Nurse Svenja arrives to take over ward duty from the night shift, alongside two of her colleagues and a trainee nurse. “We have other options in the David Ward,” Kügler explains. Dementia patients on general wards are more frequently given medication to sedate them, or they are physically restrained, he says, which can trigger a delirium episode – an acute decline in brain function. “That would be a little overwhelming for the staff of a general ward,” he says. These patients might display defensive or aggressive behavior, or they might have the tendency to try to wander off, he explains. “One thing dementia patients need is a special setting that would be very difficult to create on a general ward,” says Christian Kügler, who is responsible for the David Ward as the head physician for geriatrics and internal medicine. Nearly one in five patients over 65 is affected, as determined by a 2016 study, conducted by the Mannheim University of Applied Sciences and the Technical University of Munich and funded by the Robert Bosch Stiftung. Dementia is prevalent among older patients in German acute-care hospitals. It was established in 2011 and was the first specialized ward for internal medicine in Germany that was specifically tailored toward dementia patients.

The David Ward is an internal ward especially for dementia patients who have been hospitalized as the result of another acute illness. “We don’t want to put on a performance for them, but we also don’t want to keep confronting them with a reality that, for the most part, they don’t really see anymore.” “The patients are in their own world,” says the nurse. Schulz sits down next to the “Waiting Room” sign and watches the goings-on in the ward for a long while. Treating dementia patients with dignity requires empathy and, in many cases, creativity. “We could have designed this to look like a bus stop, too,” says the head nurse, “but that would’ve meant deceiving the patients.” After all, the bus would never come. Nurse Svenja Ostojic gently takes hold of the man’s elbow and guides him to a seating area designed to look like a waiting room. Like all the patients in the David Ward of the Evangelisches Krankenhaus Alsterdorf (EKA), a hospital in Hamburg, he suffers from severe dementia. He feels the urge to leave, but the life he wants to return to is in the distant past.

An older man in corduroys shuffles slowly down the bright hallway, turns around, and shuffles back the same way he came.

Looks Can Be Deceiving by Quinn Ward