Welcome to Alicia’s monthly advice column where she’ll provide tips on caring for a loved one with dementia. Alicia Seaver is the Director of Memory Care at Bridges® by EPOCH and is a certified memory impairment specialist. This month’s topic is traveling with your loved one.
One of the toughest choices facing family members is whether to let a loved one with dementia travel. In the shadow of illness and limited time, the promise of meaningful travel is not to be underestimated. At the same time, there is also potential for a difficult, even traumatizing experience, if the individual can’t handle the change in routine and location. Will this person enjoy, merely endure, or likely just struggle through a trip? For the wellbeing of our loved one we want to make sure this answer is based in reality, and not on wishful thinking.
Memory loss is often marked by variations in functional capacity. Sometimes these ups and downs correlate with changes in diet, sleep, weather, time, season or other factors. At other times, the fluctuations seem to have a life of their own.
Assessment for travel requires a thorough understanding of the person’s general patterns, symptoms and reactions to various stimuli. People with dementia will often present very differently in different contexts, e.g. briefly over-functioning at the doctor’s office or with family members not frequently seen.
It’s essential to gather information from caregivers in different settings so that a comprehensive, round-the-clock behavioral profile is created. For instance:
- Does the person become agitated at sundown?
- Can he or she sleep through the night?
- Is a particular kind of music soothing (or aggravating)?
- Does the individual become anxious when a bathroom is not available?
- Do they refuse medication, and what impact does that have?
- How long can the person wait?
- How does the person handle crowds?
Triggers should be identified and taken into account when planning travel, and should be well understood by the travel companion.
Every effort should be made to minimize stressors and to maximize adaptation and resourcing while away. It’s much easier to bring along their comfort food, a favorite Johnny Cash CD, or a familiar set of watercolors rather than trying to find these on the road. Create a behavioral plan and a travel resource kit for support in difficult moments. Have a backup plan for early return in case things do not go well. The Alzheimer’s Association has additional suggestions and considerations for travel.
Next, take the individual on travel “test-drives.” This serves two purposes. It provides information on how the individual responds to unfamiliar settings.
Additionally, graduated trips may enable the person to feel more comfortable being away. Say you’re considering an interstate bus trip. Get the person on a local bus. If things go well, test out a longer excursion or proceed with the actual trip, if advisable. If things don’t go well, see if you can identify triggers that might be adjusted, and try again. If you can’t get a local bus trip to work, it probably doesn’t make sense to consider a longer one.
If it turns out that your loved one can no longer handle travel, this can be difficult to face. It is, however, much better to find that out when you, and they, are still at home.
If there is a topic you would like Alicia to discuss, please send suggestions to [email protected].