1. Traveling and Dementia Josepha A. Cheong, MD UF Psychiatry and Neurology

2. UF Psychiatry - ALZONLINE.net Overview General issues and principles General issues and principles Traveling by car Traveling by car Traveling by plane Traveling by plane Resources Resources

3. UF Psychiatry - ALZONLINE.net General Issues and Principles Safety Safety –Availability of support for the caregiver –Access to emergency medical care –Reliable transportation The “3-5 Year Old” Rule The “3-5 Year Old” Rule –Similar to travel with a toddler

4. UF Psychiatry - ALZONLINE.net General Issues and Principles Limitations Limitations –Of the person with dementia –Of the caregiver Preparation Preparation –Established itinerary –Ample time for travel and for rest

5. UF Psychiatry - ALZONLINE.net A Person with Dementia Should Not Travel if… Severe disorientation and agitation in unfamiliar surroundings Severe disorientation and agitation in unfamiliar surroundings Delusional, paranoid or aggressive behavior Delusional, paranoid or aggressive behavior Severe incontinence Severe incontinence Wandering behavior Wandering behavior (adapted from the Alzheimer’s Association Info Sheets for Dementia Care)

6. UF Psychiatry - ALZONLINE.net How to Determine is Travel Will Be Tolerated Take a “trial” trip that is shorter in length Take a “trial” trip that is shorter in length Modify trip plan according to behavior and tolerance of the trial Modify trip plan according to behavior and tolerance of the trial Observe patient’s ability to deal with change and unfamiliar surroundings Observe patient’s ability to deal with change and unfamiliar surroundings

7. UF Psychiatry - ALZONLINE.net Key Issues Time – allow plenty of time for breaks and for adjustment to an unfamiliar setting 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 Safety – always be vigilant for wandering or inadvertent “escape- seeking” behavior

8. UF Psychiatry - ALZONLINE.net Key Issues Safety – identification and contact information should be kept on a bracelet at all times 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 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

9. UF Psychiatry - ALZONLINE.net General Principles for the Caregiver Be prepared to do everything for the patient with dementia Be prepared to do everything for the patient with dementia Begin the trip with getting plenty of rest Begin the trip with getting plenty of rest Arrange for assistance if at all possible Arrange for assistance if at all possible Plan all the possible details in advance Plan all the possible details in advance

10. UF Psychiatry - ALZONLINE.net Key Principles Pack the necessities and clothing for the patient Pack the necessities and clothing for the patient Travel during the non-peak season Travel during the non-peak season (avoid Thanksgiving – Christmas) Maintain your sense of humor Maintain your sense of humor

11. UF Psychiatry - ALZONLINE.net Key Principles When planning a trip, inquire regarding facilities that could accommodate a person with dementia 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 Check-in all luggage except for medications and a set of clothing Bring familiar clothing and other objects for orientation Bring familiar clothing and other objects for orientation

12. UF Psychiatry - ALZONLINE.net Airline Travel Take the shortest route possible with the fewest plane changes Take the shortest route possible with the fewest plane changes Bring a set of clothing in case of a spill or toileting accident 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 Book a seat that keeps the interaction with others to a minimum Limit fluids Limit fluids

13. UF Psychiatry - ALZONLINE.net Airline Travel Minimize carry-on luggage Minimize carry-on luggage Consider a mild tranquilizer but only with an MD’s consultation Consider a mild tranquilizer but only with an MD’s consultation Make certain that there is plenty of identification Make certain that there is plenty of identification Limit time in crowded gate areas Limit time in crowded gate areas Bring a snack and a distractor Bring a snack and a distractor (adapted from Totebag and Toothbrush: Travel Tips for the Alzheimer’s Caregiver. Moxley, 1996)

14. UF Psychiatry - ALZONLINE.net Car Travel Limit time in car to 2hrs at a time Limit time in car to 2hrs at a time Be certain to secure seat belts and door locks Be certain to secure seat belts and door locks Bring extra set of clothing Bring extra set of clothing Stop early in the day to allow time for the person to adjust to the change in environment Stop early in the day to allow time for the person to adjust to the change in environment

15. UF Psychiatry - ALZONLINE.net Car Travel Never leave person unattended Never leave person unattended Make certain of identification information Make certain of identification information Carry recent photographs of person Carry recent photographs of person Plan itinerary in advance, leave copies with friends and families Plan itinerary in advance, leave copies with friends and families Have assistance whenever possible Have assistance whenever possible

16. UF Psychiatry - ALZONLINE.net Review Safety is always the primary concern, even if it means NOT traveling Safety is always the primary concern, even if it means NOT traveling Allow time for adjustment to change Allow time for adjustment to change Try to maintain as much of the daily routine and schedule as possible Try to maintain as much of the daily routine and schedule as possible Have realistic expectations of the person’s ability to tolerate change Have realistic expectations of the person’s ability to tolerate change Assistance is ALWAYS a good thing Assistance is ALWAYS a good thing

17. UF Psychiatry - ALZONLINE.net Resources Alzheimer’s Association Information Sheet on Travel Tips Alzheimer’s Association Information Sheet on Travel Tips Moxley J. (1996). Totebag and Toothbrush: Travel Tips for the Alzheimer’s Caregiver. Winston- Salem, North Carolina: Piedmont Triad Alzheimer’s Association Moxley J. (1996). Totebag and Toothbrush: Travel Tips for the Alzheimer’s Caregiver. Winston- Salem, North Carolina: Piedmont Triad Alzheimer’s Association

18. UF Psychiatry - ALZONLINE.net Resources Hall GR. Travel Guidelines for People with Dementing Illness. Iowa Geriatric Education Center – Virtual Hospital: Hall GR. Travel Guidelines for People with Dementing Illness. Iowa Geriatric Education Center – Virtual Hospital: www.vh.org/Patients/IHB/GeriatricEduca tion/Travel.html

19. UF Psychiatry - ALZONLINE.net Questions?