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Written by Jane Verity
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Members please log in and click this link The Bus Stop Band-aid for your full version of this article.
The challenge
What do you do when a person with dementia continuously asks to go home? Or when people with dementia beg you to let them out because their children are crying? Sometimes this behaviour can be so intense that it drives everyone: staff, residents, visitors and volunteers up the wall.
The answer
The most popular answer today seems to be… installing a bus stop! The person wanting to go home can then go and sit at the bus stop and wait for a bus that never comes. A staff member may creatively say, ‘The bus isn’t coming today. It only comes every second day.’ Or even, ‘The bus has broken down and isn’t coming.’
Our first reaction to this solution is often, what a simple and innovative idea?
Undoubtedly, the bus stop solution was created with the best of intentions in mind; namely to ease distress and keep the person happy. However, we can do better than offer a bus stop band-aid. We can make it unnecessary.
A band-aid solution
The bus stop band-aid solution does not address the underlying cause of a person with dementia wanting to go home.
To experience what the person means by the words: I want to go home, we need to ask ourselves this question: What does home represent to me?
Our answers are most likely to be emotional representations of home and this is also true for people with dementia. It is unlikely that they are actually thinking of the physical home that they are either living in right now or have left in order to move to a residential care facility. Some people with strong religious connections may think of home as going home to God. They can be indirectly saying that they wish to die.
Others may be searching for emotional fulfilment of wounded or unfulfilled needs. The 5 universal emotional needs most often overlooked and unfulfilled for people with dementia are:
- To feel needed
and useful
- To have
opportunity to care
- To have
self-esteem boosted
- To love and be
loved
- To express
emotions freely
When these needs are not fulfilled in this reality, the person with dementia tends to go back in their memory to a time when their needs were met. When a person wants to go home they are usually looking for love – unconditional love. When we experience love, we also experience safety and security. When we experience these positive factors, we also experience that it is OK to be ourselves and our self-esteem and identity are maintained.
Instead of using band aid solutions in dementia care, let us all take the opportunity to make a conscious decision to move our care to a new and deeper level. Let us seek out the underlying social, emotional and psychological causes. Once we do so, it becomes obvious that there is so much we can do to prevent the behaviours we normally think of as difficult. It takes willpower, creativity, understanding, patience, love and a desire to do things even better.
Further reading – Click topic
- The Bus Stop Band-aid – Members article – Jane Verity (Read the full article to discover the emotions and reasons behind the words, I want to go home;
learn positive ways to fulfil unmet needs and proven strategies to
remove the necessity for the bus stop and other band-aid solutions.
Also, learn why “Best” is the Enemy of Greatness.)
- How to Communicate with Someone who Can’t Speak
– Précis/Members article – Jane Verity (Read this article to learn 4 body
language techniques to show people with dementia that you are really listening;
learn the importance and the difference between intuition and logical,
rational thinking and which is most effective in communicating with
people who have dementia; learn strategies and effective questions to
uncover unmet needs and to draw out the person’s feelings and needs;
learn question techniques to check on your guesses and 6 steps to being
a good communicator.)
- Understanding Symbolic Language
– Précis/Members article – Jane Verity (Read this editorial to discover the
fascinating and revealing language of spoken and gestured symbols; read
a true account of how the principles of the 7 Step Symbol Solver
revealed the meaning behind previously mystifying behaviour. Learn a
mirroring technique to elicit meanings behind behaviours and gestures.
Read advice to avoid overlooking the obvious; 5 tips for Best Attitude
and learn about universal symbols and their meanings.)
- My Neighbour is Trying to Kill Me! – Members article - Follow-up story to Understanding Symbolic Language revealing the deep symbolism behind this once “seemingly” delusional accusation.
- Hugs not Drugs
– Members short article – Jane Verity (Discover 3 factors behind
attention-seeking behaviour, the 5 secrets to “great” hugs and 5 hints
to check if a hug is creating discomfort in another person plus a
wonderful non-threatening excuse for exchanging a big hug.)
- A Doorway to the Present
– Members article – by E. Joy Bowles BSc. (Learn how brain cells respond to
incoming messages about odours and how we can use them to redirect or
distract agitation; plus learn how odours can be used to encourage
people with dementia back to the present.)
Relevant Resources:
How to Truly Understand People with Dementia – Manual – Jane Verity – Visit our Online Store
5 Universal Emotional Needs – A4 poster – Visit our Online Store
Dementia Reconsidered – Tom Kitwood – Open University Press -1997 – Visit our Online Store
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