My mom has Alzheimer and her doctor says, it's critical...

A fellow caregiver asked...

My mom has Alzheimer and her doctor says, it's critical Alzheimer. She has a hard time communicating but if you listen intensely, you can figure out what she's trying to communicate. She repeatedly asked to visit Ireland, where she was born and lived the majority of her life. She is 88. Is she well enough to undertake a two week holiday. What are the determining factors? She could not travel by herself and I plan to accompany her. My concerns lie with the actual flight (6-7 hours). Also if we do go and she’s gets to Ireland and wants to come home, do I automatically book a return flight or wait to see if the anxiety subsides?

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.


"Critical" Alzheimer's is a new expression to me. Did your mother's doctor explain what he or she meant by using that term? If "critical" were another way of saying advanced or late stage Alzheimer's, the answer to your question would be an unequivocal no!

Even if your mother is not yet in the advanced stage of Alzheimer's, there are still some issues to consider. Your mother could handle it just fine - or it could be a complete disaster thousands of miles from home. Before you promise her anything, there are a couple of things to consider.

How realistic is her wish?

Wanting to "go home" is one of the most common issues with people with Alzheimer's and dementia; we don't always know what exactly they mean by "home." It could be their most recent abode or they may be referring to their childhood home. This may have less to do with wanting to go to the actual place and more to do with longing to feel safe. Think back to your perceptions as a child, before you discovered that life existed beyond your immediate world. The present is growing increasingly more bewildering to the individual with Alzheimer's. She has problems remembering anything that happens in the present, whereas she can bring to mind childhood memories in exquisite detail. Consequently she yearns for the security of being a child in the sanctuary of family, not realizing that none of that exists anymore. It's more about feeling and less about place. Then again, she's likely living either in the home of a family member or in a long-term care facility and may think of this as a temporary arrangement. A woman of my acquaintance has lived in her care facility for seven years, but is convinced that she's on holiday, staying at a nice hotel and "going home tomorrow."

Can she handle a long trip?

Your mother may understand that what and whom she used to know in Ireland may no longer be there. Then it might be reasonable to consider the visit. The next question is: Can she handle a long trip? Because of her mental state and her age, she may be too physically and emotionally fragile for such a long trip. Before you order tickets and passports, take a couple of trial runs. The first can be a short 2 or 3 night stay in a hotel in an unfamiliar neighboring community. The next should be a plane trip, at least two hours in the air, preferable with a change of planes. On this trip you're trying to mimic a serious journey, hauling suitcases, waiting at least an hour in the terminal; standing in lines, changing gates, using the bathrooms on the plane and in the terminals and going through security. If your mother's using a wheelchair, she'll be searched with a pat-down at the security check. Make this trip harder, rather than easier. Overseas travel is much more strenuous than cross-country.

Should you consider the trip?

If she handled the trial runs with flying colors, you might consider the journey. However be prepared for the repercussions. The confinement in the cramped space of a jumbo jet combined with 6 to 8 hours of recycled air may cause increased confusion and a sharp decline in her cognitive ability. I also suggest a one-week trip at most.

Try a "staycation"

If you're not absolutely certain that she will be able to handle the trip, you can still treat her to virtual tours back to the old country. You can share picture books and encourage her to share childhood stories. (You might want to record these sessions.) When you do, try to avoid the types of questions that push the wrong buttons: "Do you remember?" for instance. Instead, you can simply say, "I just love to hear about growing up in Ireland." If her eyesight is good enough, you can look up her old stomping grounds on one of the maps sites on the Internet. Google, Mapquest and Bing all have great satellite maps. If in spite of all your distractions and diversions, she's still persists with her wish, you could "plan" the trip; get brochures from travel agencies and flight schedules. However, you don't mention a particular date or time, because she may actually remember in spite of her dementia.