The Bus Stop

Summary

Radiolab – "The Bus Stop" (March 23, 2010)

Host: WNYC Studios | Producers/Hosts: Jad Abumrad, Robert Krulwich, Lulu Miller

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Overview

This episode of Radiolab dives into a unique and compassionate solution for dealing with dementia and Alzheimer’s patients who are prone to wandering. Focusing on an elder care home in Düsseldorf, Germany, it tells the story of how staff addressed the problem of residents escaping in search of their past lives—by installing a “bus stop to nowhere.” The segment gently explores questions of truth versus kindness, the nature of memory, and inventive caregiving.

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Key Discussion Points & Insights

The Challenge of Wandering in Dementia Care

• Problem Introduction (01:39): Lulu Miller shares the dilemma faced by most elder care homes: residents with dementia become disoriented, want to “go home,” and sometimes escape.
  • “Many people who develop dementia or Alzheimer’s, they’ll become disoriented and confused and suddenly think, where am I?” – Lulu Miller (01:48)
• Real-life Example (03:03): Lulu relates her own family’s story—her grandfather, believing he needed to teach a class at Harvard, wandered off barefoot in frigid weather.
  • “He got up at 5 in the morning, left the house, and walked to the train station…he thought he had to teach a class at Harvard.” – Lulu Miller (03:12)
• The Lived Experience: The emotional toll of searching for missing residents and the heartbreaking necessity for locked wards is discussed:
  • “Some people have to be locked in, which just feels cruel.” – Lulu Miller (04:16)

The Bus Stop Idea: Creativity Meets Compassion

• Origin of the Idea (04:53): Mr. Goebe, an advisory board member at the Benrath Senior Center, suggests a fake bus stop in front of the home.
  • “Right in front of the home they should build a bus stop…that has just one crucially odd feature: there’s no bus coming. No bus, never.” – Regin (06:13)
• Initial Reactions:
  • Both staff and neighbors are skeptical and even laugh at the idea. Some consider it “cynical” and inappropriate (07:04).
• Implementation (06:44):
  • The home builds a bus stop with a bench and sign identical to regular ones, immediately visible from the entrance.

How the Bus Stop Works

• First Experience (07:39): An agitated resident suffering an episode goes to the bus stop believing she needs to go home. Nurses allow her to sit outside, and after a while her distress fades.
  • “She sat there, very patient. And she waited for the bus…Eventually she forgot why she was there.” – Regin (08:01 – 08:47)
  • “The nurse said, ‘We go in and have a cup of tea together.’ And then she came back and everything was fine.” – Regin (08:47)
• How Often It's Used (09:13):
  • Staff use the bus stop regularly—sometimes proactively guiding upset residents there, other times finding escapees waiting at “their stop.”
• Dynamic of Memory and Urgency:
  • “When the people get to the bus stop, the mood is very dark…I’m feeling so lonely. I want to go home…My parents wait for me…” – Regin (09:41–09:46)
  • With time, anxiety and urgency fade: “That urgent feeling disappears…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.” – Regin (10:29)

The Moral Question: Is It A Lie?

• Ethical Quandary (11:05):
  • Jad poses the question: “Isn’t this maybe a little bit cruel? Because it is a lie that’s happening here.”
• Response:
  • Lulu and the staff frame it as a kindness, a way to escort patients gently from their own reality back to the present, rather than forcibly confronting their disorientation.
  • “Why not just allow that other world to be true for just a beat, and then gently coax them back?” – Lulu Miller (11:48)
  • “That’s the aim of the whole thing, to lead those memories very gently into this now, this today.” – Regin (11:57)

Broader Application: Meeting Patients Where They Are

• Expanding the Approach (12:07):
  • The bus stop concept inspires the home to adapt to other residents’ past-oriented needs—like allowing a retired baker to rise early and bake in the middle of the night (12:18).
  • “They just say, okay. And they let him get up…they take him to the kitchen and let him bake.” – Regin (12:33)
• Reflection on Memory and Safety:
  • “Here’s this way in which people can be somewhat lost in their memories and yet exist in the present safely.” – Lulu Miller (12:47)

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Notable Quotes & Memorable Moments

• On the bus stop’s function:
  “It’s a bus stop to nowhere.” – Regin (06:13)
• On memory’s dual role:
  “The forgetting is both the problem and the solution.” – Lulu Miller (10:59)
• On ethical caregiving:
  “Why not just allow that other world to be true for just a beat, and then gently coax them back.” – Lulu Miller (11:48)
• On the change in care atmosphere:
  “It changed the atmosphere in the home.” – Regin (12:10)

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Timestamps for Important Segments

• [01:39] — Introduction to the problem of wandering in elder care
• [03:03] — Personal story: Lulu’s grandfather’s experience with wandering
• [04:53] — Mr. Goebe’s “bus stop” idea is introduced
• [06:44] — Construction and placement of the bus stop
• [07:39] — First real-life use of the bus stop with a distressed resident
• [10:29] — Discussion of how urgency and memory fade over time at the stop
• [11:05] — Ethical debate about lying versus gentle truth
• [12:18] — Expansion of “meeting people where they are” in daily routines

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Tone & Language

The conversation is warm, respectful, and gently probing. Lulu Miller’s empathy and curiosity lead the narrative, with hosts Jad Abumrad and Robert Krulwich providing thoughtful questions and encouragement. The tone balances sincerity and humor, particularly when discussing the unusual but effective solution.

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For those who haven’t listened:

This episode is a heartwarming, thought-provoking look at inventive dementia care, weighing the comfort of gentle accommodation against the harshness of strict truth. It’s a testament to the power of creative problem-solving grounded in empathy.

Transcript

[A]

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[B]

Wait, you're listening.

[C]

Okay. All right. Okay. All right.

[D]

You're listening, Radio Lab. Radio Lab Sharks from WNYC and npr.

[B]

Hey, I'm Jad Abumrad.

[E]

I'm Robert Krilwich.

[B]

This is Radiolab, the podcast. And today we thought we would.

[E]

We would tell a lie.

[B]

Right?

[E]

That's what we're gonna. We're going to. We're going to.

[D]

You know what?

[E]

I think we should get on with it.

[B]

Yes. This one comes to us from our producer, Lulu Miller.

[D]

All right, so I'm going to tell you a story. Takes place in Germany.

[C]

Guten Tag.

[D]

At an old folks home.

[E]

Hello.

[D]

And that's not where we are right now, but we brought two of the people who work at the home into a studio.

[C]

We have to close the door, otherwise.

[D]

Yeah, it sounds like you're having a party over there. So the story really belongs to this guy, Richard Neubreuther. He's the director of the home, which is called Benrath Senior center in Dusseldorf. But we've also brought Regin in. Regina hall, who also works at the home and speaks more English.

[C]

I just help Mr. Neuriter translate. Shall we do it like this?

[D]

Yeah.

[C]

Okay.

[D]

So Mr. Neuriter has a problem. It's a problem most nursing homes face.

[C]

Which is that many people who develop.

[D]

Dementia or Alzheimer's, they'll become disoriented and confused and suddenly think, where am I? Where am I?

[C]

This is not my world. And I have to go back to my house. My are waiting for me.

[D]

And usually, you know, nurses will intercept them.

[C]

Relax, you are living here.

[D]

But occasionally, people somehow slip out the front door.

[C]

Yeah.

[D]

Escapes, they happen and then they wander. They had one woman make it onto.

[C]

A bus and she escaped about how many kilometers?

[D]

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.

[C]

Yeah.

[D]

And for the people who work at.

[C]

The home, says Regin, you get crazy. Not knowing where is the person and where did she go?

[D]

Test, test, test, test. This is something we all know about. Do you guys know I'm working on this story about the Alzheimer's?

[C]

Yes.

[D]

And while reporting this piece, I was checking in with my parents about some stories like this. What happened to my grandpa?

[E]

Well, well.

[D]

And they told me one I'd never heard one morning.

[E]

This was in February.

[C]

Yes.

[F]

This was on a very, very cold day. Frigid, cold morning.

[D]

My Grandpa got up 5 in the morning, left the house and walked to the train station.

[F]

He probably got the earliest tea, took.

[D]

It all the way out to Cambridge because he thought he had to teach a class at Harvard.

[B]

Did he used to teach at Harvard?

[D]

No, but he'd given lectures there. So anyway, it's pitch dark early in the morning, frigid Boston weather.

[F]

And he was only in his long underwear with his coat and hat and scarf on over that.

[D]

He didn't even have shoes on. He was just wearing his slippers.

[F]

He was picked up by the police because he was, you know.

[E]

Hypothermic.

[D]

Yeah, he was hypothermic.

[E]

He was hypothermic. I mean, his. When they brought him into the hospital, his temperature was too low down.

[D]

I did not know that.

[F]

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.

[E]

A locked floor. That's what it meant.

[D]

So that essentially is the problem.

[C]

Some people have to be locked in.

[D]

Which just feels cruel.

[C]

Yeah, it's horrible. Yeah, it is.

[D]

And then in walks a fellow named Mr. Gooble.

[C]

No, no, no, Goobe. Goo Goo sounds really awful.

[B]

Oh, really?

[C]

Okay, try to make it more like goo be.

[D]

Goo be. Yeah. Okay, Mr. Goober. No, no, Goober.

[C]

No.

[D]

Okay, we'll just like. We'll just use you saying it.

[C]

We'll do Mr. Mr. Goebe.

[D]

Okay, so Mr. Goebe was an older gentleman. He sat on an advisory board at the senior center.

[C]

And one day he came up with this idea.

[D]

That's Richard Neurriter 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.

[C]

When Mr. Goebbel came into the office of Richard and presented his idea, Richard was just laughing. He thought, it's very funny. What a funny idea.

[B]

Well, what is it already? What's the idea?

[D]

Well, Mr. Gooble thought that right in front of the home they should build a Bus stop.

[C]

A bus stop?

[B]

What? Build a bus. I don't understand. What would that do?

[D]

Well, think about what a bus stop is.

[C]

When you see a bus stop, it's the first. First step into the wide world. From a little bus stop, you get anywhere.

[B]

Yeah.

[D]

Regin says that in a lot of these wandering cases, the first place people often head is to a bus stop.

[B]

Ah.

[D]

And so back to our friend Mr. Grube. He thought what they should do is build a bus stop right in front of the home that has just one crucially odd feature.

[C]

There's no bus coming, no bus, never. It's a bus stop to nowhere.

[D]

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 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.

[C]

Second thought was, maybe not that bad.

[D]

So they bolted in a bench made.

[C]

Of iron, put up a sign in.

[D]

Yellow and green, just like every government issued bus stop.

[C]

And when you get out of the home, you see it immediately.

[D]

And the staff say, richard and Regine just thought this was a stupid idea.

[C]

It's not appropriate, or it's even cynical.

[D]

And most of all, that it probably just wouldn't work.

[C]

Yeah.

[D]

And at first it looked like they were right.

[C]

One by one, the neighbors, you know, normal people, they said, oh, new bus stop. And they waited there for the bus.

[D]

Oh, no. And so one by one, Richard would have to run out and explain, that's not for you. So there was this period of adjustment.

[C]

Yep. And then one day, an old lady.

[D]

An actual patient from the home, started having an episode.

[C]

She was very troubled in her mind.

[D]

She was a little girl and she needed to get home to her parents.

[C]

My mother waits for me. I have to go home. Home, home. Very quick. The nurses talked to her and tried to calm her down, but she began to cry.

[D]

So they thought, well, let's just let her walk out.

[C]

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.

[D]

And eventually a nurse came over and sat with her.

[C]

And they waited together, side by side.

[D]

Eventually, she forgot why she was there.

[C]

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.

[D]

It's been two years since. Since the bench first went up. And Richard and Regin say they use.

[C]

It all the time, every couple of days.

[D]

Sometimes the nurses will take someone who's upset and wants to go home.

[C]

The nurses say, let's go to the bus stop. Let's see what we will do and how we plan the 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 over, oh, she's waiting for the bus. And then somebody goes there.

[D]

But one thing is always the same. When the people get to the bus stop, the mood is very dark.

[C]

I'm feeling so lonely. I want to go home.

[D]

And also urgent.

[C]

My parents wait for me, my children wait for me. I have to go there quick, quick, quick.

[D]

But then. After a while, as they're sitting there thinking their escape is on the way.

[C]

That urgent feeling disappears.

[D]

Do you know why? Or can I guess, can you describe it disappearing? Like, does it go away slowly or suddenly?

[C]

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.

[D]

Which is. It's interesting. It's the forgetting is both the problem and the solution.

[B]

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.

[D]

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.

[C]

The people, hold them back, call the police. They don't accept it because it's not their world. It's two completely different worlds.

[D]

And so they say, why not just allow that other world to be true for just a beat and then gently coax them back.

[C]

That's the aim of the whole thing, to lead those memories very gently into this now, this today.

[D]

And this idea has sort of spread at the nursing home.

[C]

It changed the atmosphere in the home.

[D]

Now they try to do this sort of time shifting in all different ways.

[C]

Sounds a little bit complicated, but it isn't like for example, they had this.

[D]

Guy who's a baker who always used to want to get up at 2.

[C]

O' clock in the morning.

[D]

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.

[C]

Day at 2 o'. Clock.

[D]

They take him to the kitchen and let him bake.

[C]

And then he says, well, I'm always in time and I'm proud. I never miss an hour of my work.

[D]

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.

[B]

That's our producer, Lulu Miller with Music Choice. If you want to know anything new about the Benrath Senior center in Dusseldorf, Germany, check our website, Radiolab.org I'm Jad Abumrad.

[E]

I'm Robert Krulwich.

[B]

Thanks for listening.

[C]

Message two.

[E]

This is Bob Hilkberry, a Radiolab listener from Oshkosh, Wisconsin. The Radiolab podcast is funded in part by the National Science foundation and the Sloan Foundation. Bye.

[C]

End of message.