Many people enjoy travel as a form of recreation, relaxation, and an
opportunity to learn. While travel may be a positive experience for most
people, it poses special problems for people with dementing illnesses, for
example, Alzheimer's disease, multi-infarct dementia, Parkinson's disease,
Pick's disease, or injury that results in disabling intellectual
People with dementia have ever-increasing trouble with changes of pace,
changes in location, fatigue, groups of people, changes of time zone, and
noise. In a familiar environment, there are many environmental cues that
help a person with dementia to remain moored in reality. A favorite chair,
a well-learned TV control, and a familiar floor plan are taken for
Unfamiliar places, however, lack these well-known moorings and result
in increased confusion, anxiety, and fear. Even places that once were
familiar, such as a winter home, can seem new or alien, triggering fear or
anger. Caregivers who are planning to travel need to plan trips carefully
in advance, using both travel and healthcare professionals to determine
the best possible methods to cause the least distress to your loved one.
The following guidelines have been developed to assist you with travel
planning. After reading the guidelines, you might want to discuss them
with either your physician or your local chapter of the Alzheimer's
Using them can enhance the success of the trip.
What can be done in case of emergency? Do you know of medical services in
the areas you travel to? Do you need to take special medications with you
in case of agitation? Having a plan can save hours of stress and panic.
What are the care receiver's limitations and strengths?
As a general rule, the more advanced the disease, the more difficult
travel will be. For example, care receivers who are still relatively
independent and care for themselves will have fewer problems with travel
than someone who requires direction to bathe and change their clothing.
Also, people with behavioral problems such as paranoia or delusions
(missed perceptions, fears, or fixed false beliefs or thoughts) have a
more difficult time even when intellectual skills are relatively good.
As a rule, someone who requires assistance with
bathing, changing clothing, dressing, and toileting will have significant
difficulty even with short, simple overnight trips. At time when it may be
easier for retired people to visit adult children who work, it may be
better to have the children visit you—even if it means paying for their
Care receivers who exhibit any of the following behaviors should avoid
overnight travel unless in an emergency:
Become physically or verbally aggressive
Missed perceptions, have paranoid thoughts,
hallucinations, or delusions (for example, think people steal from
Become confused during or after social outings
Wake at night confused
Have poorly managed incontinence (or who
require special assistance or equipment
with feeding if public dining rooms must be used)
Have episodes where they do not recognize their
Yell, scream, or cry spontaneously
Resist or argue with their caregiver's
Wander or pace
Demand to leave social settings or restaurants
Are easily frightened, confused or agitated
Are unable to communicate their needs to others
Have unstable medical conditions
Assess the caregiver's limitations
There are also caregiver-related issues to be considered. Caregivers
should avoid traveling with their impaired person if they (the
caregiver) have any of the following characteristics:
Become upset or can not manage well during a
Are embarrassed when their loved one acts out
Have unstable or complicated health problems
Are embarrassed to go into an opposite sex
to supervise their loved one
Are unable to manage in high stress situations
Insist on maintaining strict honesty and argue
loved one about mistakes and missed perceptions
Are not able or willing to make significant
during the trip—often at a moment's notice—to meet their
loved one's changing needs, including canceling the
Don't think they want to take the trip but will
do it for
their loved one
Think there will be no change in their loved
behavior during the trip
Are not willing to plan well in advance.
Resist seeking help as needed, thinking they
manage on their own.
Think that trips to familiar places (such as an
child's home or cabin) will be 'just like it used to be'
because it's 'familiar and fun.'
While travel may be enjoyable, getting to your destination is
generally not relaxing. The following are principles to consider when
planning the trip:
The process of 'getting there' should be as
short and simple as possible. Plan a trip that involves as few changes
Trips should be to a single destination, rather
than a series of visits. For example, you would want to travel to a
wedding and home, but not take three months stopping at friends' homes
along the way.
Stick with the familiar. Vacation in ways your
loved one was accustomed to before the onset of the disease.
Consider a shorter trip. Day or weekend trips
may be a better alternative, particularly if you are unsure of your
loved one's reaction to travel. If everything goes well, go for a
If your loved one has not traveled in six
months, schedule a 'trial' overnight stay nearby home to see if your
loved one can still tolerate travel.
Gather necessary papers and documents,
including insurance cards, passports, physician's phone number,
medication refills, and the care receiver's medical record. Do not
expect your loved one to carry these documents or tickets.
l Rest periods should be built into the travel schedule. Planning too
many activities, such as meals in a restaurant, can lead to late night
confusion or agitation. Do not plan activities for the night you
Save travel for your loved one's best time of
Use services specifically designated for people
Spend as little time as possible in areas with
large groups of more than 20 people, loud noises, or lots of activity
(for example, airport gate areas). Avoid busy places and situations
that will cause anxiety for your loved one.
Never expect the person with dementia to travel
alone. Do not expect travel employees (flight attendants, gate
personnel) to care for or supervise your loved one. Always have the
care receiver carry identification.
Expect your loved one to become more confused,
agitated, or behaviorally difficult during the trip. Assist with menus
Do not expect other members of a tour to
volunteer or be agreeable if you need help with your loved one.
Advise hotels, airlines, tour operators, or people
you are visiting that you are traveling with someone with memory
impairment. Be specific about your safety concerns and special needs. If
you are staying in a private home, guest home, or bed and breakfast, do
not surprise your overnight host with your loved one's condition. Explain
it fully, well in advance. Do not think they won't notice. Don't be upset
if they feel they cannot handle the visit—especially if there are
children in the home.
Never travel without a full set of
Always provide family members with an itinerary
and call home regularly.
Make a list of the daily routine and special
items you need to take with you.
Always have the person with memory loss
identified, preferably with a bracelet your loved one cannot misplace.
Use good judgment when telling your loved one
about the trip. Discussing it too far in advance may produce anxiety
Be flexible. Have a contingency plan that
allows you to leave early if your loved one becomes ill, agitated, or
wants to go home.
Keep your sense of humor and laugh at all the
things that happen. They will be part of a wonderful memory of your
If the trip is prolonged, develop a list of
medical professionals and Alzheimer's Association chapters along your
lNever leave your loved one alone or ask
strangers to watch him/her. A person who does not know your loved one
or the disease will not know how to react in a difficult situation.
Avoid traveling at peak travel seasons such as
Thanksgiving and Christmas
Take medications with you to manage stomach
upset, diarrhea, or other temporary problems caused by changes in food
Know how to get help and who can help in
countries where you do not speak the language.
Check the Yellow Pages to see if there is a
travel agent in your area specializing in planning trips for people
with disabilities. If so, use the specialized service.
Dr. Geri Richards Hall has been a professor and
practitioner in the field of geriatrics and nursing for many years and has
written many articles about memory disorders and caregiving. She currently
serves as Associate Professor (Clinical), Director Master's Programs and
Advanced Practice Nurse Memory Disorders Clinic at the University of Iowa
. Caregivers may download the full text of the travel guide brochure and
about five other booklets related to dementia management from the
University of Iowa Center on Aging at
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