Traveling%20and%20Dementia

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Traveling and Dementia

• Josepha A. Cheong, MD
• UF Psychiatry and Neurology

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Overview

• General issues and principles
• Traveling by car
• Traveling by plane
• Resources

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General Issues and Principles

• Safety
• Availability of support for the caregiver
• Access to emergency medical care
• Reliable transportation
• The 3-5 Year Old Rule
• Similar to travel with a toddler

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General Issues and Principles

• Limitations
• Of the person with dementia
• Of the caregiver
• Preparation
• Established itinerary
• Ample time for travel and for rest

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A Person with Dementia Should Not Travel if

• Severe disorientation and agitation in unfamiliar
  surroundings
• Delusional, paranoid or aggressive behavior
• Severe incontinence
• Wandering behavior
• (adapted from the Alzheimers Association Info
  Sheets for Dementia Care)

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How to Determine is Travel Will Be Tolerated

• Take a trial trip that is shorter in length
• Modify trip plan according to behavior and
  tolerance of the trial
• Observe patients ability to deal with change and
  unfamiliar surroundings

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Key Issues

• Time allow plenty of time for breaks and for
  adjustment to an unfamiliar setting
• Safety always be vigilant for wandering or
  inadvertent escape-seeking behavior

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Key Issues

• Safety identification and contact information
  should be kept on a bracelet at all times
• Medications keep at least 2 copies of a list
  of all the meds (dose and schedule), be sure to
  bring enough medications to cover the period of
  the trip

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General Principles for the Caregiver

• Be prepared to do everything for the patient with
  dementia
• Begin the trip with getting plenty of rest
• Arrange for assistance if at all possible
• Plan all the possible details in advance

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Key Principles

• Pack the necessities and clothing for the patient
• Travel during the non-peak season
• (avoid Thanksgiving Christmas)
• Maintain your sense of humor

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Key Principles

• When planning a trip, inquire regarding
  facilities that could accommodate a person with
  dementia
• Check-in all luggage except for medications and a
  set of clothing
• Bring familiar clothing and other objects for
  orientation

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Airline Travel

• Take the shortest route possible with the fewest
  plane changes
• Bring a set of clothing in case of a spill or
  toileting accident
• Book a seat that keeps the interaction with
  others to a minimum
• Limit fluids

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Airline Travel

• Minimize carry-on luggage
• Consider a mild tranquilizer but only with an
  MDs consultation
• Make certain that there is plenty of
  identification
• Limit time in crowded gate areas
• Bring a snack and a distractor
• (adapted from Totebag and Toothbrush Travel Tips
  for the Alzheimers Caregiver. Moxley, 1996)

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Car Travel

• Limit time in car to 2hrs at a time
• Be certain to secure seat belts and door locks
• Bring extra set of clothing
• Stop early in the day to allow time for the
  person to adjust to the change in environment

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Car Travel

• Never leave person unattended
• Make certain of identification information
• Carry recent photographs of person
• Plan itinerary in advance, leave copies with
  friends and families
• Have assistance whenever possible

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Review

• Safety is always the primary concern, even if it
  means NOT traveling
• Allow time for adjustment to change
• Try to maintain as much of the daily routine and
  schedule as possible
• Have realistic expectations of the persons
  ability to tolerate change
• Assistance is ALWAYS a good thing

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Resources

• Alzheimers Association Information Sheet on
  Travel Tips
• Moxley J. (1996). Totebag and Toothbrush Travel
  Tips for the Alzheimers Caregiver.
  Winston-Salem, North Carolina Piedmont Triad
  Alzheimers Association

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Resources

• Hall GR. Travel Guidelines for People with
  Dementing Illness. Iowa Geriatric Education
  Center Virtual Hospital
• www.vh.org/Patients/IHB/GeriatricEducation/Travel.
  html

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Questions?