Why bus drivers are being taught about dementia
Thousands of bus drivers around Britain are being given special training so they can help passengers with dementia.
It's part of an initiative by the Prime Minister which is trying to encourage everyone to be more aware of the needs of older people who have dementia, to help them in their daily lives.
I watched a training session at a First Group depot in an industrial part of north-west London. It is home to more than 100 buses, and a work base for 300 drivers.
Upstairs, 11 members of staff gather for what proves to be a hard-hitting couple of hours. It begins with a simple memory test.
The trainer, Keith Sheard, promises the drivers an easy exercise. He asks them to draw a picture of both sides of a 1p coin, with as much detail as they can remember.
He jokes: "Dead easy this - you handle these coins every day!"
There are groans as some of the drivers fail to recall the portcullis, or find they have written "one pence" rather than "one penny".
Twelve points are up for grabs - but the drivers only manage between two and five.
Keith puts the exercise into the context of dementia, telling the participants: "Imagine if you forgot the detail in every aspect of your life - having breakfast, getting dressed - just imagine how frustrating that would be."
Next the drivers are asked to write down on different pieces of paper their most prized possession, the name of their most loved person, a skill they are proud of and a treasured memory. Keith then comes round and takes away one bit of paper from each person.
He tells them: "I was your dementia for that moment in time. Just take a moment to think what your life would be like without what I've just taken from you.
"And if you thought it couldn't get any worse, it does. Because over time, I'm going to come back and take everything else from you - so you'll be left with absolutely nothing."
The drivers admit they are finding this emotional and hard to think about. Inevitably stories emerge about family experiences.
The briefing includes details about how different forms of dementia affect the brain. This leads into a discussion about how drivers can help confused passengers.
There are some barriers to good communication - such as the screen designed to protect inner city staff from assaults.
And the drivers admit that if someone seems troublesome on a busy bus, their first instinct is to try to remove that passenger. But now they have an extra awareness of what might be amiss, particularly if there is no smell of alcohol on the passenger's breath.
Keith explains: "You need to be aware of the difficulty of grasping day, date and time that people with dementia have.
"You might be telling me that my pass is out of date or that I can't use it until half past nine - but if time doesn't have any real meaning to me, I don't understand your point or why you're getting so excited about it."
The drivers are given advice which includes smiling and making eye contact, letting the passenger sit down so they have extra time to compose themselves, and not pulling away quickly if they seem unsteady on their feet.
All those in the session will now train other drivers in the First Group, and the hope is that other transport companies will follow suit.
One of the participants, Krystyna Ryan, 59, "Drivers need to be able to help their passengers who have any health issue - and dementia especially, because it's not always recognised or spoken about."
Nick Vane, the commercial growth director for the UK bus division of FirstGroup, sees the awareness course as a natural extension of other work in the company.
He said: "This industry has moved over a long period to improve accessibility, with innovations like low floor vehicles to help disabled people. It seems a natural progression to now look at more hidden disabilities.
"It was fascinating to watch the interaction in the session. The participants related it to personal circumstances in their families, but also to how they can help people in their work."
Around 3,000 of FirstGroup's drivers will have gone through the training by February.
Andrew Chidgey, director of external affairs at the Alzheimer's Society, which helped guide the training, accepts the health service still needs to play its part in treating people with dementia - but says helping sufferers in this practical way is also vital.
He said: "What this identifies for the drivers is they have a really important role in helping people in their community to remain independent. That's also true for people like newsagents and other workers."