The holiday season is stressful at the best of times, but taking someone who has dementia to visit family or friends over the holidays can quickly become an ordeal. Whether you plan to drive to the next town or fly across the nation, take some time beforehand to think about how travel and change affect people who lack memory and rational thought.
When people lack rational thought, they are unable to perceive cause and effect, or follow a sequence, or prioritize events or information. So, although it may be obvious to you that getting on an airplane and flying for several hours means that you will not be sleeping in your own bed that night, it isn’t likely that someone with dementia will see that as a certainty. In addition, although for most of us there is at least a semblance of logic in the process of waiting at the ticket counter to check our bags, shuffling along in a security line, being frisked by a uniformed TSA agent, having our carry-ons gone through, and then waiting at the gate for an overdue flight, such sequential events are not something people with dementia can understand and plod through easily. Frustration and meltdown are more likely to occur when something seems random and unfathomable.
In addition, deadlines mean nothing when you cannot track time or read clocks, and meeting them is even less likely when you can’t see that putting shoes on is essential while drinking a cup of coffee isn’t.
“Where are we?” Without memory, we live entirely in the present (see my earlier blog on the experiential self vs. remembering self). So, if we find ourselves in unfamiliar surroundings, our natural reaction is concern – or at least curiosity – and we continue to have that reaction every time we realize that we don’t know where we are. (Keep in mind that the psychological present is about three seconds.) Although a small child might be bored and ask several times how much longer the trip will last, someone experiencing dementia is likely to feel fearful in unfamiliar surroundings and need reassurance or information constantly for the duration of the time spent away from home.
“Do you need to use the bathroom?” When someone is experiencing dementia, s/he may not be able to interpret feelings such as hunger or the urge to use the bathroom. So, although we may be able to trust a child’s report of not needing to go, a loved one with dementia might say no and truly not realize that s/he did need a bathroom until after an accident occurs. Best to say you need to go yourself in hopes that being in a bathroom will prompt using the toilet, and be sure to carry wipes and a change of clothes for possible emergencies.
Getting lost in a restaurant. Even people in the earlier stages of dementia can become flustered and lost when they walk back out of a bathroom in a restaurant or any strange place. Be sure to keep an eye out to see that your loved one finds the way back to your table, or back to their bedroom in a strange home. In the panic of not knowing which way to turn upon leaving the bathroom, they may become unable to recognize familiar faces as well, and head for an exit.
Should we leave home at all? You may now be wondering whether you want to travel with someone who has dementia. It is a task that requires careful planning, as well as keeping a close watch on your loved one’s reactions as s/he meets so much new information and stimuli. However, if you make sure that someone is always on duty – watching for ways to ensure that security needs and understanding needs are met – travel can be enjoyable. So, try to have more than just one person available for caregiving. And recognize that stress and change exacerbate memory loss and confusion, so your loved one will function less well when away from the familiarities of home.