Should someone with Alzheimer's disease travel alone?

Bandnerdsmom... There are a lot of good answers here, but I would be very careful with some of the advice. I was a caregiver for my mom for many years...trust me when I tell you that this is different from just being a child of a parent with Alzheimer's. The one thing about Alzheimer's is that a "switch" can be thrown overnight...literally. What if your mom is by herself when that happens. Can you even begin to imagine the absolute terror that goes through a person who is in that situation?! Let's say you let your mom get on a flight by herself. She does fine. But, there is a plane delay for some reason at one of the cities, and now she must navigate dealing with a change of plans. That's bad enough, as she probably will not be able to handle it. Let's say that she has to stay in a hotel at an airport overnight. Let's say she can figure that out. Now...unexpectedly...she wakes up the next morning and has no clue as to where she is or...who she is. And, for those of you out there who say this cannot happen, oh yes it can. The fear that will go through your mother will be utter terror. Please do NOT send anyone with Alzheimer's on a trip by themselves. That's just plain irresponsible, and I don't care if I am stepping on anyone's toes. When you take care of someone with Alzheimer's, as I did for years, you have to think one step ahead at all times.

As far as I know, there are no airline regulations re: someone with dementia flying. When I flew *with* my husband who has early- to mid-level Alzheimer's, I alerted the airlines that an elderly man with memory problems would be travelling on their flights so that there'd (maybe) be extra help in case of an emergency. My husband was a regular solo business traveler (worldwide) , but it was clear by the end of our journey that he couldn't have managed alone. For me, the important questions to ask are: Could your mother cope if something went wrong? Would she have a problem managing gate changes or flight delays or cancellations or an emergency in the terminal? Would she understand and respond appropriately to announcements over the airport loud speakers? Could she manage an unexpected overnight at the airport or a hotel? If at a hotel, could she manage a shuttle to/from the airport and getting meals? Is she savvy enough to AVOID being victimized by the sleazy/criminal people who regularly frequent large airports and to communicate effectively with airport personnel? Sad to say, this may be a situation where the only answer is that flying is not as easy or safe as it used to be and that she would not be safe travelling alone.

Moecam, Dlanz and I have brought forth several suggestions from the Professional Travel Industry point of view. The point that can't be stressed enough is you must consider the safety of the crew and other passengers in the event the plane must be evacuated. When there is an emergency people panic and instinct of self preservation kicks in and the crew can't focus on just one passenger who is either physically or mentally disabled. Fast action and the ability to respond to commands is essential.
Having traveled throughout this world much of it on my own, my career allowed me to have those adventures. Now is the time to acknowledge I can't do it anymore on my own, for the safety of others. End of point.

My mom has late stage Alzheimer's and I work for a major airline.

The airline policy is if a person cannot safely evacuate during an emergency they should not travel alone.
As an airline employee we are limited in the type of questions we can ask to ascertain a passenger's ability to travel.

You should be very concerned if you think your loved one isn't capable of traveling alone, especially if it isn't a non-stop flight. Yes, planes do divert if a passenger is ill, disruptive, or if for any reason the flight crew determines that comfort and safety of passengers is compromised. And some airlines pass the cost of the diversion on to ill passenger!

Personally, I have seen it happen too many times; family members putting an elderly person on a plane who is incapable of flying alone and easily confused in unfamiliar surroundings. I think it's elder abuse!

My mom has flown one time in the last 16 years and was with my dad and sister. It was so difficult my dad said never again! Mom was agitated and confused.

I certainly hope you can prevent what could be a crisis!

Unless someone with the airline can help, and I am skeptical about that in this age of people not caring about their fellow man, I would be worried. I love to travel and dread this happening to me at some later stage in life as I have so few people or no one at that stage. Check with the airline. It may also depend on the level that person is in.

I was on a flight and sat next to a woman that was traveling alone with dementia. She had connecting flights to make and panicked when she asked me where the flight was going and it did not match her final destination. This caused a delay in the flight while the attendants checked to make sure she was on the correct flight. During the flight she continually checked for her things and could not find her other boarding passes. I helped her find them then she forgot where they were again. By the grace of God she was seated next to me whose mother recently passed from dementia so I was able to deal with her. Can you imagine her sitting with someone who did not understand? I managed to calm her and told her I would help. I alerted the attendant that she would need assistance. When the flight landed none of the attendants helped her and no one was waiting to help. I assisted her to the restroom and had time to help her onto her connecting flight. I once again told the attendants of the new flight that she would be needing help and could easily lose her boarding pass and have problems finding it. I was very doubtful that they would help her as they had not on the previous flight. So as I watched her board her next flight I hoped there would be another good Samaritan on board to help because it seems most airlines only help physically handicapped people and have no patience or help available for dementia customers so no no no from personal experience should they ever fly alone!

If I were in your shoes, I would first call the person she was going to visit and explain just how confused and incontinent she is. If that person won’t recind the invitation to visit, I would then call her doctor AND the airline and explain again. I would think one of those three avenues would get the trip cancelled. You might even be able to pull it off without them knowing you were involved. They are leaving themselves open to a visit from Adult Protective Services, believe me, you do not want to be on their radar. Best of luck.

As a former flight attendant, I must ask some questions that you need the answers to:
1 - is the flight non-stop? - direct only means you don't need to get off the plane not there are no stops - only non stop so that she doesn't get off at wrong place/city
2 - there is a service for unaccompanied minors [UM] - I have seen those kids as young as 6 flying on their own but there is a hand off procedure when the UMs change from ground staff to air crew & back to ground staff - see if there is a similar service for your step-mom - might be a charge but the wheelchair service might work out for this 
3 - how far will she be accompanied by family/friends within the airport at each end?
4 - is this trip really necessary?
5 - make sure she only carries a big purse but she may be a target to some bad people so all valuables should be left at home
6 - buy her a silver ID bracelet with contact info in case she gets lost [she should have this anyway] 
7 - write out travel info & place a copy in her pants' pocket

You sound like a caring person to be so worried about her - GOOD ON YOU!

Oh, my! ABSOLUTELY NOT! I was so flummoxed and appalled when I read this. I have to ask since dad doesn't have dementia, why isn't he traveling with? Would it be an airline with direct service from Arizona to Logan or would she have to stopover in  Chicago?

PLEASE REMEMBER !!! She is not alone on that plane. If there is a problem, the flight crew does not have time for a one on one with your Mother. Is it fair to anyone to put that kind of responsibility on them?

I was a Certified Travel Counselor for 37 plus years before I was diagnosed with early onset Dementia/Maybe ALZ just shy of two years ago in my mid 50's. I have literally traveled much of this world and understand the perils of traveling even for someone whose life is not impaired by dementia. I read through the link BarbBrooklyn posted and it is an excellent guide.
I traveled with my family for a Christmas cruise in 2016. This was my most difficult experience traveling since my diagnosis. Thankfully, my DW and two of my three adult children, and our 10 yr old at the time were with me. Remember, I spent my entire adult life traveling and yet, there were many times I was confused, yet aware enough to tell my wife and adult children, they would have to make decisions, I didn't feel as though I'd make the correct decision. Yes, there were times I was plain frightened because I was not familiar with the particular ship we were on or airport we were in. I did insist they get off of the ship and enjoy the ports and I stayed on board enjoying the pool and our huge balcony. I felt perfectly comfortable in the environment of an uncrowded ship.
I pray each day that I don't lose touch with being mentally aware enough to continue telling my family, I need for them to make the decisions for me when I know I need help. Sadly, I know the day will come that I probably will lose that lest vestige of reason and be totally dependent on my family making decisions for me.
Yes, I believe I am smart enough to leave you with this bit of professional advice. I would not allow even someone in the early stages of any dementia to travel on their own. Perhaps approach things with the attitude, lets go on this adventure together and visit Boston, perhaps cruise to Alaska or Hawaii, if at all possible. I know neither of my adult children wish to travel with me again, but they would if I needed them. I was pretty high maintenance on that trip. Don't let a patient with any dementia travel by themselves, you'll regret it and their journey will have serious consequences for all. My Opinion.

Too too many what ifs. She needs a travel companion unless...
- she is used to flying this route and she knows all the airports like she knows her city. If she can’t go to grocery store on her own, no flying on her own.
Lymie, love love the “unless she was a flight attendant” sentence!
- can answer basic FAQs in detail on who she is and where going
- she can sit in 1 location in a chair or wheelchair for hours and be able to get up without vertigo or numbness in legs/butt.
- she can get dressed and undressed totally on her own, including taking jewelry off & on & do it all efficiently within a couple of minutes
- can follow orders...seat belts, trays, securing carry on’s, giving boarding pass
- can read & understand signs that are 8’-25’ away. The newer digital Arrival/departure boards that flip every few seconds seem to be super challenging to elderly travelers
- she can use cell phone & access text / emails to be aware of gate change
- can toilet, dispose of Depends and wash hands on her own
- knows how to deal with cash
- can read, knit, pray the rosary or whatever to keep her mind occupied so not agitated and anxious.

I fly pretty regularly and it’s basically now like taking a bus with wings. And it’s not a luxury bus with beds, bar and full bath. Flights are packed, folks are rushed, airports crowded. If there’s a problem you have to be able to think & move quickly. Nobody gives a rats butt about that old lady.

My mom flew extensively till her 90s & she had Lewy dementia, so appeared pretty cognitive & competent. Why it worked was that she knew the airports, no change of plane flights, she was totally ambulatory but had wheelchair preordered for all flights (& knew to tip), always did handicap preboarding, no luggage except for her tote bag & small purse, and ok on toileting & she limited fluids. She did crosswords. Family or friends took her to airport & stayed till wheelchair loaded her in. Once she got needing her footed cane for walking she stopped flying. It’s just to frenetic in an airport for solo traveler with a cane that’s elderly.

BandNerds - why can’t your dad understand the situation? He may actually be lots less competent that you realize. Or he has a death wish for her. She needs flight companion & she/dad pay for the companions flight. There’s gonna be someone wanting to go up to Boston, or to Phoenix. Craig’s list always has ride shares posts. It would be super low risk too as they get the ticket only the day of flight at the airport and you have all their info in order to book it.

The answer to this has so much to do with variables we just don't know about. The first most important variable being how far along she is in her Alzheimer journey and how accustomed to flying she is. If she was a flight attendant, flew regularly for business for instance or has made this trip to see her family regularly and often for years it might be doable, with some careful planning and help. However if she gets anxious, agitated or otherwise lost in her head when there is any deviation from routine, she is dealing with new people or something simply doesn't go the way she thinks it should....How she deals with day to day life is of course a big factor here. While I wholeheartedly agree (and sounds like you do too) the best set up would be for someone she knows and trusts to travel with her, it doesn't sound like this is an option. So my next question would be is it a direct flight? I believe there are direct flights from PHX - BOS and providing the above considerations indicate it might be doable I would guess you could arrange the same sort of thing with the airline that can be arranged for an unaccompanied minor. A wheelchair as someone else suggested and clearance for you dad or whomever to push her to the gate (airline can provide a special credential so he can go through Security without an actual boarding pass) where a gate agent would take over and get her on the plane. The flight staff would be aware of her circumstances and be especially attentive and then on the other end whoever is meeting her might be allowed to wait at the gate but in BOS my guess is staff would accompany her from the plane to (probably send a cart and a wheelchair) the baggage area where there would be a meeting place set up for whatever family is meeting her on the other end. Again so many variables we don't have answers to but if you aren't concerned about her behavior or ability to understand and look forward to what is happening a direct flight could work. I would suggest she carry with her or attached to her somehow a note explaining the basic situation with contact info in case something does go awry, perhaps attach one of those Tiles that allows you to track things or a watch designed for elders and children that accomplishes the same thing even if she is good about keeping her phone with her but those are just other covering all your bases ideas not really part of the answer to your question.

If on the other hand the considerations above scream this is a very bad idea and there isn't anything that might make it ok I think I would caution against doing or saying things that might come across as forcing your will on your dad. I get he's in denial and I can imagine why if I put myself in his shoes but I fear that if he feels forced or like his authority and reason is being questioned he might dig in harder and you may simply find he puts he on a plane and doesn't share the details with you or something just to prove it's his life, his wife and he knows best. I might try the approach of concern for her. Is the incontinence embarrassing for her (an overnight Depends or one with a pad also will probably be fine for the flight if she isn't able to change them on her own), if she has had episodes of anxiety or high stress brought on by a new situation or when someone isn't understanding her...anything that might occur during this trip... then the concern is a real one that this could occur here and that might not just be awful for her but it might make her more fearful of doing other things, going out in public or even accelerate the disease. What if she were to wander and get lost in totally unfamiliar surroundings, again it would be awful for her and quite possibly dangerous. Is there the possibility she wont be comfortable away from home and with family she isn't used to seeing every day? How dependent has she become on him and has she stayed with someone else recently? Going across country only to find out that doesn't go well for her could be an issue for everyone. I'm just coming up with things that might make for worse than a bad experience for her because we know he cares about her and doesn't want to make things worse. Maybe having the person she is going to see come to her and he can go visit you or something, just to see how that goes would be a good idea before sending her to them? Again, I don't know the circumstance around who she is going to see and where so this may be impossible for some reason but maybe a variation could be found and if you can finagle the conversation so making adjustments or ways to address concerns are your dad's idea (or he thinks they are) all the better!

It sounds like your dad is in good health/mind but something medical prevents him from making that length flight? Is there some way to make that part of the consideration, if she had a horrible episode and Sally can't calm her down or help her the way you do what then since you can't go rescue her/them? "I've just heard these stories that sound horrible and don't want you or Betty to have an experience like some of those", "maybe I'm reading too much but I want to learn as much as I can about her condition and came across travel warnings, you know me I like to plan for contingencies"... You may not be able to persuade him or prevent this too, unfortunately it can be a grey area and there aren't any legal or official ways to stop our elders from making decisions or doing things we know are bad. Even with POA I don't think you would have the authority to prevent them from doing this and you might need to let it go and watch it happen. It's up to you if you are willing to be part of the clean up should it go wrong, though I think a better plan would be to let whoever she is going to see in Boston know about your concerns and any other family, children she has and let them take on the responsibility. You also have to pick your battles, certainly make your reservations known but weigh the pluses and minuses of spending all your influence capital on this or and not having it for the next important thing that will come up. It might be one of those times you need to let them learn hard lessons from their mistakes (or it miraculously goes smoothly) rather than alienate your dad so much he just shuts you down when you suggest letting the pharmacy manage the medications or getting an emergency call button. Good luck, my heart goes out to you. You really are in a tough spot here and maybe more so because she isn't your mother...I can relate to that situation.

Another person brought up lawsuits against the caregiver...yes that can happen too. I didn’t even think of that. I don’t think pilot will allow her to board and fly even though airlines may be uninformed about dementia/Alzheimer’s. She can start screaming uncontrollably too...OMG it would be a disaster

If she can’t go w someone then cancel. Airline won’t be held responsible when she gets lost or help when she has bowel accident

OMG, no way should an incontinent person with Alzheimer’s do anything alone! Unless the toileting issue was due to a medical problem prior to having Alzheimer’s, that means she’s in the later stages of the disease where some folks are in memory care facilities due to all the unpredictable issues that go with dementias. If she even could navigate through the airport, find the right gate, go through security and get on a the plane without a problem, there’s still the actual plane ride to contend with which includes the health and safety of the other people on the flight. Aside from all the stress and confusion the flight would cause your stepmom, who very well may “think” she would be fine, the other passengers on the plane would be trapped and be a captive audience with whatever event transpired. I would think( definately do not know) that your dad may even be open to lawsuits being her caregiver and allowing her to be a danger to herself and others. Just way too many things could go wrong, definately a horrible idea no matter how stubborn or how far in denial your dad and step mom may still be with regards to her having Alzheimer’s .

Don't let her go. Boston airport is very very busy and confusing for a person in their right mind. It is reckless to send a person like that without a family member. Don't let her go.

Aside from any travel plans, your step-mom should wear some type of ID (a bracelet?) and carry a mobile phone with an ICE (in case of emergency) programmed into it.
She should wear an adult diaper and carry a spare, even for a trip near home. Do not restrict liquids too much since dehydration is dangerous. Perhaps omit caffeine and soda. I agree that solo air travel is a bad idea.

If she has been diagnosed with Alzheimers', has neuropsych testing been done? If not, get the doctor to recommend that and take her to a memory care center for that testing. It will produce a report that documents exactly what types of issues she has with brain function and also will produce a list of recommendations that should be followed. So for example, it might state the person cannot live alone, should not travel alone, need medication management etc. This will hopefully be more respected by your father. He is in denial that he has a wife with dementia. If she is incontinent, she will be sitting in liquid or worse on the plane; how is that a good idea? This really should be stopped. you mention she is your step-mother. Does she have children of her own you can discuss this with?

Losing dogs in kennels labeled with destination are still lost. What about hiring appropriate care to travel with her, deliver her, return. Then the same thing for the return flight. If you find someone appropriate there use the same person for the return. No matter the way you look at it, it is a round trip times three.

If there is no way anyone can accompany her on this trip and the trip can not be canceled without it costing an arm and a leg (you know they charge for everything)Most airlines have a program where a staff person has to accompany a minor that is flying alone maybe they would do that for the adult that has disabilities. Obviously no personal care would be done but getting safely from point A to B might be enough. (although if they rerouted a few dogs over 3000 miles no telling what might happen)

Bad Plan, VERY bad plan! My experience with mom (Stage 6) is that stressful situations can increase the level of confusion and bizarre behavior on a monumental scale. Would dad be willing to pay for you or someone else to travel as her companion? How importanat is this trip to her? I recently went on an 8 day road trip with mom to visit relatives in another state. It was very hard on her. Routine is very important to Alz patients and travel is anything but routine. I'm guessing the airline would decline to take her if they knew. Check with their customer service department and they should be able to direct you to the best person to speak with. My dad (before he passed in December) also didn't recognize moms decline. He would let her make serious decisions that she was not equipped to make. My heart goes out to you.

Please look up here, on this site, the many many stories about 'airline travel with the incontinent dementia sufferer'. The stories will make your hair curl. Print them out and show THEM to your father. Sending your mother on a plane alone will be a real fustercluck. So many things can go wrong. Do you expect the airline to 'take care of everything'? No. Bad bad idea. Tell Mr. Helpful Dad he has to go with her.

Does your Dad need respite? This may be his way of getting it.

She may or may not be able to handle this. We really don't know. Instead of cancelling her flight (behind her back?) as someone suggested, a family member (not your dad, obviously) should simply go with her if it's such a concern.

Absolutely not!! Even if the airlines were ok with this, its yours stepmoms life you’re dealing with. My husband had early onset Dementia at 53. He was still walking but got confused as well. And incontinent as well?? No way. I took him on an airplane ride because he desperately wanted to see this elderly aunt in another state. He had to use the restroom in the airport so i showed him where it was and waited at the end of the corridor. After 10 minutes I had to ask someone to go look for him. Thankfully, he found him but when we were in the air, an hour later, he had to use the rest room again!! I went to help him and the stewardess insisted I return to my seat. I tried to explain his medical condition and she said she would assist him and firmly sent me back to my seat! I did but of course watched the door like an eagle. I finally see it open and I ran to see how things were (was he zipped up, etc.) and when I got there I saw that he had SPRAYED THE ENTIRE ROOM!! OMG! What a mess! I tried to clean it the best I could but was interrupted to return to my seat. I was so annoyed, I did and when I got to my seat. I sat just in time to see the poor pilot use the toilet! That stewardess should have been fired but when you are attending a person, they are your first priority. They get very confused in unfamiliar surroundings which makes matters so much worse. For Gods’ sake, do not allow this to happen unless she has a competent companion that knows how to deal with Alzheimer’s patients. Being stubborn is one thing. Being reckless is another. You are dealing with lots of unknowns- an airport, security, lots of unfamiliar faces, the ride itself and then the reverse. I can not imagine why anyone would allow such a thing. Please help her...

No, just do not let this happen! Even if early stages it is taking a chance on anything happening. Call her doc let doc know the plan, ask doc to chat with dad. JUST NO!

I suppose it depends a lot on your Step-Mom and how far advanced the disease is, but my Mum has quite mild dementia and I don't let her get the bus into town on her own any more! There's no way I'd let her fly or catch a train by herself.

Celmira; It's wonderful that your mom can still travel!

Please note that the OP says that her step-mom is incontinent and is starting to wander. I think that the poor woman is a bit further down the path that your own dear mom.

I recall that my ex's elderly great aunt was still flying coast to coast in her 90's with some sort of significant congitive impairment. She was fine.....until she wasn't.

She left her purse (passport, etc) at her home airport, SFO and was totally confused and agitated when she got to JFK. Son and DIL then had to fly across the country to accompany her home.

As long as there is family that can drop everything and clean up the mess, it might not be so bad. But the OP's dad CAN'T fly. So who is going to have to ride to the rescue?

My mom will be 83 yo this year. She was diagnosed with Alzheimer.  She has traveled alone three times already to spend time with my sister then return to the USA. We have had no problem with the airline we use so far. We explain to the airline that she is traveling alone. The airline requested my phone and address as well as my sisters as well as email address. When we arrive at the airport, she is placed in a wheel chair. So far so good. She is not totally gone. She still recognizes us, and can use the bathroom on her own when she is home. When she will travel, i do not allow her to drink anything from the previous evening to lessen her chances of having to go to the bathroom while on the plane.