How do public transport staff identify people with dementia? Behind the scenes with SMRT's inclusivity training

SINGAPORE: When new frontline staff join transport operator SMRT, many might not expect to be trained to spot someone who appears confused, lost or anxious. 

But it’s compulsory for these employees, including bus captains and MRT station staff, to attend training to identify such passengers and learn how to respond appropriately. 

For instance, they learn that they could approach a passenger who appears confused by saying: “Afternoon sir, is there anything I can help you with? You seem lost.” And a passenger who appears lost and anxious could be told: “I understand your situation. Allow me to direct you to your destination.” 

After all, these passengers could have dementia – and this "inclusivity training" is part of SMRT’s Demonstrate a Service Vision training that includes dementia awareness within six months of joining the company. 

CNA recently attended one such session customised by NTUC LearningHub to suit SMRT’s needs. 

Developed in collaboration with the Ministry of Social and Family Development, Jurong Community Hospital, Lien Foundation and Singapore Association of the Visually Handicapped, the course aims to make training relevant and authentic to enhance transport staff’s understanding of the needs of priority passengers. 

The training also covers other vulnerable groups, such as wheelchair users and the visually impaired. A practical session is held at the Jurong Community Hospital Mobility Park fitted with steps, slopes and a "mock-up" MRT carriage, bus and taxi, where therapists from the hospital guide SMRT staff on how to assist priority passengers.  

With about 2 million people riding the MRT every day, such training is important for SMRT frontliners, noted Ms Norendrawati Suseno, associate trainer at NTUC LearningHub. 

“Do you know how many people they meet at the MRT a day? So they have more chances than any other industry as a frontliner meeting such passengers. If you can think about the amount of people taking MRT every day, they’re bound to meet one of those that they have learnt about,” she said. 

Ms Norendrawati, who has also trained employees from hospitality, attractions, entertainment and retail sectors, pointed out that the application of the training would be “very different” for transport frontliners. 

“It will be very useful because they will be able to actually interact with such passengers. We call them the priority passengers,” she added. 

DEMENTIA'S VISIBLE TELL-TALE SIGNS

By the end of this year, all 98 SMRT train stations across Singapore on the North-South, East-West, Circle and Thomson-East Coast lines will be listed as dementia “Go-To-Points”, SMRT announced on Feb 27.

“These GTPs (Go-To-Points) serve as resource centres and ‘safe return’ points where members of the public can bring persons living with dementia who appear lost or unable to remember their way home,” the transport operator said in a media release. 

“SMRT’s station and interchange staff are trained to identify and assist the persons who have been brought to them, and will assist to reunite them with their caregivers.”

Hence one of the key learning points of the training is identifying the visible characteristics of dementia. It also specifically addresses scenarios in crowded and public areas such as MRT stations or bus interchanges.

At an MRT station, in particular, this could be commuters who look lost and confused as they don’t know where they are or where they’re going. 

“They may be wandering aimlessly at the MRT platform or not move and just stare blankly at other commuters moving in and out of the train or bus. They may also spend a lot of time staring closely at the signboards or rail information systems,” director of the Institute of Business Excellence at NTUC LearningHub, Anthony Chew, told CNA.

Other possible scenarios could include commuters “shouting, hitting out and even hurling (objects), seemingly unaware of their surroundings”. They could also be “unable to communicate themselves when they speak” or “ask a repeat question every few minutes”, added Mr Chew. 

For commuters with dementia who “might not disembark at the terminal”, the staff could “approach them tactfully to assist, and not show frustration or force them out of the vehicle”. 

Recounting a scenario where a possible person with dementia appeared to be “spacing out”, Ms Norendrawati said a restaurant manager she once trained had observed an elderly man standing around outside his outlet. He thought the man was undecided about entering the store, so he informed the man that he could go in whenever he was ready. 

“(People with dementia) may actually come to you sometimes, and when you ask them another question, they may suddenly say things like, ‘Where am I? Where is this place?’ And that’s what happened to this particular uncle. That is a sign of dementia,” she said. 

And if the person exhibits such signs, they shouldn’t be left alone. 

“This is where that restaurant manager regretted after sitting in my class, because he said, ‘I don’t know where he went to but I can imagine he probably got lost.’ I told them that if they identify (a possible person with dementia), but they’re not too sure yet, ask them (questions),” she added. 

“Sometimes we don’t want to accuse them of having dementia as well. Tell them that you could serve them a drink to make them realise that someone is there, and at the same time, get the connection.” 

Some people with dementia might throw a temper, so in this situation, “take them aside, reassure them with patience and calmness”, she added. 

“Assure them that they’re going to be okay, so they are not embarrassed. Treat them with respect and dignity.”

Additionally, both Mr Chew and Ms Norendrawati told CNA that a common misconception addressed in the training is that only the elderly suffer from dementia — but it can even happen to younger individuals in their 40s, including those who are “well-educated” and who are are “often perceived as being more mentally active”.

Mr Chew added that most importantly, the course also teaches staff to “give much respect to maintain the dignity of persons with dementia”. 

“There is a need to ground such individuals and bring them back to reality. It takes a lot of time and patience, as we cannot expect them to immediately remember."

DEMENTIA AWARENESS TRAINING IS ABOUT LIFE SKILLS

But such inclusivity training goes beyond helping those living with dementia, as they might not even realise they’ve lost their way, said Ms Norendrawati. 

“Rather, I think it helps the family. It becomes very concerning if you lose your loved one.”

She added that her students can range from individuals who’ve been working for 30 years to a younger crowd. While the former may have more stories to share about their experiences, there is an occasional younger staff member with a parent who has “gone through certain things that we’ve spoken about or shared”. 

“They will say, ‘Yes, my mum is like that. My dad is like that.’ And this is where learning takes place as well. … (The younger SMRT staff) really appreciate (the training), because they get practical tips based on the perspective that others can see, ” she said. 

“(Dementia awareness training) is actually life skills. Because I told them anytime we can have a parent that can come with some of these disabilities.” 

In 44-year-old assistant station manager Choi Whey Shiong's experience, caring for his late grandmother who had dementia made it “quite easy” for him to identify people with dementia. He recounted a moment prior to attending the training where he saw an elderly male commuter mumbling to himself, and thought “something was not right”. 

While Mr Choi managed to help the commuter with skills he had, he noted that different commuters require different “techniques”. 

“We cannot have one technique applied to everybody because some are more sensitive. Some might get agitated more easily. So you will need to judge the situation and apply the right method. Of course their safety has to be the priority,” he said. 

Despite his existing knowledge about dementia, Mr Choi was given an added boost of confidence after attending the training session. 

“Without the training, handling persons with dementia was based on self-instinct. Now when I help those commuters in need, I have more confidence. It gives me more courage to do the thing that’s right.”