Q: My mother is 79. She has depression and mild Alzheimer’s dementia. She lives in an in-law apartment attached to my home. We bring her meals and supervise her bills and medications, but otherwise she manages around the home just fine. The problem is that she wants to visit her family in Italy one last time before she isn’t able to do it anymore. My brother and I will take her over on the airplane and, once she gets there, family will keep a close eye on her. My concern is this: Will she get confused with all the changes, and is a long plane flight safe for someone like my mother?
A: Your question is quite timely as many folks are making their summer vacation plans. There are several parts to your questions. Let’s take them one at a time.
The first concern is about your mother’s dementia and the possibility of her getting confused. This depends on the individual. There are a number of signs that may indicate that travel is not a good idea, such as disorientation, confusion or agitation even in familiar settings; asking to go home when away from home on short visits; delusional, paranoid or disinhibited behaviors; anxiety when in crowds; or difficulty managing continence.
It is good that you and your bother will go with her on the flight, and that she has family to help her once she gets to Italy. It is important that the family in Italy is aware of your mother’s memory condition. Make sure you take all her medications and bring enough pills to last for the duration of the trip.
Have a list of all her medical conditions and any other important instructions for your family. It might be helpful for your mother’s doctor to write a letter describing her medical condition. While she is there, have her wear or carry some form of identification in case she wanders away or gets lost. You might want to consider travel health insurance for the time she is away. It can be expensive, but if she gets sick or needs medical attention while overseas, most Medicare insurance won’t cover her.
Try to get a nonstop flight to make the trip easier. If a nonstop flight is not possible, pick connecting flights with plenty of time between them to avoid the stress of rushing at the airport. Make sure to let the security teams and flight crew know in advance that your mother has memory problems so they can accommodate her better. Having a wheelchair, even if your mother can walk just fine, can be helpful in getting through long lines and security.
Your doctor can prescribe some anti-anxiety pills in case the travel makes her agitated, but use them sparingly since they can make your mother sleepy and predispose her to falling down and getting hurt.
The second concern you have is about long plane flights. There is a small risk for developing blood clots during long periods of sitting. That risk can be lessened by wearing elastic support stockings and loose clothing, not smoking, avoiding alcoholic drinks and drinking plenty of fluids to prevent dehydration, not crossing your legs when seated, taking strolls up and down the aisles when possible, and doing calf and foot stretches whenever possible. Before leaving, check with your mother’s doctor. If she is particularly susceptible to blood clots, for example if she has any kind of vascular disease or has cancer, your doctor may want to prescribe a blood thinner or aspirin for the trip. Also there are some other heart and lung conditions that require people to travel with oxygen even if you don’t need oxygen at home. The high altitude makes the air thinner and less oxygen is in the air on the airplane. Your mother’s doctor will know if this is needed and help you with letters to the airline to make arrangements.
Once you get to Italy, make sure to give your mother time to recover from the stress of the flight. Give her a few days to adjust before she goes out and starts travelling and seeing family. Schedule time for her to rest or nap in the afternoons and make sure family watches that she doesn’t get overly tired or stressed by the changes to her routine.
To combat jet lag, have your mother take a zinc supplement daily in the weeks leading up to her trip. Try to get her to sleep during the flight. If her doctor prescribed an anti-anxiety pill, once she is safely on the plane and it has taken off, the anti-anxiety pill may help her sleep during the flight. Once arriving at your destination, the best way to minimize jet lag is to go to sleep at the normal bedtime (based on the local time zone). Also avoid alcohol and caffeine for the first few days and drink plenty of water. Dehydration makes jet lag worse.
If you follow these suggestions, your mother should be able to enjoy her trip. Safe travels.
Questions can be mailed to Center for Geriatrics, AskDrViv, at 95 Armory Road, Stratford CT 06614 or emailed to email@example.com.