Waiting for a bus that never comes

For an increasingly elderly population, the humble bus stop can be an important source of solace and normality, even if there are no buses

One of the results of the great demographic shift of age structures due to longevity is a long-term increase in the proportion of old people, and in the proportion of your life you will spend old. This causes many problems for planning mobility, including how to handle the expectations and needs built up during a life-time of car-based movement, as people are no longer so competent or avid to drive. The resource and design implications for transport systems are crucial and problematic.

At a personal level, on one hand nearly everybody wants to live longer, and it is great to be able to hope for prolonged health and active enjoyment of life after work. On the other hand, many of you will have had experience of an elderly relative with one of the many diseases of age, and the older of you will fear it yourselves. Alzheimer’s is one of the most troubling – in the 1980s my mother died of it, after two years in a nursing home, and some years later my aunt went through almost exactly the same experience. I was the main visitor in both cases, a weekly duty of stress and unhappiness. One of the frequent symptoms is the puzzled desire of Alzheimer’s patients just to leave this place, that they don’t understand, and ‘go home’. But there isn’t a home they can go to, any more, which is difficult enough to explain even once, but explaining every week is nearly intolerable.

There was recently a flurry of slightly flippant news stories picked up in the press, which I thought were new but in fact turned out to be a repeat of the same story from a year ago, and possibly earlier, in a season where the media like slightly quirky human-interest stories in the absence of real politics. You might have seen the stories? They are about an old people’s home in Dusseldorf where a fake bus stop has been constructed (in the garden, or in the street outside, according to different versions of the story) as part of therapy and, in a sense, patient management. The story has been repeated in more or less the same words in many websites, and papers including The Daily Mail and The Telegraph; I haven’t tracked down the first mention but it is over a year ago. The story goes:

German nursing homes are using a novel strategy to stop Alzheimer’s patients from wandering off: phantom bus stops. The idea was first tried at Benrath Senior Centre in Düsseldorf, which pitched an exact replica of a standard stop outside, with one small difference: buses do not use it.

The centre had been forced to rely on police to retrieve patients who wanted to return to their often non-existent homes and families. Then Benrath teamed up with a local care association called the ‘Old Lions’. They went to the Rheinbahn transport network, which supplied the bus stop.

“It sounds funny but it helps,” said Franz-Josef Goebel, the chairman of the Old Lions association. “Our members are 84 years old on average. Their short-term memory hardly works, but the long-term memory is still active. They know the green and yellow bus sign and remember that waiting there means they will go home.”

The result is that errant patients now wait for their trip home at the bus stop, before quickly forgetting why they were there in the first place. “We will approach them and say that the bus is coming later and invite them in for a coffee,” said Richard Neureither, Benrath’s director. “Five minutes later they have completely forgotten they wanted to leave.” The idea has proved so successful that it has now been adopted by several other homes across Germany.

Delving a little deeper one finds several, and perhaps many, other examples. In the UK, the Cleveland View Care Home in Middlesbrough has created a sort of social environment with a pub, cinema, indoor garden, hairdressers, old-fashioned parlour and ‘children’s’ (i.e. dolls) nursery. Part of the scheme is an (indoor) bus stop – the manager Odette Crawford said, “We put the bus stop in because a lot of residents with dementia walk about looking for a purpose or maybe looking to go home. They will sit and wait at the bus stop and forget what they are waiting for and then move on to other activities.”

In various web discussions, nurses or relatives have reported similar schemes elsewhere – one claim is that the idea started not in Dusseldorf but in the Netherlands, has been running for over ten years in Denmark, and has many examples in Australia. The media coverage has a (maybe slightly nervous) hint of jocularity about it but that may just reflect the universal sensitivity and sorrow of the condition. Handled well, and sympathetically, without cynicism or contempt, it must be good to soften the cruelty of declining competence and give an illusion of normality and peace to troubled people.

Waiting for a bus is a very simple context, with an objective, a form of social interaction and shared intent. There is the implied promise of a journey, even if that promise is not delivered. There is a rationale for sitting outdoors, even when the weather isn’t too good, which as long as you can must be better for the spirit than those terrible rooms with the television booming. From the point of view of transport sociology there are some quite deep ramifications. I hadn’t really thought of a bus stop as a place of solace or normality but there is a lot of symbolism there. I have mentioned it to a number of people and everybody’s first reaction is how sad the idea is, but I don’t see it that way. The sadness is about approaching death, which nothing can cure.

In Spanish, and I think some other Latin languages, the word for wait and the word for hope are, in fact, the same. A bus stop says, while there is life, there is hope.

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Phil Goodwin is professor of transport policy at the Centre for Transport and Society, University of West of England, Bristol, and emeritus professor at University College London