting with her arms folded. It had already been about a half hour of this when I arrived on the scene. After a couple minutes of thinking and talking to her, I asked, “Okay, where do you want to go?” “I want to go back to where I was,” she said, which of course was a doctor’s office. It was clear that she wasn’t sure where she wanted to go, but either way, this bus had to go somewhere. “I hate hotels, I am not going to stay here!” she exclaimed.

I paused, and went to the bus driver. “Can you drive us around for five minutes and then park in the back of this building?” I asked. He was probably exhausted with this already, but he was a good sport. “Sure.” He did exactly that, and I attempted to talk with my resident on the way. She was frustrated and wasn’t giving me much in the way of conversation. We arrived at the back of the building. “Where is this! I don’t want to be here, I want to go home…no one listens to me, why did my granddaughter put me here? I raised that girl…why am I here…” she went on. 

It was nearing another half hour before I was able to find something that may work to coax her off the bus. “Okay, this is where the bus stops,” I said. “You know how buses have routes, and this is where this one ends. We need to get on another bus.” “No,” she said, “I know that you’re trying to trick me and I won’t get off this bus!” I sighed. “Okay, how about this? We can either stay here overnight, I can get a cab, or we can rent a car, but in any case, we have got to get off this bus.” Something seemed to click as she realized that we had to leave the bus. I understood now that she didn’t want to be left alone. “You’ll stay with me, right? When you get the car? You’ll travel with me,” she said. “I’m right here,” I said. 

We finally got inside. I sat with her and talked. I then went and got her favorite tea and a piece of cake, since she had missed the usual dinner hour. Suddenly, she was peaceful again. It seemed as though the concerns about the bus had washed away, and she was all smiles for the rest of the evening.

They all think I’m crazy.

“We’ve got to get out of here!” she screamed. “They are dangerous people and they’re after us! They think I’m crazy but I know the truth!”

It was dinnertime, and she was upset, to say the least. If our residents get agitated, (which honestly, isn’t often) it’s usually in the late afternoon. You may have heard the term “sundowning” before. Sundowning refers to a person with dementia who becomes upset or aggressive as the sun starts to go down, or in the late afternoon. It’s often because of a basic need: the person is tired, or even hungry. In any case, this particular resident was angry.

“They’re after us!” she yelled, pointing at the other residents and RAs in the dining room. I walked in and went up to her. “Don’t worry, [insert name here], I’m here to help you. Let’s get out of here and go to a safe place!” I said with some urgency in my voice. She felt validated, because someone was agreeing that the dining room was unsafe. “Let’s go out here,” I offered. She stood up, suddenly calmer because we were leaving, and came out into the hallway with me. I walked with her and talked to her calmly. “Do you like this painting?” I asked, as we approached a picture on the wall. I asked her to tell me about the picture, and it was a great, calming distraction. After only about three minutes, we were ready to return to the dining room. She was calm again, and dinner was ready.

Music

It’s almost unbelievable, when you haven’t seen it, to realize the power of music even on people with advanced dementia. There’s this one resident at Clare Bridge who has been a dancer her whole life. Most of the time, she’s very quiet, very reserved. She is a little hunched over when she walks, and doesn’t say much, if anything, ever. She’s always pleasant and smiling, but she doesn’t interact often with other residents. Yesterday we turned on some music and encouraged everyone to dance. I was blown away when this petite, slightly hunched older woman got up and took my hand. Everyone clapped and laughed in amazement as she started to dance. Her hips moved like those of a woman many years younger, and her slightly hunched back straightened out and she even leaned back, throwing her hands in the air. She twirled and danced effortlessly, and most of the RA’s who walked by stopped to watch. “I had no idea she could dance,” one said.

I actually work for a pretty large regional healthcare company. It’s a network of hospitals, primary care physician groups, home care, and nursing homes. We only serve Colorado and Kansas at this point. I just knew that there was a Clare Bridge in the area because you hear about facilities around, for referrals and the like. Where did you get your MA?

Oh, awesome! Brookdale Senior Living has a lot of Clare Bridge locations across the country, and they actually just bought Emeritus Senior Living, so there will be even more. I got it at UNC Greensboro last May, and I’ve always loved memory care.

Everyone can see I’ve been crying.

“I don’t want to sit in there. She’s turned on me, and everyone can see I’ve been crying.”

She was sure that her daughter wasn’t coming to visit, and that her daughter hated her for an unknown reason. She was also sure that not eating dinner was a good way to take revenge. All of the convincing in the world couldn’t coax her to the dining room. “No, they can see that I’ve been crying,” she said.

I could have told her that this was a terrible revenge plot; that not eating wasn’t the best way to get her daughter to come visit. That her daughter would probably be in tomorrow. Instead, I decided on a new route. This resident hails from England, a place where I spent a semester during college. While there, I learned that everyone drinks tea. A lot of tea. And they drink it with milk. I walked her back to her room, and then went to the dining area. A Resident Assistant and I prepped her tea and milk, and I brought this to her in her room. She was suddenly smiling again. “The English take their tea with milk, don’t they?” I asked. After she finished her tea, I brought her a plate from the dining room. We sat together on her bed while she told me about England, her daughter, and her life after marrying an American soldier. She ate everything on her plate without any coaxing. I even brought her dessert to her room. It didn’t take any arguing, tricks, or coaxing—just a little adjustment and patience—and we had a lovely, quiet dinner.

Flowers, a cake, invitations.

“I need a cab!” he said, motioning to the phone.

“Oh, where do you need to go?” I asked.

“I’m getting married soon,” he smiled. “I need flowers…a cake…invitations…all those things!”

I knew that this eighty-something-year-old man probably wasn’t getting married soon, but that didn’t matter. This was his world, and in his world, he was getting married. I smiled. “That’s great! Who is the lucky lady?” I asked. He announced her name to me with a big grin on his face. “She’s the most beautiful woman in the world,” he said. Suddenly, the concern over getting a cab was gone. Instead, he was focused on telling me about this woman he loved. “Are you married?” he asked me. I laughed, “No, I’m not,” I said, recognizing where this was going. “How old are you!” he asked. “I’m twenty-five.” His eyes widened. “…And you’re not married yet?!” he exclaimed. “You’d better get hitched soon! A man needs a wife, and a woman needs a husband. I don’t want to be alone anymore.”

I could have done a lot of things here. I could have said, “No, I can’t call you a cab…you have dementia!” I could have said, “That doesn’t make sense, you aren’t getting married.” Instead, I took interest in his story, and it made both of our days that much better. I learned something about this man, and was able to live in this beautiful reality that he had constructed. No, he isn’t getting married soon, but in the grand scheme of things that doesn’t really matter.