Very elderly advanced dementia person on plane journey?

jenniferpa

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Jun 27, 2006
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OK - I'm a US resident (not citizen) and many moons ago contemplated doing this with my mother. I was going to use pipop1's suggested mode of travel (cruise ship). Because of the financial issues of healthcare it really was a non-starter unfortunately. But what I did do, and made my life and Mummy's much easier in a practical sense was finding an extra-care facility with a really good and reliable on-site care manager who would basically do all the things I wasn't available to do. All the everyday things, such as food, cleaning, clothing, personal care, plus necessary medical appointments and the like.

I fully understand the panic engendered by having elderly parents 3000 miles away, and in the OP's case my understanding is that her visa status is such that she will not be able to return to the UK if there are problems (which I didn't have to deal with).

What I'm suggesting is that if she (or another family member) could find a case manager who would do all the sorts of things that an adult child does in these situations, it might make the current situation tenable if not perfect.
 

BR_ANA

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Jun 27, 2012
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Brazil
If I had to travel with an incontinent parent, I would began to train how to change diaper alone on an airplane restroom. Or on the seat.

Maybe if you ask a travel agent about travellers with special need (prescribed by a doctor)

Maybe some cruise that cross Atlantic Ocean can be more comfortable. (I know some cross from Europe to South America on October and April)


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Mal2

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Oct 14, 2014
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Enfield
My 96 year old father might have to go to a home, as he has advanced dementia. But his children all live in America. What are the chances he could take the ride over the Atlantic? He is enthused, having always loved flying, and would be in first class, lounging with all his family on board, but he is unable to walk, incontinent, etc. He is very amenable to reason. He will submit to laying in a dirty pad until the carers come, etc.
His head doctor in the hospital team said he could fly, but he was more fit, ie able to stand, then.

Reading the above post. There seems there are no problems where money is concerned, with regard to medical costs, etc. It appears that the intention is for Dad to go into a home in US, maybe they have already looked into this. The whole family is going to be on the plane with Mam & Dad, they are flying l st class, which is more roomier that coach or business, so no problem with moving him if required. I would suggest another meeting with the head doctor, to see if they still agree Dad can fly.

I took my husband to my daughters in Florida, 4 years ago. Not 1st class though, sadly. We had wheelchair assistance. We split the travelling from home to the airport, staying at the airport hotel the night before, ready for the early flight next morning, so he was not tired when starting the flight next day. My husband slept through the whole flight.

I hope everything works out for everyone.
 

Pickles53

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Feb 25, 2014
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Radcliffe on Trent
If I had to travel with an incontinent parent, I would began to train how to change diaper alone on an airplane restroom. Or on the seat.

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F

Sorry, but I can't imagine that it would be possible to change an adult diaper on an airline seat, even in first class, without a totally unacceptable loss of dignity for the PWD. Airline bathrooms are tiny so that's not going to work either.

The OP says her father doesn't mind sitting in a dirty pad, but skin damage can happen very quickly, certainly a long haul flight would be long enough for sores to develop, not to mention the loss of dignity.

And the other passengers do have to be considered too; they won't all be family members.
 

Pickles53

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Feb 25, 2014
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Radcliffe on Trent
Absolutely agree. I have my doubts as to whether the airline, and on the day the check in staff and pilot would even allow boarding of a very elderly, infirm incontinent, immobile PWD. Why on earth does the OP and others think the airline would risk the disruption to other passengers and the possibility of having to divert the flight should PWD become distressed or cause distress to others?

I feel very sad for the OP. I don't know the reason why she is so desperate to get her parents back to the USA but I think she is struggling to accept that the pratctical difficulties make this an unrealistic idea, not just because of the flight problems (which seem insurmountable to me) but for all the other reasons which Amy in the US and others have so eloquently described.

Apart from everything else, the airline would have to consider how they could get someone immobile off a plane in an emergency situation before accepting him as a passenger. The risks are just too great.
 

Moonflower

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Mar 28, 2012
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It is very hard, I feel so sorry for the OP, and the elderly parents
It seems there are three elements to this
The right for the parents to live in the US, and access to medical care there
A dr saying the PWD can fly
The airline being prepared to accept them as a passenger

To be honest even if the first 2 are sorted, I can't see an airline agreeing. From a safety point of view, being able to evacuate the aircraft in an emergency, and from the point of view of the other passengers

How about an air ambulance? This would be very expensive, but if funds are available for health care in the US maybe its affordable?

I wouldn't dismiss a good care home for both parents. They could be together, the burden of caring would be removed from your mother and she could be free to come and go from the care home - go shopping, visit friends etc. Expensive yes, but not as expensive as care in the USA
 

BR_ANA

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Jun 27, 2012
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Brazil
I believe the issue is overstaying a visa in UK to sort PWDs out? If you do this its often difficult to come back?

Agree with your points above.

Idk UK law, however maybe OP could get ask for overstay as she is caring for 2 vulnerable adults.


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Beate

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May 21, 2014
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London
The way this country deals with immigration at the moment, I seriously doubt that. People have been deported for less already, like the lady who was caring for her husband but due to some minimum income rules she was deported to Singapore.

I still think it would be better for the parents to stay where they have lived the majority of their lives, but obviously with proper care in place, in extra care sheltered accommodation or a care home.

There must be someone else in that family who could fly over now and then to check up on things?
 
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Amy in the US

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Feb 28, 2015
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I agree that it's clearly a challenging and upsetting situation for the OP and her family, and that the OP's mother needs additional support and help in caring for her husband.

Here in the States, one can hire a case manager to help manage various aspects of care for someone (whether due to dementia, disability, and/or other medical issues). It's like a personal assistant for dealing with the paperwork and administrative side of things, rather than the hands on care.

I would imagine something similar is available in the U.K., perhaps by a different name, and that this might be helpful, should the OP's parents remain in the UK for whatever length of time.

OP, we hope for an update, if and when you feel able to provide one, please. Best wishes.
 

Jessbow

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Mar 1, 2013
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OP could get ask for overstay as she is caring for 2 vulnerable adults.

A 6 month visa already over stayed by 2 years ( I think I recall correctly) is unlikely to get thought of favourably, whatever the circumstances!
 
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whileaway

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Dec 11, 2015
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The first thing I need to ask is: is he a us citizen? Because if he isn't this plan is a non-starter. Secondly, who will be travelling with him?

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He is a US citizen, and would be traveling with his wife and son and an American fireman who has some medical training and also could carry him in an emergency. His daughter has a ticket booked on another airline, but could travel with him too, if she threw away her ticket and bought a new one.
 

whileaway

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Dec 11, 2015
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Some possible resources:

Medicare dot gov is the official web site for Medicare in the US. Here is a link to their website, to determine if one is eligible for Medicare coverage:

https://www.medicare.gov/eligibilitypremiumcalc/


Here is a link to the US Alzheimer's Association: http://www.alz.org

The national office can put you in touch with your local Alzheimer's association office. The local office will have information about workshops, support groups, resources, and services in your area. They likely have a website, and you can probably find it if you Google "Alzheimer's Association city state" or "Alzheimers Association county state" for your area.


I'm afraid I can't provide a link to your local (US based) Senior Council/Area Agency on Aging/Senior Services entity, as I don't know where that would be. However, if you Google "senior services city state" or "senior services township state" or "senior services county state" then you should get the correct results.

Some areas, especially in and around large cities or major metropolitan areas, might be covered by more than one agency. They may be at the state, region, county, city, and/or township level. In a very small state, it may be only the state level.

Thank you. I haven't heard of Senior Services. I will certainly try it and the Alzheimers website. I have been in contact with Medicare, but his Federal employees insurance would have to kick in until he resubscribed to Plan B, which he let lapse 7 years ago.
He has been overseas for 60 years, in England for 50! I have been blacklined for spending too much of the last two years in their home. My mother is become increasingly dependent on me. I had to postpone my trips back to the states when my father went twice to hospital, and now they must come and stay with (my brother or) me, it seems.
 

jenniferpa

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Jun 27, 2006
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I assume he has been filing federal tax returns as an expat? Because if not, you'll have to sort that out.

I think at this point, assuming you are sure that you can get health coverage for him and your mother, your biggest hurdle is getting the airline to agree in advance to transport him.

The other thing I should mention is: are you in a filial responsibility state? Because if you are, you could be on the hook for any medical or other bills they could not pay.
 
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whileaway

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Dec 11, 2015
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In another thread, which I think we need to be aware of to better understand the situation, (https://forum.alzheimers.org.uk/sho...r-my-mum-needs-rest-but-remains-on-24-7-watch) the OP says his parents haven't lived in the US for 60 years, so with all the family resident in the US or Canada, I think it's fair to assume they might be American citizens.

My real worry is the scale of the task of supplanting two very elderly people, one of them with dementia, to another continent where everything, including the health system, is very much different to what they were used to. Can you pack up their belongings and sever all ties to the UK (possible tenancy, bank accounts etc) in a month? How much will the long-distance flight and getting through immigration impact your father? Where will they live? Who is going to look after them or are you looking at nursing homes? Will you be able to get adequate insurance in place (especially now that Trump is trying to repeal Obamacare), and what will be available in your area in terms of support? I have no doubt that the actual medical care will be good (no idea about the social care), but what of it can he get for what price? You say respite here is expensive but I can't imagine any of that being cheaper over there. Will his wife still be expected to look after him? To be honest, I don't think anyone should have to look after someone else at 91. I am half that age and I am exhausted! How much support will be forthcoming from the rest of the family, seeing as you don't talk of any current involvement by them and had to overstay your visa as seemingly no one else was available?

It really all needs considering in depth before you make any far-reaching decisions.

My brother would have them across the large garden in a house he is renovating to accomodate my Dad's hospital bed and another bed for a carer, whoever that would be. His house would be in view, and within call. He is great at turning him in bed and solving problems on practically everything. Not so good on feeding and changing him. When he was here for a month, he kept Dad using the turner, which kept up his leg arm and hand strength, and kept him continent, using the commode . That's gone now. But we will have carers in, as here, and count on one to maybe do the cooking and give Mum a break. I will be drafted in to help. The medical establishments and care centers are pretty thick about.
They have Medicare plan A and a federal employees insurance policy that should pay much better than Obamacare.
We must buy my father an alternating air cushion, I think, for the trip. We must have him certified fit to travel. My mother wants to go back, partly to see her siblings, 4 still alive in the North of the States. But it is largely that she hasn't intimate friends here, nor family. Her friends have become infirm, or died, or moved away in the years. My parents have been very happy. But now they have had two years of being more or less housebound and isolated. I have been their only confidant and helper. (Although there is a very kind man from their church who will drive them anywhere anytime! And will even sit with my father.)
It might be daft, as everyone says. But they want to try a new life in America.
 
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whileaway

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Dec 11, 2015
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Hello, Would the trip be for a vacation or is the plan for Dad to travel to live with family? Will Dad get a residential visa? Will he be able to afford the very high medical fees if required, as he is highly unlikely to get affordable comprehensive insurance? The airlines will need written evidence of " fitness to fly" and he will probably need two to accompany him.Airplanes do not have toilets large enough for two, so sadly he will have to sit in a wet or soiled pad until after the plane lands. He may become confused during the journey and will also be subject to time changes.

What are the benefits for Dad to make this trip viable. We took my blind but able bodied 82 year old Mother with mixed Dementia to South Africa for a family wedding. On the flight home, she asked " why have we been?" and two weeks later had no memory of the trip.

Sorry to sound negative, but I cannot feel that this trip would be for the best, however well intentioned.

I see what you mean. No, this trip would be one way. Both my parents would go back to live in America. It will be awfully hard, the problems many, but they both want to, and my mother says she could not cope without me or my brother- or some family, in the house or nearby. She has aged about ten years in ten months. I am exhausted too. But we cannot put my father in a home.
 

whileaway

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Dec 11, 2015
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OP could get ask for overstay as she is caring for 2 vulnerable adults.

A 6 month visa already over stayed by 2 years ( I think I recall correctly) is unlikely to get thought of favourably, whatever the circumstances!

No, I overstayed a number of months for each of the last 2 or perhaps 3 years. I would always plan to get back after two or three months, but my mother would beg me to stay, and I had to-.
 

whileaway

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Dec 11, 2015
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I assume he has been filing federal tax returns as an expat? Because if not, you'll have to sort that out.

I think at this point, assuming you are sure that you can get health coverage for him and your mother, your biggest hurdle is getting the airline to agree in advance to transport him.

The other thing I should mention is: are you in a filial responsibility state? Because if you are, you could be on the hook for any medical or other bills they could not pay.

We've kept their taxes up to date. They have Federal insurance. I have power of attorney for my father, jointly with my mother, in health.
 

whileaway

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Dec 11, 2015
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It's not as bad as you think, Smashey.
Of course it is still pretty loopy.
My brother would bring a fireman from his town to help take my Dad back, as this man could carry him right off the plane in an emergency. Then too, my brother is 6 foot 4 and strong.
I think we need to get executive seats and have a cushion with variable air pressure, and also request an oxygen cannister, because the air pressure depletes blood oxygen.( I believe there is a gadget to determine oxygen level with just a pinch of the finger.) And we must travel practice with him first- getting him out and about in a wheel chair. And we need to have a doctor's certificate. (He takes no pills. He is reasonable and calm by nature. (But I guess we had better have a sedative. Benadryl knocks him out- he is so unused to meds.)We would have to make sure he had a bowel movement the day before travel, and book a pureed diet. We might need to use the airport's changing room to make sure he had a dry pad just before flight. And so on.
 

Moonflower

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Mar 28, 2012
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I think then, I would be inclined to get in touch with the airline(s) and ask if they would be prepared to carry him, and what they would require in terms of doctors letter etc to agree to him travelling.
I think they may be concerned about a long journey in a dirty pad, both from his point of view and fellow passengers
Better to find out how helpful the airline is going to be in advance. You don't want him being turned away at the airport
 

whileaway

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Dec 11, 2015
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I think then, I would be inclined to get in touch with the airline(s) and ask if they would be prepared to carry him, and what they would require in terms of doctors letter etc to agree to him travelling.
I think they may be concerned about a long journey in a dirty pad, both from his point of view and fellow passengers
Better to find out how helpful the airline is going to be in advance. You don't want him being turned away at the airport

Of course. It seems one hazard after another, but we are thinking and planning and finding out.