Travelling and going on holiday

Going on holiday can be enjoyable for people with dementia and their loved ones, offering new experiences and a break from routine. Many people like to travel alone, although this can become more difficult as the dementia progresses. Others prefer to travel with a companion - often the person who normally cares for them. This factsheet gives tips and advice about going away for people with dementia and those who accompany or care for them.

Planning your holiday

Going on holiday should be a relaxing and enjoyable experience. However, it is important to plan carefully in order to avoid potential problems. Someone with dementia might find a new environment confusing, or may have difficulties readjusting once they return home. Meanwhile, a travel companion might be so concerned about giving the person with dementia a good holiday that they forget to relax themselves. For these reasons, it is important for everyone involved to think carefully about the kind of holiday that would suit them.

If you are organising a holiday for someone with dementia, try to be open with others (for example, hotel staff) about the person's needs, and explain potential difficulties or limitations, so that everyone knows what to expect. Trying to hide problems can make life more stressful for everyone.

What type of holiday to take

People enjoy a range of types of break, depending on their interests, personal preferences, time available and finances. The extent to which the person's dementia affects their daily life will also determine the type of holiday that is most suitable.

• Staying with friends and relatives – If you are considering paying a visit to friends or relatives, or if a number of you are going away together, discuss the situation and suggest how each person might be able to help. For example, some members of the group might spend some regular time with the person with dementia during the mornings or afternoons. This can give the person and their usual carer a break from each other. Alternatively, they might provide extra help with particular tasks, such as preparing dinner. People are usually more willing to offer support or share responsibilities once they are clear about how they can contribute.
• Independent travel – This option offers the greatest choice and flexibility, and may be suitable for someone with mild dementia, but you will be responsible for arranging your own travel and accommodation. Speak to the hotel or B&B before you book, to check that it is the right place for you. Try to ensure that there will be a friendly, welcoming atmosphere and that staff will be understanding if any difficulties occur. It may be a good idea to book out of season, when everyone will be less rushed and can give you more time and attention. Tourism for All provides a range of information about accessible places to stay.
• A mainstream package holiday – Again, if the person's dementia is mild, you may want to go on a mainstream holiday where everything is arranged on your behalf. If you choose this option, talk to the travel agency and holiday company before you book. Make sure that they are aware of your needs, and that all the support you need will be available.
• Specialist provision – A range of holiday and travel services are available for people needing special support. A person with dementia may be accompanied by a friend, relative or carer, or may use respite services (see Factsheet 462, Respite care), to give themselves and their carer a break from each other. Vitalise provides specialist holidays for people with disabilities and their carers, with centres across the UK. It also offers breaks at five purpose-built centres in the UK for people with dementia and their carers. If a carer feels they need to take a break on their own, the person with dementia could go on holiday separately, through a company offering specialist support, or, as above, could stay at a respite service. For more information contact Carers UK.

(For all contact details see 'Useful organisations'.)

Whatever type of holiday you choose, try to find out as much as you can beforehand about the place you intend to visit. Are there interesting places to see, activities you can enjoy and pleasant places to relax? If anyone travelling has a physical disability, will it be easy for you to get around? Local tourist offices can provide useful information.

Be aware that someone with dementia who is independent in familiar surroundings may need extra support when coping with a new environment or changes to their routine. Even if they are travelling with a companion, the holiday may be more enjoyable for everyone if another friend or relative comes too.

Knowing your rights

Since 1995, under the Disability Discrimination Act (DDA) UK businesses have been required to make 'reasonable adjustments' to make sure their services are accessible to disabled people. But in October 2004 a landmark change took place, when Part 3 of the act came into play. This new legislation requires service providers in the UK (including, for example, travel agents, train companies and hotels) to remove any physical barriers that prevent disabled people from accessing their services, where reasonable - for example, removing steps from entrances. They are also required not to treat a disabled person less favourably - so if you ask for a room with an accessible shower, for example, they can't charge you more.

The DDA does not just cover physical access. The definition of a disabled person is anyone with 'a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities.' This includes people with mental health conditions and learning disabilities, and many people with dementia would fall into this category. The duty to ensure that a person can access a service may range from providing wheelchair ramps, to offering an auxiliary aid, to helping someone get off a train at the correct station and waiting with them until their family arrives.

The DDA is a UK law, so it only affects services within the UK (such as trains, buses and coaches). Air transport is not covered under the DDA, although a new European directive called 'Access to Air Travel for Disabled Persons and Persons with Reduced Mobility' places responsibilities on airport managers, airlines, tour operators, ground handlers and travel agents to be trained in disability awareness and disability equality. Vessels such as cruise ships are not covered if they travel more than 12 miles from UK coasts.
On the whole, travel companies are more aware than ever before of the needs of their passengers with disabilities. Whichever form of break you are taking, whether or not it is covered by the DDA, contact all the companies involved first. Make a list of your requirements and ask how they can help you.
For more information about rights, contact the Equality and Human Rights Commission helpline (see 'Useful organisations').

Preparing and packing

The earlier you start preparing for your holiday, the less stressful it will be. Allow plenty of time to organise passports, insurance and other administration. It can be very helpful to write a list of all the belongings that you are taking with you. This list should state what is in each piece of luggage and how many pieces of luggage there are. Each person travelling should carry one copy of the list on them, and another copy can also be left with someone at home.

Make sure all luggage is clearly labelled with your name and address. Also put a sheet of paper with your name and address on it inside each separate bag or suitcase, in case items get lost.

Passport and other identification documents

Anyone travelling outside the UK needs a current passport. Most airlines require a valid passport, or another identity document that includes a photograph, even for flights within the UK. Check the passport expiry dates of everyone travelling, several months in advance. For travel to some countries, your passport must have several months' validity remaining so it is important to check the requirement for the country you plan to visit.

It is a good idea to make two photocopies of the personal details page of your passport. Leave one copy at home with a relative or a friend, and carry the other copy with you (separate from the passport itself), along with copies of your important documents. Write down the phone numbers of places to call if documents or bank cards get lost.

A MedicAlert bracelet or similar identification may be useful for a person with dementia in case they become separated from whoever they are travelling with, or become too confused to speak clearly.

Medicines

If you are likely to be separated from your luggage during your journey – for example, on an aeroplane or a coach – keep any medication in a carry-on bag, together with a list of the medicines and dosage routines. Medication must be kept on you at all times. If any medication needs to be kept in the fridge, tell the airline in advance and make sure you will have access to a fridge where you are staying.

The journey

Airports, railway and bus stations, ships, trains and even large aircraft are usually busy and confusing places in which it is easy to get lost or to lose touch with someone. If you are travelling with someone with dementia, always make a mental note of what they are wearing, and consider carrying a recent photograph of them. If you need help, look for people who are wearing official uniforms (for example, security staff, airline counter staff or train conductors).

Travelling by air

Airlines generally state that people who travel with a 'permanent or stable condition' do not require medical clearance. However, it is best to check at the time of booking what, if any, medical information is required.
Some airlines may not let someone with dementia fly alone if there is a possibility that they may become distressed while in the air. Airline cabin staff do not offer special assistance with medical needs, eating or visiting the toilet, and airlines will insist that a person with these needs has an escort for the flight. Some airlines can provide an escort for a person travelling alone, although the person travelling has to pay for the escort's fare.

British Airways advises people with a condition that may affect their ability to fly to contact its Passenger Medical Clearance Unit, which offers a free advisory service to doctors, other healthcare professionals and passengers. (See 'Useful organisations'.) Airports and airlines should provide the following assistance to anyone with a sensory, physical or learning disability:

• assistance to reach check-in
• help with registration at check-in
• a briefing for you, and any escort or companion, on emergency procedures and the layout of the cabin
• help with getting on and off the plane
• help with stowing and retrieving baggage on the plane
• an on-board wheelchair (not always available)
• someone to meet you off the plane and help you find your way around the airport.

To help you access the support you need, you may need to complete a form called an incapacitated passengers handling advice (INCAD) form and/or a Medical Information Form (MEDIF), which must be filled in by your GP. These are available from travel agents and airlines. They last for only one journey, but some airlines provide frequent travellers with a Frequent Traveller Medical Card (FRMEC).

Many airlines can escort people from the car park, train station or taxi stand if they are informed in plenty of time. Compare the arrangements offered by different airlines before booking, and check whether the cost of any special assistance is included in the price of your ticket.

If the airline cannot offer assistance, the airport may be able to. Many airports publish information about facilities at the airport, including information for people with special needs. If you use a wheelchair, check the policy of your airline as you may be expected to transfer to an airline wheelchair at check-in.
If your flight is cancelled, ask the airline to make special arrangements for you if you may need to rest. (This is a good reason to tell the airline of any medical conditions prior to travelling.)

Pack a small travel bag of essentials in your carry-on bag, in case your flight is delayed or your luggage is delayed on arrival. Take the items you need to make you feel comforted and comfortable (change of underwear, nightwear, shirt, socks, basic cosmetics, toothbrush) and remember any medication that you might need.
Remember that liquids, gels and aerosols are only allowed in individual containers of 100ml, and all containers must fit comfortably in one transparent, re-sealable bag no larger than 20cm x 20cm (for example, a freezer bag). This includes toiletries, cosmetics and toothpastes. The only exceptions are essential medicines. Pack any other items in your hold luggage.

Travel Care is an airport-based charity that offers advice on travel arrangements and operates from Heathrow and Gatwick (see 'Useful organisations'). For information on assistance available at other airports, contact the airport's main switchboard.

Travelling by train

Rail companies can arrange to meet a person at the departure station and escort them onto the appropriate train, if they are informed at least two days in advance. They will also take a person to their connecting train, if necessary. This support can be booked through the national Assisted Passenger Reservation Service. To arrange assistance, phone National Rail Enquiries (see 'Useful organisations', below) and ask for the phone number of the rail company you are travelling with.

Eurostar provides a complementary assistance service for passengers with special needs, and assistance can be provided at any Eurostar terminal. This service can be arranged when you book, as long as this is at least 48 hours before the journey (see 'Useful organisations').

Always confirm any arrangements the day before setting off, and make sure you have also arranged assistance for the return journey.

Travelling by coach or bus

Although passengers are responsible for seeing their luggage on and off the bus, the driver should assist with actually putting the baggage onto the bus. Keep all valuables, tickets and medication with you on the bus.
Many individual coach companies run their own services for travellers with special needs - for example National Express has a Disabled Person's Travel Helpline. There are also a number of specialist companies that offer UK and European coach travel with fully accessible vehicles, for those who use a wheelchair. For more information, contact Tourism for All. (For contact details see 'Useful organisations'.)

Travelling by sea

Vessels that travel more than 12 miles from the UK coastline are not covered by the Disability Discrimination Act, so may be less accessible than ferries travelling from the mainland to the Isle of Wight, for example. Check with the individual ferry or cruise ship operator as to whether they would require someone with dementia to have a companion or escort, or medical clearance for the journey. Make sure you tell them what assistance you will need at the time that you book the ticket. Some UK-based ferry companies offer discounted fares for disabled people. However, you may need to apply in advance to obtain a discount.

Travelling by car

If you are planning a long car journey, make sure that everyone is comfortable and that seatbelts are properly fitted. If you are planning to stop at motorway service areas, remember these can be vast and sprawling complexes and it is easy to get lost or disoriented, or separated from travelling companions. It might help for people with memory problems to keep on them a record of the model, colour and registration number of the car (a clear photograph would be ideal).

Plan your journey carefully, booking in regular breaks from driving, and listen to traffic updates before you set off.

If something goes wrong

It is important to make sure you are protected in case of eventualities such as sickness or lost items. You can do this by taking out travel insurance and ensuring you have the correct medical documents to entitle you to health care abroad.

Travel insurance

You will need a travel insurance policy that covers all passengers for all medical conditions. Some policies do not cover claims arising from a 'pre-existing medical condition or defect', which could mean that any illness or accident linked to dementia may not be covered. Policies that do not have this clause sometimes have higher premiums, so it might be necessary to shop around. There are specialist insurers that cater for people with special needs. Contact Alzheimer's Society for more details (see 'Useful organisations'). You might also consider making sure you are covered for travel delay.

The European Health Insurance Card

Inside the European Economic Area (EEA), free or reduced-cost emergency treatment is available to UK patients with a European Health Insurance Card (EHIC). The EEA consists of the 27 member states of the European Union plus Iceland, Liechtenstein and Norway. Switzerland is also covered, with some exceptions. This card replaces the E111 form. For details of where to apply, see 'Useful organisations' under EHIC.

There are a number of circumstances in which the EHIC does not cover medical treatment, so check through the terms and conditions carefully before travelling. Remember also that the card is not an alternative to travel insurance - you will still need insurance to cover eventualities such as repatriation.

Treatment in countries outside the EEA

Even if you are travelling to a country not covered by the EHIC, you may be entitled to some health care. The UK has reciprocal healthcare agreements with certain countries outside the EEA for the provision of urgently needed medical treatment either at reduced cost or, in some cases, free. The range of medical services may be more restricted than under the NHS, and if charges are involved, these cannot be refunded by the British government. Either way, you need to carry sufficient insurance to cover them.

To obtain treatment, you will normally have to produce your passport or some proof of UK residence, such as a driving licence or medical card. Requirements vary from country to country. For more details, go to www.nhs.uk/countryguidance/nonEEAcountries or contact the Department of Health Customer Service Centre for more details. (See 'Useful organisations'.)

Financial assistance

If you have dementia or are caring for someone with dementia, and you are having difficulty in meeting the cost of a much-needed holiday, you may be able to get financial assistance from a relevant charity.

Tourism for All publishes a guide to financial help towards the cost of a holiday or respite care, which gives details of various charities that may be able to help. The Directory for Social Change publishes a guide to grants for individuals in need. It gives details of national and local charities that make grants to individuals. A copy is available in every Citizens Advice Bureau. (For contact details see 'Useful organisations', below.)

If you would like funding for respite care, contact the local social services department.

For details of Alzheimer's Society services in your area, visit alzheimers.org.uk/localinfo
For information about a wide range of dementia-related topics, visit alzheimers.org.uk/factsheets

Useful organisations

British Airways

Passenger Medical Clearance Unit
T 020 8738 5444
E pmcu.pmcu@ba.com
W www.britishairways.com

Advises travellers about whether they consider patients with certain medical conditions fit to travel with them.

Carers UK

20 Great Dover Street
London SE1 4LX
T 0808 808 7777 (advice line, Wednesday and Thursday 10am-12pm and 2pm-4pm)
E info@carersuk.org
W www.carersuk.org

Provides information and advice to carers about their rights, and how to access support.

Citizens Advice Bureau (CAB)

Various locations
W www.citizensadvice.org.uk
www.adviceguide.org.uk

Your local CAB can provide information and advice in confidence or point you in the right direction. To find your nearest CAB look in the phone book, ask at your local library or look on the citizens advice website (above). Opening times vary.

Department for Transport Sustainable Travel and Equalities Division

Great Minster House
33 Horseferry Road
London SW1P 4DR
T 0300 330 3000
E elena.barcan@dft.gis.gov.uk
W www.gov.uk/government/policies/making-transport-more-accessible-to-all

Provides information for transport users with any kind of disability and the 'Access to air travel for disabled people' code of practice.

Department of Health Customer Service Centre

Richmond House
79 Whitehall
London SW1A 2NS
T 020 7210 4850
E dhmail@dh.gsi.gov.uk
W www.dh.gov.uk

Provides an information service to the public, the NHS, other government departments and voluntary organisations, on behalf of the Department of Health.

Directory for Social Change

24 Stephenson Way
London NW1 2DP
T 020 7391 4800
E use the enquiry form on the website (see below)
W www.dsc.org.uk

Publisher of 'A guide to grants for individuals in need'.

Disabled Persons Transport Advisory Committee (DPTAC)

Great Minster House
33 Horseferry Road
London SW1P 4DR
T 020 7944 8011
E dptac@dft.gsi.gov.uk
W dptac.independent.gov.uk

Advises the government on the transport needs of disabled people in the UK. The 'Door to door' section of its website offers information to disabled people about travel using all forms of transport, including a long list of useful organisations.

EHIC Application Service

T 0845 606 2030
W www.ehic.org.uk

Provides information about applying for the European health card. Forms are available from your local post office, or apply by phone or online (see above).

Equality and Human Rights Commission

Freepost RRLL-GHUX-CTRX
Arndale House
Arndale Centre
Manchester M4 3EQ
T 0845 604 6610 - England (helpline)
  0845 604 8810 - Wales (helpline)
E info@equalityhumanrights.com
W www.equalityhumanrights.com

Set up in October 2007 to replace the Commission for Racial Equality, Disability Rights Commission and Equal Opportunities Commission. Provides a helpline and takes legal action on behalf of some individuals whose legal rights have not been upheld.

Eurostar

T 08705 186 186
E use the enquiry form on the website (see below)
W www.eurostar.com

Provides booking facilities and advice on train travel from the UK to various destinations in mainland Europe.

Gatwick Travel Care

Room 3014B
South Terminal
Gatwick Airport
West Sussex RH6 0NP
T 01293 504 283 (weekdays 9am-5pm, weekends 9am-4pm)

Offers information, advice and support to travellers, visitors and airport staff.

Heathrow Travel Care

Queen's Building Room 1308
Heathrow Airport
Hounslow TW6 1BZ
T 020 8745 7495 (weekdays 9am-5pm)
E heathrow_travel_care@baa.com

Offers information, advice and support to travellers, visitors and airport staff.

MedicAlert

The MedicAlert Foundation®
MedicAlert House
327-329 Witan Court
Upper 4th Street
Milton Keynes MK9 1EH
T 0800 581420
E info@medicalert.org.uk
W www.medicalert.org.uk

Charity providing a identification bracelets and necklets for individuals with hidden medical conditions and allergies.

National Express Assisted Travel Team

T 08000 28 28 78 (8am-8pm Monday to Saturday, 10am-8pm Sunday)
E use the enquiry form on the website (see below)
W www.nationalexpress.com

Provides specialist support on coaches across the UK.

National Rail Enquiries

T 0845 7484 950
W www.nationalrail.co.uk

Provides information about all UK rail travel, including train company information and promotions, train times and special assistance.

RADAR

12 City Forum
250 City Road
London EC1V 8AF
T 020 7250 3222
E radar@radar.org.uk
W www.radar.org.uk

Campaigning and advisory body, set up by and for disabled people. It works for better lifestyles for disabled people and their families. Publishes a guide to places that can accommodate people with disabilities.

Tourism for All UK

7A Pixel Mill
44 Appleby Road
Kendal
Cumbria
LA9 6ES

T 0845 124 9971
E info@tourismforall.org.uk
W www.tourismforall.org.uk

Holiday and travel information service for disabled and older people, and their carers.

Vitalise

212 Business Design Centre
52 Upper Street
London, N1 0QH
E info@vitalise.org.uk
W www.vitalise.org.uk

Vitalise is a national charity providing essential breaks for people with disabilities, visually impaired people, and carers. Vitalise's centres provide 24-hour care on-call and personal support in a relaxed holiday environment. They also run breaks especially for guests with Alzheimer's disease and dementia, although they must be accompanied by a carer.

Factsheet 474

Last updated: August 2010
Last reviewed: July 2010

Reviewed by: Carrie-Ann Fleming, Information Officer, Tourism for All