The holidays are quicky approaching us!  That means traveling near and far to visit with family and loves ones.  This is such a great time of the year so I wanted to provide you with some tips to help traveling go smoothly when you are bringing along someone who has a cognitive impairment.   In addition, November is also National Alzheimer's disease Awareness Month so I wanted to address a topic related to Alzheimer's disease this month.  Below are some holiday travel tips from the Alzheimer's Association:

• Avoid having a rushed schedule.  This only increases anxiety.
• If traveling by plane, minimize stops and long layovers in the airport
• Travel at a time when the person is most alert
• Rely on familiar and comfortable destinations
• Carry identification such as the Safe Return/Medic Alert bracelet, which can be purchased through the Alzheimer's Association.

Following these tips will help the caregiver and the person with dementia have a safe and hopefully a great time when visiting families and friends.  In addition, vaccinations are also important for older adults when traveling.  For more information on vaccinations and traveling with older adults, please refer to Jean Bandos blog titled "Vaccinations and Travel Planning for the Elderly".

Likely you have seen some variant or another of this article "Helping the Elderly Keep Their Driving Skills" talking about helping seniors keep their mind sharp.  Whole companies have cropped up like the one mentioned in this article, Posit Science, around the idea computers and software can help. 

Certainly games like these are interesting and often fun, but their claims are largely unproven.  Comments like the brain is "the most important muscle in the body" is, at best, metaphorical.  The brain is, of course, nerve tissue not muscle tissue.  "Exercising" the brain has little impact on senior memory loss brought on by Alzheimer's or other serious forms of dementia. 

Driving is one of the big safety issues with seniors and for those people who are not facing serious cognitive decline, they may find these games fun and somewhat beneficial.  Of course, physical limitations such as immobility are not impacted.  At a minimum, I would expect some gains in driving skill just from the heightened awareness.  Likely most of us could gain from that lesson.

See more on Posit at http://www.positscience.com/. 

The elderly are particularly susceptible to heat stress, and it's important to keep your aging loved ones and elderly neighbors safe during the summer - especially if they are without air conditioning.  A few safety tips for caregivers:

• check on the elderly a few times a day during the summer months
• help them obtain home air conditioning
• take them on outings to places with air conditioning, especially if they are unable to drive themselves
• supply them with electric fans

For more information and tips, plus the signs of heat stroke, see my blog post on summer safety for the elderly.

My Mother has lived in an Assisted Living facility for almost two years.  In many ways she has adapted well and I think she is comforted by the fact that I live nearby.  However, as her Alzheimer Disease progresses, I often hear “I want to go home.”  In talking with others, I’ve learned that this is quite common... yet hearing it tears at the heart of every caregiver I know. 

Following are some tips you may find helpful when the senior in your life tells you repeatedly:    “I want to go home.”

• Remember that it is very common for a senior to repeat this request often.  Usually they mean the home from 60 or 70 years ago, not the one they left most recently.
• “Home” means different things to different people – love, security, belonging, safety.  When a senior asks to “go home,” try to determine if there is an “unmet” need (i.e. need to feel safe, need to belong) and try to fill that as best you can.
• Don’t refer to the senior’s current location as home.  Point out that they are staying there for “awhile.”  When they say “I want to go home” tell them you will talk about it and name some future date.
• Find a good reason for them to stay where they are – i.e. people are nice, good food, close to family, nice apartment, fun activities and try to get them to “buy into it.”

As a caregiver, the responsibility for decisions regarding your parent’s care falls to you.  Often you wish you could discuss the options, choices and next steps with your parent, just as you discussed so many choices in the past…where to go to college, where to have your wedding reception, which neighborhood to select.  But parents with Alzheimer’s cannot help with current decisions as their ability to reason, compare and choose has been ravaged by the disease.  Sadly, dementia robs them of their ability to chart their own course.

So, what should caregivers do when faced with a variety of paths – how do you know how to choose what is best for your parent? How do you know when a parent’s living environment is no longer safe? How do you know when a parent needs more assistance? 

Here are a few suggestions:

• Pay attention to your parent – they may be confused, but they will give you clues when things aren’t going well.  They may seem more agitated, confused or disoriented.  Their routine may change and a situation that has worked well in the past, now poses problems.  For example, they may no longer want to eat dinner because they either can’t remember where the Assisted Living Dining Room is located, or they are afraid to leave their apartment.  
• Check in with their caregivers – have other family members, a companion, assisted living staff or adult day care workers noticed a change in your parent?  Are they concerned? 
• Take your parent in for a check-up – have the Doctor evaluate your parent and review their medications and mental and physical health. 
• Review your parent’s ability to complete Activities of Daily Living – things like bathing, dressing, continence, mobility, feeding.  Has there been a change in their ability to do these things?
• Engage a Geriatric Care Manager – have them conduct an independent assessment to provide an unbiased view of the situation.

Once you have gathered the above information, spend time thinking and talking to others you trust about the findings.  Choose the next step based on what you think is best for your parent at this moment in time.   For instance, if you determine that they need more assistance, think about the pros and cons of providing additional assistance in their current environment vs. moving them to a new environment such as a Memory Care Unit.   There is no “right” decision.  Take comfort in the fact that you have been both thorough and thoughtful when you made the decision.  Always remember that your parent is better off when you address concerns as they arise vs. postponing decisions until a crisis arises.

Caregivers for those with cognitive decline or Alzheimer's can find free help from their local Alzheimer's Association.  Whether you're looking for ways to better communicate with someone with Alzheimer's, ways to reduce your caregiver stress, or even seeking other local resources, the Alzheimer's Association is a great place to start your search.

Local Alzheimer's Associations often give conferences for caregivers.  Topics often covered include communication, home safety, and well-being.  Presenters have extensive experience in geriatrics and caregiving topics.  In addition, you can connect with other caregivers for support.

There will be a caregiver's conference on May 15th in Indianapolis, and I encourage you to attend.  For more information, visit the local Alzheimer's Association website. 

For information on events in your city and state, visit the national Alzheimer's Association website.

Family members are finding themselves in the "Sandwich Generation"...still working full-time, raising children, and caring for an elderly parent.  Alzheimer's Disease costs businesses "more than $67 billion dollars each year."  $40.5 billion of that cost is due to "family caregiving resulting in absenteeism, productivity losses, and replacement worker costs."  These statistics are a red flag to businesses of what is to come...the amount of people living longer is growing and the number of individuals with Alzheimer's Disease will more than double in the next 30 years. 
Family members who provide some form of care to an aging parent are more at risk for developing physical illnesses and stress which can affect a person's mental health, overall well-being, and work productivity. (Teepa Snow, Dementia Care & Training Specialist)

Providing a safe, structured, and supportive environment to the person with Alzheimer's Disease can be difficult especially if one lives in an area with limited resources.  Caregivers are often trying to handle "home situations" during the day while at work...dealing with insurance companies, managing home care staff, running home on your lunch break to check on mom or dad, etc.  US businesses are starting to realize the tremendous effort families are working with in being a caregiver.  Some businesses are adding additional resources to their employee benefits program to assist family caregivers. 

As a caregiver, is the company you work for equipped to provide assistance and resources to you?  I'm interested to hear how businesses are addressing this important issue.

**The following post is from my guest blogger, Natalie Langley, MSW.  She is a Geriatric Care Research Analyst for SCANS (for more on SCANS, please see Eric Tinsley's blog by clicking here).**

As the winter weather is now upon us, a safety topic that is a concern for older adults is driving when the roads may be covered with snow or ice. 

Adults 65 and older are in more car accidents per mile driven than those in nearly all other age groups.  If you must drive in the winter weather, here are some tips to help keep you safe while on the road:

• Winterize your car before the bad weather hits (check the tires, windshield wipers, and antifreeze and change if necessary)
• Listen to the weather reports and check for winter weather advisories before getting on the road
• Avoid icy roads, overpasses or bridges if possible; look for another route
• Drive slow when roads are covered with snow or ice
• Take a cell phone with you when driving in bad weather and always let someone know where you are going and when you expect to arrive so they can call for help if you're late
• Keep an emergency kit in your car stocked with: a first aid kit, blankets, extra warm clothes, a windshield scraper, rock salt, a bag of sand or cat litter (to pour on ice or snow in case your wheels get stuck in the ice or snow), a shovel, a flashlight, water, and jumper/booster cables.  

If you're a caregiver, please share these safety tips with your loved one - or offer to give them a ride or arrange transportation for them.

If you're a caregiver, you may also be concerned about the safety of a loved one and wonder if he or she should still be driving.  For more about driving safety and warning signs for caregivers, please see my previous blog entry 'Is it time to take away the keys?' by clicking here.

Safety is a huge concern when the cold weather hits, especially for seniors.  If your aging loved ones are on a limited income and having difficulty paying heating bills, they may qualify for assistance. State and local energy agencies, or gas and electric companies, may have special programs. Another possible source of help is the Low Income Home Energy Assistance Program (LIHEAP). This program supports some people with small incomes who need help paying their heating and cooling bills. Your local Area Agency on Aging, senior center, or community action agency may have information on programs like these.

As a caregiver, or concerned family member, are you are worried that their landlord may want to cut off the gas or electricity in cold weather if they cannot pay a utility bill? Many states and cities now have laws to protect against this, at least until other plans are made.  Check with the local government about the laws that may apply where you or your loved ones live.

To find out about assistance in your area, contact your local Area Agency on Aging (AAA) who will provide information on the assistance programs.  To find your local AAA, visit http://www.n4a.org/  or call 800-677-1116.

This time of year, there are more home fires than any other time of the year, so home safety is especially important. Most of the fires are due to home heating devices. Burning wood, natural gas, kerosene, and other fuels also produces carbon monoxide. Unless fireplaces, wood and gas stoves, and gas appliances are properly vented, cleaned, and used, they can leak dangerous amounts of carbon monoxide and also are fire hazards.  Since older adults are three times more likely to die or be injured in a home fire than those who are younger, I wanted to share some simple tips on things that older adults can do to protect themselves this winter.

MOST IMPORTANT: HAVE AN ESCAPE ROUTE/PLAN TO FOLLOW IF YOUR HOUSE DOES CATCH ON FIRE.  Run through the plan at least once a month to identify any problems that could prevent a safe escape.

There are some other tips you should always follow. You should:

• Have fireplaces and wood stove chimneys and flues inspected yearly and cleaned when necessary. (Ask your local fire department to recommend an inspector or look in the telephone book under "chimney cleaning")
• Put a smoke detector and battery-operated carbon monoxide detector in areas where you use fireplaces, wood stoves, or kerosene heaters.
• Open a window - just a crack will do - when using a kerosene stove.
• Make sure space heaters are at least 3 feet away from anything that might catch fire (such as curtains, bedding and furniture).
• Keep a fire extinguisher that can be used for a variety of types of fires (including chemical fires) in areas where you use fireplaces, wood stoves and kerosene heaters.
• Never try to heat your home using a gas stove, charcoal grill, or other stove not made for home heating.

If the older adult has a space heater, review the following tips to increase the safety of this device in the home:

• Make sure your space heater has been approved by a recognized testing laboratory.
• Choose the right size heater for the space you are heating.
• Keep substances that can catch fire like paint, pets, clothing, towels, curtains, and papers away from the heating element.
• Keep the door to the rest of the house open for good air flow.
• Turn the heater off when you leave the room or go to bed.
• Make sure your smoke alarms are working.
• Put a carbon monoxide detector near where people sleep.
• Keep the right type of fire extinguisher nearby.

For any disaster planning (including that to encourage home safety), an excellent reference is The Hartford and the MIT booklet “It Could Happen to ME; Family Conversations about Disaster Planning”.

Perhaps the most difficult thing for a senior to do is give up the car keys.  Eventually nearly everyone has to, but driving is a major key to living independently and person's sense of well-being. 

Consumer side technology is being developed to help improve safety issues with seniors.  GM is developing a car windshield that uses infrared sensors, cameras, and lasers to enhance sharpness of items on the road.  The idea is to make lane marks or objects in the path of the vehicle more distinct.  See this article General Motors designs windshield that enhances objects to help seniors for more details on the development.

This is a example of a home (car) safety product targeted specifically at older adults.

For the last several months, we have been discussing safety concerns for the older adult.  We all know that medication management and fall risk prevention are instrumental to healthy aging, but a holistic picture is what is most important to assist in aging in place and maintaining good “health”.  As the boomers age, we will see more and more written on wellness, well-being, and just overall aging tips. 

But what is key to a healthy life style?

According to American Geriatrics Society it is

1. Not smoking
2. Drinking alcohol in moderation
3. Exercising
4. Getting adequate rest
5. Eating a diet high in fruits and vegetables
6. Coping with stress and
7. Having a positive outlook.  

These are important, but I feel that whether you are elderly or young, you need to understand your overall health issues, have social connections, be at peace with where you are in life, have a purpose, live in a safe environment that supports your needs, and keep your brain functioning. 

Good Morning America does a segment that highlights individuals celebrating their 100th or older Birthday.  Today a man was 107! I am always amazed at the life history of those over 100...  The majority have remained both physically and intellectually active and have remained connected with society.  Amazing, they never reference how many fruits and vegetables they have eaten!!   So stay connected… and do your brainteaser and always learn something new each day. 

In several of my past blogs, I discussed safety concerns and the older adult.  One the main concern is medication safety. Not just the management of medications but how many are actually taken.

It is often reported in the news about a medical error made and the impact it has on individual lives.  Those articles are frequently about hospitals errors.  But have you ever thought about the older adult and how they manage at home...?  The impact our current health system has on managing medications...?  How chronic illnesses such as congestive heart failure, diabetes, and arthritis impact the older adult and his/her caregivers...?  Different providers – prescribing different medication – generic versus brand names.  multiple medications with multiple doses all affect the medication management and the safety of the older adult.

Let’s look at the key safety issue: polypharmacy (multiple medications).  
A caregiver may ask what defines polypharmacy or how many pills or too many?  The answer would have to be that different entities in the current health care system define Polypharmacy differently.  I have seen it defined as low as two or more medications, but in general it deals with using more than three to five medications or herbal supplements for longer than 90 days in a given year.  In my career I have witnessed shoe boxes filled with medications that have numbered over 20 different medications- especially when dealing with multiple chronic diseases, over the counter medications, herbs, and vitamins.

Where should the caregiver and/or older adult start in trying to deal with their medications?
First, realize that the main problem with polypharmacy is that it increases the clients’ risk for drug interactions.  Drug interactions occur when one medication or herbal supplement reacts negatively with another medication when they are taken together. It is important to report any side effects to your physician.
 
The following are some steps you can take to prevent drug interactions:

• Provide a complete list of your medications and herbal supplements to your physician and/or pharmacist
• Discuss how each medication/herbal supplement works inside the body.
• Verify with your physician that you are receiving the recommended dose of each medication/herbal supplement.
• Verify with your physician that you are receiving the recommended form of each medication/herbal supplement you are taking (pill, liquid, tea, extract).
• Determine how many times a day your medications/herbal supplements should be taken.
• Discuss any side effects that might be experienced.
• Discuss the common prescription medication interactions.
• Discuss the common herbal supplement interactions.

If you can not complete a list of medications, take them all into your physician or pharmacist and have a list made for you. 

The National Institute on Aging is a great resource for learning more about medication managements, herbs, vitamins and safety concerns - learn more by clicking here.

Since I don’t have a healthcare background, I had a very limited understanding of physical therapy.  I thought it was only “prescribed” after an injury or surgery to help with rehabilitation.  I didn’t realize it could be “prescribed” to treat on-going issues often faced by seniors, such as loss of mobility or  balance deficiencies.

We became concerned when my Mother became increasingly unsteady on her feet and had difficulty getting up from a chair.  We thought these symptoms were signs of progressing disease or advancing age and “came with the territory.”  When we shareed these concerns with my Mother’s gerontologist, he ordered a physical therapy evaluation and three physical therapy sessions a week to increase her mobility.  My sister and I were thrilled to learn that exercises could help and that my Mother could be taught techniques to help her get in and out of the car and move around more safely and easily.

Mother has been attending her “exercise class” for about two weeks.  She told me she likes it and that they do most of their exercises while sitting in a chair… so it is not too difficult.  We are thrilled she is paying attention and participating.  Earlier this week, I took my Mother out to dinner.  We were seated in a long, low booth.  As we went to leave, I offered my hand to my Mother to help her up. She looked at me and shook her head and said “No, I need to use my legs.”  And I watched in amazement as she positioned her feet and pushed up with her legs and got out of the booth.  We both reacted with big smiles – because she had “done it herself.”

The My Health Care Manager's Client Portal serves as a communication platform for families caring for aging parents. It provides easy access to information like:

• Schedule of care events (e.g. medical appointments, therapy, geriatric care visits)
• Medical issues (e.g. Alzheimer's, arthritis, incontinence, congestive heart failure, diabetes, COPD)
• Health provider contact information and specialties
• Medication list including dosage, frequency, prescribing physician, and other specifics
• Recent Hospitalizations
• Client contact information
• Updates on key issues of aging such as Caregiving, Advanced Directives, Living Independently, Family Communications, Depression, and more
• Resources
• and more

It also supports secure, private interactivity with the Health Care Manager providing geriatric care for the family using tools like a discussion board, contact logs documenting visits and phone conversations, and posting of care goals like improving home safety, reducing isolation, improving depression, improving mobility, supporting treatment plans, and so on.

As a follow up to my blog about safety issues with seniors, I found another important handout on Alzheimer's Disease and wandering.  It provides good information, tips, and resources.  Please check out In Search of the Alzheimer's Wanderer by Mark Warner.  Mark is also in charge of the Alzheimer's Daily News, a publication of the Ageless Design Research Foundation.  He sends daily emails regarding news and information about Alzheimer's Disease.  To subscribe to this free publication, check out his website at www.alznews.org.

Summertime is always great to be outdoors, but with the high temperatures, the risks of heat exhaustion and heat stroke are high.  Heat exhaution is caused by exposure to high temperatures and inadequate replacement of fluids.  Those most at risk for heat exhaustion are seniors, people with high blood pressure, and people who work outdoors the majority of the day.  Warning signs include:  heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea/vomiting, and fainting.  The person's skin may be cool and wet, pulse may be fast and weak, and breathing may become fast and shallow.  If the person is not treated, it may progress to a heat stroke.  To help prevent heat exhaustion, have readily available cool, non-alcoholic beverages, stop and rest every 1-2 hours when outside, wear lightweight clothing, take a break in an air-conditioned area, take a cool shower/bath after being outdoors for a long period of time.  For more information, check out WebMD.com.

An Alzheimer's patient once came to me after he had got out of his house and was found hours later in a ditch approximately 2 miles from his house.  Wandering is often a scary symptom of Alzheimer's disease and dementia.  It's confusing and scary for a senior who does not know where he/she is or where they are going; and is scary and worrisome for family caregivers.  Wandering can occur anytime but tends to increase in the late afternoon/early evening hours.  There are several things caregivers can do to keep their loved ones safe at home. 

Tip #1:  Use deadbolts on doors leading outside, place them high or low on doors
Tip #2:  Take locks off of bathroom and bedroom doors to avoid your loved one from locking themselves in
Tip #3:  As the sun starts to go down, close the blinds/curtains and turn lights on
Tip #4:  Install appliances that shut off automatically
Tip #5:  Keep toxins i.e. cleaners, bleach, poisons; and prescription medications in a safe, secure space
Tip #6:  Remove clutter from around the house
Tip #7:  Install a door alarm or place a motion sensor in your loved one's room at night to alert you when they are awake and moving
Tip #8:  Label doors, drawers, and cabinets; this is most helpful in the earlier stages

A professional geriatric care manager can help you in reviewing your home and finding assistance for home modifications.  For more tips and information, check out The Complete Guide to Alzheimer's-Proofing Your Home and home modification tips.

Summer is officially here... and the heat waves begin. Did you know that more people die from heat waves each year than from hurricanes, lightning, tornadoes, floods, and earthquakes combined?? (CDC)  As a caregiver or friend, how can you help keep your loved ones safe?

Older adults are particularly vulnerable to the effects of heat stress because the elderly do not adjust as well as younger persons to sudden changes in temperature.  Also, an older adult’s chronic illness may affect how his/her body responds to heat and many older adults take medications that impair the body’s ability to regulate its temperature or medications that inhibit perspiration.  

Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body's temperature rises rapidly, the body loses its ability to sweat, and it is unable to cool down. Body temperatures rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.
Warning signs for heat stroke vary, but may include the following:

    - An extremely high body temperature (above 103°F)
    - Red, hot, and dry skin (no sweating)
    - Rapid, strong pulse
    - Throbbing headache
    - Dizziness
    - Nausea

According to the CDC, you can help protect elderly relatives and neighbors who are at risk by:

    - Visit him/her at least twice a day and watch them for signs of heat exhaustion or heat stroke
    - Take him/her to air-conditioned locations if they have transportation problems
    - Assist them in obtaining air-conditioning
    - Make sure older adults have access to an electric fan whenever possible.

Heat wave deaths can be prevented. For more information, visit these links:

http://www.hhs.gov/disasters/emergency/naturaldisasters/heat/index.html 

http://www.epa.gov/aging/resources/factsheets/index.htm#itdhpfehe

June is Home Safety Month.  Have you assessed your parents’ home and developed a disaster plan?  With all the environmental issues that are in the news, it’s a good time to review home safety and develop a disaster plan for parents or the special older adult in your life. The focus of this blog is on falls, which are the number one safety risk for older adults. Nearly one third of America’s older adults fall each year, with seventy percent of these falls occurring at home.

Ten Tips for Home Safety – Fall Prevention

1. Remove all throw rugs; if one cannot live without throw rugs, make sure they are secure with non-slip backing
2. Install grab bars in bathroom, especially in the shower/tub
3. Provide adequate lightening, especially around stairwells and pathways 
4. Keep a flashlight by the bed 
5. Use a nightlight 
6. Keep pathways clear of objects, especially electric cords
7. Remove clutter
8. Make sure the handrails on stairways are accessible and sturdy
9. Check carpets for any tears and/or holes
10. Review all medications- prescriptions, over the counter, herbs, and vitamins with doctor and/or pharmacist to reduce risk of dizziness and weakness 

Other areas of home safety for older adults is same as for others:

• Make sure to have a working smoke detector on each level of the home 
• Have a fire extinguisher on each floor
• If there is someone in the home using oxygen, make sure there is an oxygen awareness sign and that no one smokes in the area where there is oxygen
• Make sure there is a working carbon monoxide detector on each level of the home
• Keep a telephone within easy reach with numbers large enough to see in hurry
• Have a disaster plan
• Have a fire evacuation plan

Resource:  The Home Safety Council (HSC) website, www.homesafetycouncil.org, offers more information, illustrated handouts, and virtual home safety tour.

Look for next week’s blog addressing key components of a disaster plan of an older adult.

Last week, I traveled from Indianapolis, IN to Litchfield, CT with my Mother to attend my sister’s wedding.  It was a long trip as we got to the airport early to deal with security, took a 2 hour flight to Newark and then rented a car and drove 3 hours to a Bed and Breakfast in Connecticut.  Along the way, we had to take our shoes off, give up our purses for a security inspection, and take escalators, elevators and a train in pursuit of a National rental car.  Everyone knows that traveling today is an exercise in both patience and logistics…b ut when you are accompanying a senior who is not steady on her feet and tends to be confused….. the patience/logistics requirements increase ten-fold.

Planning and advance preparation can help ease the journey.  In our case, I found it helpful to:

• Keep my Mother’s ticket and ID with mine, rather than risk her misplacing the paperwork.
• Consolidate all carry-on items in one bag (meds, jewelry, reading material), so there was less to keep track of during the trip.
• Dress for the security line….slip on shoes, no heavy jewelry, easy to remove jacket.
• Bring an extra sweater, as most airports are freezing.
• Pack snacks in case of airline delays, missed meals and long wait times.  The food court can be a long way from the assigned gate – a walk a senior is not up to.  If a senior has diabetes or a loss of mobility, packing snacks is essential to avoiding missed meals or long walks to the food court.
• Request a wheelchair or flag down a motorized cart to assist with transportation from gate to gate, if necessary.
• Stop when the senior gets tired and sit for a few minutes.  The airport pace is very difficult for a senior to keep up with.  This is especially true if your loved one has a loss of mobility.
• Limit information and do not provide it all at once – just focus on the next step and explain to the senior.  Discussing the entire itinerary i.e. we are catching a plane, then renting a car, then driving to Connecticut... is too overwhelming.
• Remember that the crowds, noise and fast pace of the airport can contribute to a senior’s confusion and anxiety.  Try to buffer them as much as possible by walking so that they are close to the wall and you are on the outside to take the bumps as people push past you.
• Be sensitive to their fears – dementia may cause even seasoned flyers to feel nervous about flying.
• Enlist help – ask someone else to accompany you to help with luggage, logistics and provide moral support.
• Enjoy the senior’s sense of wonder along the way – for them, a plane trip is a rare and exciting event. 

In summary, traveling with a senior should not be taken lightly.  Advance planning is key to ensuring a safe and stress-free trip for both caregivers and seniors alike. Be prepared, be patient and always remember that seniors will need extra special care and attention during the trip.