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Published on: August 10, 2013
by Luciana Cramer for Senior Living:
Alzheimer’s patients thrive in familiar environments and by following a familiar routine. The more consistent the type, time and frequency of activities, the better they feel.
Adherence to routine creates a sense of safety, brought by the certainty of knowing what is coming up next. It avoids confusion. Even families of patients in the earlier stages of the disease notice the emerging need to follow routine, i.e. dad only wants to go to the same restaurant, and once there, he always orders the same dish.
Routine, however, gets interrupted when traveling. While for most people traveling to new places is exciting, for the cognitively impaired traveling can be confusing. Being away from familiar surroundings, eating and sleeping in unfamiliar places, having your sleep pattern disrupted, needing to speak and interact with strangers (such as airport and hotel staff) and having to follow directions that may not be fully understood; all the novelty of traveling may be actually confusing for Alzheimer’s and dementia patients. Confusion causes distress that may result in unusual, potentially catastrophic behavior.
However, people with dementia can and do travel. Some travel because they need to, some travel because it is fun. With appropriate support and preparedness, traveling with dementia can be safe and enjoyable.
When considering traveling, the first thing to keep in mind is that no person with dementia should ever travel unaccompanied. There are too many decisions to make, directions to follow, unfamiliar surroundings to navigate. A person with dementia will find it all overwhelming and may not be able to complete the journey.
That was the case with 83-year-old Victoria Kong. On May 3, she was traveling alone. The family had notified the airline, and when her plane arrived at the Reagan National Airport terminal, an escort was waiting for her with a wheelchair and a digital sign.
Mrs. Kong walked out of the plane with other passengers, passing right by the unsuspecting escort and kept walking straight out of the airport. Family members, who were expecting her by the luggage area, did not anticipate Ms. Kong ignoring the escort. Tragically, her body was found three days later in a wooded area at a park close to the airport, where she had apparently died of exposure.
The next thing to consider when traveling with a person with dementia is the stage of dementia. As a rule of thumb, stages 6 and 7 are too advanced and vulnerable and should not travel. If in doubt about which stage your loved one is in and if travel is appropriate, ask your doctor.
During a cruise in 2012, I once observed a lady in advanced stages of dementia experiencing a panic attack. She was held by crew members (who are not trained in dementia care) and kept in restraints for two days until the ship arrived in Hawaii. She and her husband were then escorted off the ship.
Appropriateness, even when carefully considered, should not be taken for granted. The interruption in regular routine and activities aggravated by the novelty of new surroundings and personal interactions may result in anxiety and cause a person on stage 5 to present troublesome symptoms typical of stage 6.
You can minimize the risks of confusion and anxiety with careful planning and preparation for your journey. Here are some essential precautions for safe traveling with dementia:
» Changes in environment can trigger wandering. Even for a person in the early stages, new environments may be more difficult to navigate. Register the person with dementia with the Medic Alert + Alzheimer’s Association Safe Return program. If the person is already registered in the program, notify Safe Return of your travel plans. Have the person wear the ID bracelet at all times.
» Consult with the doctor prior to your trip and ask for an anti-anxiety medication to be used in case of emergency. Also ask for a letter indicating the condition and carry it with other travel documents.
» Create an itinerary that includes details about each destination. Give copies to emergency contacts at home.
» In your carry-on luggage, be sure to have medications, your travel itinerary, insurance cards, physicians’ names and phone numbers, your identification and the person with dementia’s identification, including photo.
» Inside the person’s purse or pocket, place a card with the name of the hotel or person you’ll be visiting.
» Have a bag of essentials with you at all times with a comfortable change of clothes, water, snacks and activities.
» Avoid scheduling flights that require tight connections. Keep your travel plans simple with as few layovers and flight changes as possible.
» Stick with the familiar. Travel to known destinations that involve as few changes in daily routine as possible. Try to visit places that were familiar before the onset of dementia.
» Inform the airline and airport medical service department ahead of time of your needs to make sure they can help you. Most airlines will work with you to accommodate special needs.
» If appropriate, tell airport employees, screeners and in-flight crew members that you are traveling with someone who has dementia. However, keep in mind that they are not dementia experts and may not know what to do with that information.
» Even if walking is not difficult, consider requesting a wheelchair so that an airport employee is assigned to help you get from place to place.
» If you will be staying in a hotel, inform the staff ahead of time of your specific needs so they can be prepared to assist you.
» Travel during the time of day that is best for the person with dementia.
With proper preparation and careful planning, traveling will be enjoyable and fun for both of you. Bon voyage!
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