Q: I will be traveling with my mother in the next few weeks. We want to take her with us on our vacation to see my sister who lives down South. They have not seen each other for more than a year.

My mother was diagnosed with memory loss about three years ago. She needs some help with bills and she does not drive anymore, but overall she still is very independent. My friend, whose father also has dementia , told me that there were a lot of problems when they traveled together. They had to cut their trip short and even went to the emergency room one night. Is there anything my family and I can do to avoid trouble? Am I doing the right thing by taking my mom with me? She appears to be very excited about this trip. Please tell me what you think. — Susan

A: Many people are in a similar position this summer, trying to decide whether to venture into traveling with their parents. Some of us will not have the privilege of spending time with our parents this summer. Others would rather take a vacation just with their spouses and kids as a respite. Here are the rules of traveling with someone with memory loss.

For patients who suffer from mild memory loss traveling is usually not an issue. Unless your mother has had some problems with behavior at home, like serious anxiety, paranoia and/or aggression (which are VERY rare in early stages of dementia) I do not think that you should worry. To help your mom feel secure, I would suggest a few important things. Try to make

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the trip as short and as simple as possible, even if it costs more. Avoid connecting flights or long car drives.

Make a clear trip schedule and share it with your mom in advance; write it down for her. Avoid seeing too many attractions on the way. Make your mom "responsible" for a small part of the plan, even if it is very trivial. She could, for example, make sure everyone has the sunscreen on or take the kids to the restroom during the stops. Talk with your sister to make the vacation plan simple. I would advise against large parties and gatherings. I am assuming that your sister is fully informed about your mom's memory loss, but if she is not, she needs to be.

You will need to observe your mom for signs of stress and anxiety. As we have discussed before, people with memory loss do not respond to change. It is usually the predictability of their environment which keeps them stable. This is also the reason that they usually refuse any new activity like a senior center trip or adult day care. Travel, with all its commotion and chaos, can be scary even for a "regular" participant.

For a person with more serious, moderate memory loss, especially if they have not traveled much before, and if there are some behavioral issues the story will be much more complicated. The first question everyone needs to honestly ask is "who is this trip really for?" Quite often the trip is really NOT for the elderly frail person, but rather for the other family members or for an occasion (wedding/graduation). Sometimes it may be best to reconsider. Maybe the siblings can meet in the town where the mother or father lives. Maybe they can use the time to spend with the parents and offload the regular caregivers. Maybe the time can be used to catch up with doctor appointments and so on. I suspect that your friend's father had more advanced memory loss and this is why their trip had turned into disaster. Sometimes we are being asked to give calming medication to be used "just in case." We do not like to do it but occasionally it may help. You may choose to discuss this option with your mom's doctor.

Patients with advanced dementia should NOT travel unless in an emergency. The benefit of the travel almost NEVER outweighs the risk of serious behavioral issues. I have experienced way too many situations when, despite my warnings, a family took its loved one with serious dementia away from their surroundings which led to outbursts of agitation, even violence. There are occasional exceptions — after all human nature is never fully predictable — - but they are few, far between. I sincerely hope that all of us traveling with and without parents will have a wonderful vacation!