With the holiday travel season upon us, families cringe with anxiety at the thought of traveling with a loved one who struggles with a dementia. I will often be asked by a client if their loved one with Alzheimer’s can travel, and how to prepare for the journey. If your loved one is still in the beginning, mild stage he or she may be able to enjoy the trip, but precautions and preparation are paramount to a successful trip.
New faces, new environments, a change in daily routine, not to mention a time zone change, can prove to be a challenge for the dementia patient. That being said, if your loved one is still in the early stages of the disease, you should consider planning trips to visit family and friends now, before the disease progress. Once the individual is in need of assistance with bathing, dressing and toileting, travel will present significant problems, even just a short drive will be problematic for the more advanced dementia patient. Individuals exhibiting any of the following most likely will have a very difficult time traveling:
- Being disoriented, confused or agitated
- Asking to go home
- Difficulty managing bladder and bowel
- Anxiety or isolating behavior
- Agitation or signs of wandering
- Paranoia, hallucinations
- Being verbally or physically aggressive
- Spontaneous crying
- History of falls
You won’t know how your loved one will tolerate travel until you take that first trip. So I suggest you test the waters by planning a short trip away from home. Perhaps a weekend at a favorite destination within an hour or so of home. Suffice it to say, if your loved one doesn’t do well on a short trip away, he or she most likely will not be able to tolerate an extended trip.
So, let’s get going, shall we? If your destination is more than a two hour drive you might want to consider traveling by plane or train. Try to travel on off peak days, and consider if it would be better for your loved one to spend a day traveling by car instead of a crowded plane or train.
If your trip is longer than 5 or 6 hours, make arrangements for someone else to go along so that you can take turns driving. Preferably, someone who has experience with dementia or someone familiar with your loved one. You don’t want to drive alone with a dementia patient who becomes easily agitated or aggressive. Dementia patients are likely to swing open the car door in an attempt to get out, grab at the steering wheel or hit the driver. Have your loved one sit in the back seat with your driving companion. If your car is equipped with child safety locks, make sure they are engaged prior to your departure; this will prohibit your loved one from opening the door during travel. If your loved one does become agitated or aggressive, pull over as soon as possible to help redirect and calm him or her.
Be sure to pack a few things to keep your loved one occupied and comfortable. Perhaps a book or magazines, playing cards, favorite music, a favorite object or blanket from home, photos of the people or places you are headed to visit. Snacks are a good way to keep your loved one occupied, and water is a must to help prevent dehydration.
Be prepared to make frequent rest stops along the route. Remember, your loved one can no longer tell you if they are hungry, thirsty, tired, need to be toileted, etc., so it’s up to you to keep track of these matters. When you do stop, don’t ever leave your loved one unattended – too many things can go wrong. The unfamiliar surroundings of a rest stop, restaurant or service station will cause confusion and may trigger your loved one to wander off or exhibit aggressive behaviors. Try to visit places that your loved one once enjoyed, places that might seem somewhat familiar.
Remember, dementia doesn’t take a vacation. Just because you’re on holiday it certainly doesn’t mean your loved one requires any less care. Consider bringing someone along who can help with the caregiving needs. Plan your itinerary to include short sightseeing tours or visits to family and friends, time for your loved one to rest each day, and most importantly, try to maintain the same daily routine that your loved one has become accustomed to at home. This will help ease anxiety and agitation.
Prepare the essentials and keep them with you, this includes identification, emergency contacts, a photo of your loved one for identification purposes, medications, water, snacks, a change of clothes. Keep with you a message, business card size, that you can discreetly hand to restaurant servers, hotel staff, etc. that communicates your situation “Please be patient, my loved one has Alzheimer’s” or something similar. You should also be prepared to offer a simple statement should your loved one’s behaviors start to surface (“Please forgive my wife/husband, she/he is cognitively impaired”).
Be flexible. Have your Plan B laid out should you need to leave a visit early or return home early from your trip. If you’re making travel plans through a travel agent, consider purchasing travel insurance. Do not tell your loved one about the trip too far in advance, this will only bring on anxiety and constant questioning.
Traveling by air with an Alzheimer’s patient can present a whole slew of challenges. It is wise to get a letter from the doctor identifying that your loved one is an Alzheimer’s patient, under medical care, cannot process instructions, gets confused and agitated easily…etc. Speak with the doctor about medications that can help keep your loved one calm. Keep a list of medications handy. Be sure to contact airline personnel as well as airport security to alert them to your situation, ask about special accommodations (i.e. pre-boarding, attendant assistance, wheelchair, etc.). You should contact the airline at least 48 hours in advance of your travel date.
Plan to travel early in the day when your loved one is at his or her best. It’s better to fly nonstop whenever possible, especially if it’s a long trip – it’s well worth it to spend a little extra to fly nonstop. But, if you have to have a layover, make sure there is plenty of time between flights so you don’t have to rush your loved one. Have a plan in place should your plane be late, if you miss your connection or if a connecting flight is cancelled. The earlier you book your fight, the better chance you have of selecting your seats. Sit side-by-side and seat your loved one by the window, this way your loved one can’t just get up and wander. An iPod programmed with favorite music and headphones can help make the trip more enjoyable for your loved one – music is very calming and therapeutic for a dementia patient.
It will be difficult to juggle luggage, packages, flight bags, etc., all while managing your loved one. Pack lightly, and whenever possible ship your luggage or packages. This will free you up to focus on your loved one and you won’t have the hassle of waiting at baggage claim to locate your belongings.
Prior to departure for the airport, check all pockets, place anything that would set off the metal detector in a zip lock bag, including wallets, jewelry, watches, glasses, etc. Place the bag in your flight bag, carry on or purse. Make sure you have enough medications for several days and that your loved one has on him or her identification, list of medications, emergency contact information and information on their medical conditions.
Use the restroom just prior to the flight this will help avoid the need to use the airplane lavatory. If he or she must use the on in-flight lavatory, be prepared with a plan should your loved one need assistance, will he or she be able to maneuver in the confined space? Is there a chance they’ll lock themselves in and not be able to open the door?
Take along plenty of things to keep your loved one busy, as well as snacks, and drinks. There is always the risk of dehydration, which could make symptoms worse. A favorite food or treat is also a good way to redirect behaviors.
If at all possible, have a family member or friend waiting at your destination, or hire a car service so that you don’t have to wait in long lines.
It is very possible that the new environment will cause behaviors to surface and perhaps create a wander worry. Bring along a travel door alarm. They’re typically used to alert you to someone entering your room, but in the case of someone with dementia, the alarm can alert you to your loved one trying to leave the room. Enroll your loved one in the Alzheimer’s Association’s Safe Return program (alz.org) and be sure to have a current photo of your loved on hand or on your cell phone.
Remember, excessive stimulation, loud noise, hustle and bustle, too many faces and conversations are overwhelming to a dementia patient. Try to schedule as much alone time together as possible. Try to avoid crowded events and make restaurant reservations before the dinner crowd. Allow for extra time when planning activities, this will lessen the threat of agitation. Be sure that both you and your loved one get plenty of rest – it’s very draining, even for a healthy person, to travel, even more so for a dementia patient. With proper rest during the day and adequate sleep at night, you can help avoid creating more confusions and irritability.
Above all, have fun! Gear activities toward what your loved one is capable of, a quiet dinner, a visit to a museum or a walk. Your loved one’s memory is deteriorating, but they can still find joy in the moment.