Travelling and going on holiday
Going on holiday should be a relaxing and enjoyable experience. This is no different for people with dementia and their friends and family. There are lots of benefits to a holiday, such as having new experiences and giving the person with dementia and those close to them a break from routine. However, dementia can make it more difficult to travel.
This factsheet gives tips and advice about planning a holiday for people affected by dementia, including choosing the right type of holiday and arranging travel insurance and medical care. It also explains the best ways to get around and any financial help that is available for taking a holiday.
Planning your holiday
It is important to plan your holiday carefully in order to avoid any problems. People with dementia might find a new environment confusing, or may become worried if something doesn't go as planned. They may also have difficulties readjusting once they return home. On the other hand, their travelling companion may be so concerned that the person with dementia has a good holiday that they forget to relax themselves. For these reasons, it is important to think about what kind of holiday is right for everyone, and plan it well so that everything goes as smoothly as it can.
What type of holiday to take
Everyone will enjoy different types of holiday, depending on their interests, personal preferences and budget. You should also consider how the person's dementia affects their daily life when deciding on the right type of holiday.
- Staying with friends and relatives - If you are considering visiting friends or relatives, or if a number of people are going away together, you should talk openly about the situation and how each person might be able to help. For example, some members of the group might be able to 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, some people might be able to help with tasks such as cooking dinner. People are usually more willing to offer help and support if they are clear about how they can help.
- Independent travel - Travelling independently gives you more choice and flexibility than other types of holiday, which can be a good thing, but you have to do a bit more work yourself. You will need to arrange all 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 look for places that offer a friendly, welcoming atmosphere and where staff will be understanding and supportive if you have any difficulties.
- A package holiday - You may want to go on a package holiday where everything is arranged for you. 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 these needs can be met.
- Specialist holiday - there are a range of holiday and travel services available for people who need extra support. A person with dementia may be accompanied by a friend, relative or carer on one of these trips. Alternatively, you may choose to use respite services that allow the person with dementia and their carer to take a break from each other. If a carer feels they need to take a break on their own, the person with dementia could go on holiday separately. This could be arranged through a company offering specialist support. For more on this see factsheets 462, Replacement care (respite care) in England, W462, Respite care in Wales, or NI462, Respite care in Northern Ireland.
The charity Revitalise provides specialist holidays for people with disabilities and their carers at their purpose-built holiday centres across the UK. See 'Other useful organisations' for details.
Planning your holiday: tips for carers
- A person 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 goes too.
- Try to find out as much as you can beforehand about the place you plan on going to. 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.
- A smaller hotel without too many corridors may be less confusing for the person with dementia. It may be a good idea to book 'out of season', as places are likely to be less busy and staff will able to give you more time and attention. The charity Tourism for All provides a range of information about accessible places to stay (see 'Other useful organisations' below).
- Try to be open about the person's needs - for example, with hotel or airline staff. Explain the difficulties or limitations the person may have so everyone knows what to expect. Trying to hide problems can make life more stressful for everyone.
Knowing your rights
There are laws that protect the rights of disabled people in the UK, and it can be helpful to know these when taking a holiday. Under the Equality Act in England and Wales, and the Disability Discrimination Act in Northern Ireland, UK businesses have to make 'reasonable adjustments' to make their services accessible to disabled people. Dementia is classed as a disability for the purposes of these laws, even though many people with dementia would not see themselves as 'disabled'.
These laws require service providers in the UK (for example, travel agents, train companies and hotels) to remove any barriers that prevent disabled people from accessing their services. This might refer to physical barriers - for example, it might mean removing steps from entrances. The Equality Act and Disability Discrimination Act do not just cover physical access, however. Making sure that a person can access a service may range from providing wheelchair ramps to helping someone get off a train at the correct station and waiting with them until their family or friends arrive.
The law also states that service providers are not allowed to treat a disabled person less favourably than someone without a disability. If you ask for a room with an accessible shower, for example, they can't charge you more for it.
It is important to be aware of these laws, and if you feel you are having problems accessing services or are being treated unfavourably, you should speak to the company directly. If through speaking to them you cannot get the problem resolved, consider putting in a complaint about the treatment that you have received. These laws only cover the UK , so only services within these countries are affected. This means that air transport is not covered. However, a European directive (a piece of EU law) requires various service providers - such as airport managers, airlines, tour operators and travel agents - to be trained in disability awareness and disability equality. This directive is called Access to air travel for disabled persons and persons with reduced mobility. However, vessels such as cruise ships are not covered by this law if they travel more than 12 miles from UK coastlines.
On the whole, most travel companies are aware of the needs of their passengers with disabilities. Whatever kind of break you are taking (whether or not it is within the UK and covered by the Equality Act or Disability Discrimination Act), you should contact all the companies involved beforehand. It helps to make a list of your specific requirements and ask how they can help you with each of them.
Preparing and packing
The earlier you start preparing for your holiday, the less stressful it will be. You should allow plenty of time to organise things like passports, insurance, medicines and visas (if necessary).
When packing, it can be helpful to write a list of everything you are taking with you. This should say how many pieces of luggage there are and what is in each of them. Each person should carry one copy of the list with 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 luggage labels are removed or lost.
There are various different pieces of assistive technology or aids that might help if someone becomes disorientated in an unfamiliar environment. You should talk to an occupational therapist if you think any of these could be useful. There is also information in factsheet 437, Assistive technology - devices to help with everyday living.
Passport and other identification documents
Anyone travelling outside the UK needs a valid passport. Even for flights within the UK, most airlines require a passport, or another identity document that includes a photograph.
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 (in somewhere different to the passport itself, such as your suitcase). Also make copies of your other important documents, such as plane tickets and insurance documents. Write down the phone numbers of places to call if documents or bank cards get lost or stolen.
A MedicAlert bracelet (which contains information about your medical condition and needs) or similar identification may be useful for a person with dementia in case they become separated from the person they are travelling with, become confused or experience communication problems. For more information call MedicAlert on 01908 951045.
Medication must be kept with you at all times. If you are likely to be separated from your luggage during your journey, keep medication in your hand luggage or carry-on bag, together with a list of the medicines and dosage routines. Take a letter from your doctor to show to airline staff. If any medication needs to be kept refrigerated, tell the airline in advance and make sure you will have access to a fridge where you are staying.
Before you travel, you should make sure you are insured against any problems that may arise, such as sickness or lost items. Your travel insurance policy will need to cover all passengers for any medical conditions that they have. You might also consider making sure you are covered for travel delay.
Some policies do not cover people for claims that come about because of a 'pre-existing medical condition or defect'. This could mean that any illness or accident linked to a person's dementia may not be covered. Policies without this clause can be more expensive, so it is a good idea to shop around. There are a number of specialist insurers that cater for people with certain needs, such as dementia. You might want to look into these insurers.
The European Health Insurance Card
It is important that you have the right medical documents so that you are entitled to health care abroad. Inside the European Economic Area (EEA), UK residents with a European Health Insurance Card (EHIC) are entitled to free or reduced-cost emergency treatment. The EEA consists of the 27 member states of the European Union, plus Iceland, Liechtenstein and Norway. Switzerland is also covered, with some exceptions. The EHIC replaces the previous E111 form. The card is free and is valid for up to five years. You can apply for it directly from the NHS.
For more information call the EHIC line on 0300 330 1350.
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 should always have both, because you will still need travel insurance to cover things like repatriation (being returned to the UK).
Treatment in countries outside the EEA
Even if you are travelling to a country outside the EEA, where you are not covered by the EHIC, you may still be entitled to some health care. The UK has agreements with some other countries that mean they will provide urgent medical treatment at reduced cost or, in some cases, for free. You will usually not be able to get all the treatments and services that are available on the NHS , however, and if charges are involved, the British government will not refund you. You need to have insurance that can cover these costs.
To get treatment, you will normally have to show your passport or some other proof that you are a UK resident, such as a driving licence or medical card. Every country will have different requirements. For more details visit www.nhs.uk/nhsengland/healthcareabroad
Airports, railway stations, bus stations, ships, trains and aeroplanes can be busy and confusing places. It can be very 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).
Give yourself enough time to get to the airport or railway station. Arriving earlier means shorter queues or waiting times, which may make your journey easier. You might want to consider travelling at times when fewer people travel - avoiding weekends at the height of summer, for example.
Travelling by air
If you are flying, you may need to tell the airline that you or your travelling companion has dementia. Most airlines say that people with a 'permanent or stable condition' do not require medical clearance in order to fly. However, you should check when you book your flights what medical information the airline needs.
British Airways advise people with any condition that may affect their ability to fly to contact its Passenger Medical Clearance Unit, which offers a free advisory service (see 'Other useful organisations').
Some airlines may not let someone with dementia fly on their own if there is a possibility of them becoming distressed during the flight. Cabin staff are not there to help with people's medical needs, eating or visiting the toilet, and airlines will insist that a person who needs help with these activities has someone with them for the flight. Some airlines can provide an escort for a person travelling alone, but the person travelling will have to pay for the escort's fare.
Airports and airlines should provide anyone who has a sensory, physical or learning disability with:
- assistance to reach check-in
- an explanation of emergency procedures and the layout of the cabin for those who are travelling
- 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 as you leave the plane and help you find your way around the airport.
In order to get this support, you or the person you are travelling with may be asked to provide some forms. These are the Incapacitated passengers handling advice (INCAD) form, and the Medical information form (MEDIF), which must be filled in by a GP. You can get these from travel agents and airlines. They are only valid for one journey, but some airlines provide frequent travellers with a Frequent traveller medical card (FREMEC) which can do the same job.
Many airlines can also help a person when arriving at the airport. They may be able to escort people from the car park, train station or taxi stand if you ask in plenty of time. You should think about what help the different airlines can give before booking, and check whether the cost of any special assistance is included in the price of your ticket. If the airline cannot help, 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 with your airline as you may have to transfer to one of the airline's wheelchairs when you check-in. If your flight is cancelled, ask the airline to make special arrangements for you if you need to rest. (This is a good reason to tell the airline of any medical conditions prior to travelling.)
You should pack some essentials in your carry-on bag, in case your flight is delayed or your luggage is late arriving. Take the things you or the person with dementia need to feel comfortable (such as a change of underwear, nightwear, shirt, socks, basic cosmetics and toothbrush) and any medication that you might need.
You cannot take liquids, gels and aerosols in your carry-on bag in containers larger than 100ml. 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 to this rule are essential medicines. Pack any other items in your hold luggage.
Travelling by train
If you are travelling by train, the rail companies can arrange to meet you or your fellow traveller at the station and help you to the right train, if you let them know at least two days in advance. They will also take you to your connecting train, if necessary. This can be arranged through the national Assisted Passenger Reservation Service. To do this, phone National Rail Enquiries on 03457 48 49 50 and ask for the phone number of the rail company you are travelling with.
Eurostar provides help at no extra charge to passengers with special needs. This can be provided at any Eurostar terminal. You can arrange this when you book, as long as it is at least 48 hours before the journey. For more information call Eurostar on 08432 186 196.
If you have arranged help with your journey, 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
If you are travelling by coach or bus, the driver should help with putting your baggage into the storage area under the coach. You should keep all valuables, tickets and medication with you on board, however.
Many coach companies run their own services for travellers with special needs - for example, National Express has an Assisted Travel Team, a helpline set up specially to deal with requests from disabled passengers. For more information see 'Other useful organisations'.
A number of specialist companies offer UK and European coach travel with fully accessible vehicles, for people who use a wheelchair. For more information contact Tourism for All (see 'Other useful organisations').
Travelling by sea
If you are travelling by sea, you should ask in advance how accessible the vessel is. Vessels that travel more than 12 miles from the UK coastline are not covered by the Equality Act or Disability Discrimination Act, so they may be less accessible than ferries travelling from the mainland to the Isle of Wight, for example.
You should check with the ferry or cruise ship operator to see if they need someone with dementia to have a companion or escort, or whether they need to get medical clearance for the journey. You should tell them when you book your ticket what assistance you will need.
Some UK-based ferry companies offer discounted fares for disabled people. However, you may need to book early to get this discount.
Travelling by car
If you are planning a long car journey, try not to travel for more than two hours before having a break. Plan your journey carefully, factoring in regular breaks from driving, and listen to traffic updates before you set off. Try to ensure that everyone is comfortable and that seatbelts are properly fitted.
If you are planning to stop at motorway service areas, be aware that these can be big and confusing, and it is easy to get lost or disorientated, or separated from travelling companions. It might help for people with memory problems to keep a note of the model, colour and registration number of the car (a clear photograph would be ideal).
Arrival: Tips for carers
- A person with dementia may feel tired or unsettled when they arrive somewhere new. It may help to have a cup of tea, relax and leave the unpacking until later.
- You might want to ask for a mattress protector and extra sheets to be left in the bedroom in case of accidents. This will mean you won't need to ask for them in the middle of the night.
- Consider the layout of where you are staying and how best to help the person navigate. If the room is en suite, it may help to keep the bathroom door open when not in use so it is clear where the toilet is. If you are renting accommodation, consider putting up signs that make it clear what each room is.
If you have dementia or, are caring for someone with dementia, and you are having difficulty finding the money for a much-needed holiday, a charity may be able to help.
Tourism for All publishes a guide to what help is available to meet the cost of a holiday or respite care. It gives details of the different charities that may be able to help. There is a charge for these guides if you are not a member of Tourism for All (see 'Other useful organisations').
If you would like to enquire about funding for respite care, contact your local authority social services department.
Other useful organisations
British Airways Passenger Medical Clearance Unit
Advises travellers about whether they consider patients with certain medical conditions to be fit to travel.
Dementia Adventure CIC
Unit 11 Old Farm Park
Essex CM3 1LN
A community interest company that delivers short breaks and holidays for people living with dementia and their carers to enjoy together.
Mind for you
5 The Willows
Burton On The Wolds
Leicestershire LE12 5AP
Company that offers supported holidays for people with dementia and their carers together, throughout the UK.
National Express Assisted Travel Team
Provides specialist support on coaches across the UK.
Tourism for All UK
7A Pixel Mill
44 Appleby Road
Cumbria LA9 6ES
Holiday and travel information service for disabled and older people and their carers.
212 Business Design Centre
52 Upper Street
London N1 0QH
T 030 3303 0145
A national charity providing essential breaks for people with disabilities, visually impaired people and carers. Revitalise's centres provide 24-hour care on-call and personal support in a relaxed, holiday environment. They also run breaks for people with dementia.
Reviewed April 2013 by Dr Marilyn Cash, Post Doctoral Researcher, School of Health and Social
Care, Bournemouth University and Sallie Rutledge, Dementia Lead Nurse;
Proprietor, The Mede Holiday Respite Support, East Devon
Reviewed January 2016 by Alzheimer's Society
Next review due: January 2019
This factsheet has also been reviewed by people affected by dementia.
A list of sources is available on request.