So I added a personal commentary:
The Wellness Concierge Says...
The airlines regularly lose our luggage and our
packed valuables. Their databases lose our reservations. They
overbook and leave us stranded. They often cancel flights without
reason or warning. Unaccompanied minors have been left without
proper supervision and assistance. Pets have been mishandled and
died in the airline's care. Is anyone truly surprised
that they could lose track of an individual who could not fend for
himself? Or that there may have been some miscommunication between
someone requesting special assistance and the airline's promise to
help and its ability to deliver it?
Although I question the Ayala family's
judgment in letting their father fly without providing their own
in-flight escort, I'm hard-pressed to think that they would fail to tell the
airlines that a solo flyer with Alzheimer's needed assistance. Delta
did say that the passenger had requested a wheelchair in Atlanta.
(And, one assumes, at LaGuardia, as well, where Mr. Ayala boarded
the first flight segment to Atlanta. How did he navigate
security and get on the originating flight without special
assistance from the airline?)
Delta was alerted—or even if they only suspected that he
needed special help, without knowing why, and they allowed him to board,
they should have provided the promised escort service for Mr. Ayala.
(And if they were going to provide a wheelchair in Atlanta, wouldn't
they have had to provide someone to push it and Mr. Ayala? In
effect, providing an unofficial "escort" service to his next flight? Or did
someone possibly put him in the wheelchair and leave him alone at
the boarding area for the next flight? I'd
be bombarding Delta with such questions, starting with: Did someone
even show up at the arrivals gate in Atlanta with a wheelchair?)
I don't know the Ayala family's financial
resources or their flying experience—or whether they did, in fact,
alert Delta to Mr. Ayala's condition. (They insist that they did,
once when purchasing the ticket and again, via a call to the carrier
the evening before his flights.) I suspect they either didn't
have the funds to pay for someone to accompany their father or didn't question the wisdom of entrusting a loved one to an
airline (any airline's) total care. It's even possible that
they didn't consider his traveling alone to be as risky as it turned out
to be. Sometimes, alas, you can be too trusting.
But rather than judging this family or lambasting the airline for its lack of sensitivity
responsibility, we need to ask some "bigger" questions:
Should anyone with Alzheimer's,
dementia, or memory problems ever be allowed to fly solo?
Is it even appropriate to ask
the airlines to function as personal escorts for such special-needs flyers
in the first place?
Are we doing all that we can as a
society to make it easier for such special-needs passengers to
What Were They Thinking?
Personally, I wouldn't let anyone, of
any age, who had a medical condition such as Alzheimer's, dementia,
or memory problems, fly without being escorted by either a capable friend or family member. If that
wasn't possible, I'd hire a nurse or trained caregiver. (There are services that
can provide specially trained medical escorts or nurses for domestic
and international flights. See Resources,
below.). If I couldn't swing it financially, I'd look for an
alternative method of travel.
It's a challenging situation.
Individuals who are in the early stages of Alzheimer's may exhibit few or
infrequent problems and may seem capable of traveling on their own.
But given the landscape of travel today with its unexpected safety
issues, unplanned stopovers, and lengthy delays (Conditions that
challenge and stress out even the most able among us.), I'm not willing to take the
risk for anyone in my care. And I doubt that you'd be either.
The Traveler's Trilogy: Rights,
Risks, and Responsibilities
To be fair, I'm sure that there are
other well-intentioned folks who may have arranged for a loved one with special
needs to fly solo without encountering such a serious problem. Many
of them probably believe, without question, that any required
assistance could (or should) be provided by airline or airport
staffers. And I would also assume that there have been many
compassionate flight attendants, ground employees, and even fellow
passengers who have assisted (and looked out for) fellow flyers who
may have exhibited memory or dementia problems. "Angels" who provide
assistance without being asked.
But seriously, given the potential
risks, how could anyone with their full faculties entrust the
care of a loved one with such special needs to the airlines (or any
travel vendor for that matter)? We've seen what they've done with
our luggage and pets.
We don't want to deprive individuals
with Alzheimer's of their right, and need, to travel. However, if we
schedule travel for these individuals, we must do so responsibly. We
can't just pass the buck to travel vendors.
I believe that those charged with the care of
individuals with special needs must rethink what is actually
required to ensure their safety. And then take responsibility for
providing the special services that may be required on the ground
and in the air. Relying on the
airlines alone, even if they are willing and able to act as escorts
(an admittedly big "if") is a risky choice. Why tempt the fates?
Enlist Aid, But Don't Delegate
Alerting the airlines to the condition
of travelers with physical challenges or special needs is mandatory,
not optional. Even if you (or they) require no assistance, you should always
tell the airlines about a passenger's medical condition (especially
those without obvious symptoms) because it may be a consideration
when assigning a seat or in providing other routine services.
When requested, airlines
and/or airport personnel
should provide special assistance in checking in and boarding
special-needs passengers and in expediting a change of planes or
negotiating a stopover.
But asking airline and airport employees and other travel vendors
to assume the role of personal escorts for these solo travelers is
tantamount to asking them to assume primary responsibility for a
special-needs flyer. And that is not their responsibility.
Enlisting aid should not be the equivalent of handing over the
care of a loved one.
Although airline flight crews may
include trained nurses or nurse's aides, the flight crew's responsibilities do not
include serving as personal nurses or escorts for individual
passengers. And that is precisely
what many folks with special needs
If someone's condition is such that they
cannot reasonably be expected to look after themselves (as is
generally the case with Alzheimer's or dementia) at various stages of travel,
including a flight, the flyer (or the individual responsible for
their care) should provide or hire their own qualified escort. Given
the Dabney's case (and the stories of families who care for those
with Alzheimer's), it's clear that even the company of one person
may not be enough to guarantee someone's safety. How much more
evidence do you need to know that no special-needs traveler should
Before You Book a Flight:
What You Can Do to Reduce a Passenger's
Risk and Increase Their Comfort
With an increase
in the number of diagnosed cases of dementia and Alzheimer's, more
and more of us will be faced with important decisions about how to
ensure the safety of such special-needs travelers.
Here are some suggestions,
considerations, and resources for smoothing the way for safe and
comfortable air travel. Some are so obvious as to be insulting. But
as we've learned, there are times when you can never be too
► Ask for help. Even the
most independent and competent caregivers require assistance as they
travel with a special-needs passenger. Don't be afraid or
embarrassed to speak up.
► Honestly evaluate a special-needs
individual's ability to travel. Circumstances and conditions can
change rapidly. Never schedule travel without having the individual
professionally evaluated. You're not helping someone by placing them
at risk for emotional or physical problems that may result from the
pressures of travel.
► Don't expect—or ask—any travel vendor to
assume primary or sole responsibility for
► Do not allow an individual with
Alzheimer's (or dementia) to
travel solo for any part of air travel.
► Tell the airlines
that a special-needs flyer will be traveling when you are booking the
flight and when checking in. If you've requested special equipment
such as a wheelchair, be sure to confirm (and reconfimr) its availability with the
airport and the airline.
If you are working with a travel agent, make
sure they alert the airlines for you and then reconfirm on your own in
advance of the scheduled flight(s).
Don't ask another air passenger to assume escort responsibilities
for all or any part of a flight, no matter how solicitous or
helpful they may appear.
Never leave a special-needs traveler in
the care of a stranger. If traveling with a person of the
opposite sex who needs to use the restroom, enlist the help of
official airport personnel. (Make sure you check their ID.)
Enroll the Alzheimer's patient in
the Alzheimer's Association's nationwide
program. In the event that an individual is separated from
you, the program provides an identification feature that can help
locate the missing person and reunite them with their families. In
addition, the organization can "fax local law enforcement agencies
the missing person’s information and photograph" while local
Alzheimer’s Association chapters provide "family support and
assistance while police conduct the search and rescue."
► Get professional advice on how to
help an Alzheimer's patient adjust to air travel.
important and travel is anything but routine. Professional
caregivers who have escorted flyers can offer specific
advice and solutions to common concerns. The Alzheimer's Association
offers detailed tips (routines, clothing, what to pack, etc.) for air travel in
Members of an on- or offline support
group may also have useful tips and strategies.
► Don't force someone to travel by
plane who is either unwilling or unable to do so. Families and
friends mean well but they may not truly understand how problematic
air travel can be for an individual. It is one thing to drive (and
that has its own unique challenges) an
Alzheimer's patient somewhere in the company of several individuals.
It's another thing to expect them to adjust to several hours in a
cramped environment with no possible exit.
► Consult a medical specialist.
The individual may want to travel, especially if they are eager
to attend a special family gathering, but they may be jeopardizing
their condition to do so. Make sure they are medically evaluated
before scheduling a flight. Ask whether it's advisable and
appropriate to prescribe any special medication or treatments for
during, or after the flight.
► Consider the Alzheimer's
patient's schedule when
booking flights. Review their daily schedules and routines and the
times the normally awake, rest/nap, and retire. Don't schedule a
flight that would seriously interrupt their routines (asking someone
to fly late at night when they retire early, for example, or
► Aim for Simplicity: Aim
for nonstop flights and those that have a high on-time rate. Avoid
changing planes and any layovers, where possible.
► Allow extra time to check in, get
needed aid, navigate security, and board.
Alzheimer's Association (http://www.alz.org/);
• Ageless Design
Advice & Advances Web site:
Traveling With Alzheimer's;
Guidelines for Traveling With a Person With Dementia;
Travel Success Story
• The Alzheimer's Association:
Vacation Travel Tips
► Paid Nurse/Medical Escorts
It's possible to hire a local nurse to
serve as an escort. However, they may be unfamiliar with the
inherent problems and challenges of air travel.
Nurses who have
special training and experience with air travel, such as those
provided by air ambulance and medical escort firms, may be the best
Flying Nurses International (http://www.flyingnurse.com/):
877-521-1333; international, 808-521-1333; e-mail:
• U.S. Air Ambulance,
Service: (http://www.usairambulance.com/s-l/04.htm) 800-633-5384
Anyone Can Travel: The Essential Guide for Seniors, People With
Disabilities, Health Problems and All Travellers Includes
a special section on Alzheimer's
Copyright© 2004, Marlene
R. Fedin; no reprint or reuse, on or offline,
express permission of the author