Most people have become accustomed to the rhythm of airport
security checks— lap top out, jacket off, shoes off, belt and any metals onto
the tray, and then waiting patiently for instructions. These routines become
second nature, except when some cognitive impairment like dementia starts
eroding this familiarity. Traveling alone is a necessity for most people but
we need to rethink how viable this is with early stage dementia.
People with dementia might not feel comfortable taking their
jacket off or their shoes. Such (familiar) behaviors in unfamiliar surroundings
are likely to agitate the older adult. And a security checkpoint is not the
most accommodating venue to address anxiety and agitation. These scenarios will
become more frequent with an increasing prevalence of dementia and other
cognitive disorders. And it is not just at the security gate.
On Friday, May 3rd 2013, an 83-year-old Victoria Kong walked
past the assistance agent waiting to meet her at the gate as she deplaned from
her flight from Barbados to Washington D.C. She was found the following Monday
in wooded area about 200 yards from the airport perimeter. She died of
hyperthermia. Victoria King suffered from dementia and wondered out of the
airport oblivious to the pickup arrangements made for her by her relatives.
Most airlines do not have an escort policy/program in place for adults,
traveling alone with cognitive impairment. Airlines only have escort
policies/programs in place for minor children traveling alone.
In addition, most airlines do not include dementia as
needing medical clearance, and although there are some provisions offered by
airports and some airlines—in most cases dictated by law—these provisions are
insufficient given the type of problems likely to be experienced by persons
suffering from dementia. The increasing prevalence of dementia in the
population and the lack of training of security personnel and flight attendants
make this a recipe for more common friction.
Although in the early stages of dementia older adults might
behave normal, this sense of normalcy might evaporate in an unfamiliar
environment, or confusing situations as air travel has increasingly become. New
faces, new environments, a change in daily routine, not to mention a time zone
change, can prove to be a challenge for the dementia traveller.
You might get escort passes to help the person on board and
then someone at the other end to escort the person out of the airport, but the
flight itself might prove disorientating. Flight attendants should not be
dealing with—at best—agitated passengers.
If we are to address this growing friction, education needs
to come from both ends. Caregivers and family members need to understand the
limitations of their loved one and that unfamiliar and stressful situations
compound cognitive unease. Air travel is a stressful event at the best of times.
On the other side, security personnel and air flight attendants need to learn
to identify and defuse agitation because of dementia. Although it might be difficult to distinguish
anxiety and agitation because of dementia from other types of erratic
behavior (alcohol, drugs or stress), the
only way to reduce these misunderstandings is by not putting the older adult
with dementia in that position in the first place.
© USA Copyrighted 2014 Mario D. Garrett
