Unrealistic travel plans
My 87 yo LO with stage 5 mixed Alz/vascular dementia and mobility issues has unrealistic travel plans.
He had trouble today finding his way around his retirement community and was confused about meeting his 5 year companion for dinner. Which he does every Sunday afternoon.
Mobility-wise, he is basically 100% reliant on his power chair and med techs. Tonight, after I left, his power chair died and it took four people to get him back to his AL room. AL is managing his medications and helping him with transfers, dressing, and showering.
He has had a lifetime of travel which he really loved, and his companion hasn't traveled much so he wants to show her the world.
Their last few trips have been difficult for various reasons. He forgets the bad and remembers the good.
So now he's talking about taking a 2 week Caribbean cruise with her. Or maybe Alaska to see the glaciers or Egypt to see the pyramids.
I want to be supportive but I just don't think his ideas are realistic.
His companion is willing to be the party pooper and say she just doesn't want to go. She - rightfully so - doesn't want to play nursemaid and/or abandon him to do the more active things (she doesn't have mobility issues currently). I'm hoping that will work.
He doesn't want a traveling nurse (i.e. a third person to travel with him and his companion).
He has an NP who monitors his health conditions and visits him every few weeks in AL. I might be able to get a back channel communication to her and ask her to say he's not medically cleared for travel.
I doubt he'll listen to any of his children. I also doubt he'll be dissuaded by reminders of how the last few trips have been difficult, or practical questions about how will he transfer and shower and dress.
It's probably essentially denial about his physical and mental decline, and somehow he probably has to face reality and give up on his travel dreams.
Anyone dealt with this before? Advice or suggestions welcome.
Comments
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Who sets up the plans, books the flights or hotels for these trips? It’s obviously not him. So whomever is doing it should stop doing it. Especially his companion since she doesn’t want to play nursemaid. ( no one is judging her for that - it’s a common thing).
He may want to travel but if no one does the things that actually schedule the trip, then maybe the trip won’t happen
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My guess would be he would try to do it himself with the help of a local travel agent. He does still have the ability to use the Internet on his computer, his telephone, and his credit card. Said agent may not be able to figure out he has dementia, or may not care due to the financial conflict of interest.
His kids and companion won't help set up the trip; that part is accurate.
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Are you familiar with anosognosia? He sounds like he truly believes he is fine. Don't bother trying to confront him. Let him wish about traveling. Does he have access to large funds for a cruise? There is a lot of paperwork to fill out. Does he have a passport? I doubt that he could make a reservation. Everything is done online now. I am trying to buy tickets from Ticketmaster and I am running into difficulty. He is not functioning better than I am.
Iris
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I think I've heard about it and know vaguely what it is. I'll read up on it more. If I had to describe it as an amateur, he's in denial about his current ability level and how much help he is getting in AL and isn't able to think through how it would be not to have it. Minimizing, glossing over, and wishful thinking would also be apt descriptors.
He has the money, but has mostly handed over management and control to me, his POA. I did set up alerts on his credit cards so if he puts down a deposit on a trip I would know. He might need my logistical help to get the balance paid with a check.
He does have a passport, I think it's still valid. Actually I don't even know where it is for sure now, though. A lot of stuff got moved around when he moved from IL to AL a few months ago.
He's intelligent and motivated and stubborn and doesn't have very many demands on his time currently, so with the help of a travel agent he could maybe get all the paperwork done. I could see problems cropping up there, but he would still try.
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Secondcor, you have accurately described anosognosia. It is important to understand that anosognosia is NOT denial. This is why caregivers have to learn to use work-arounds to get things done. You don't want him traveling, so you will have to put up roadblocks. However, you will have to be discreet because if you confront him directly he will get upset and learn not to trust you. Make the roadblocks seem like they DON'T come from you. Don't assist him, don't let anyone else assist him. He won't be able to complete the reservation. When he gets frustrated and if he asks for help, make up an excuse. Put the onus on someone else or something else. BTW, I don't remember seeing scooters on my cruises. Travelers have to be able to ambulate.
Once you come to the understanding that he really doesn't know what he's doing, it will be easier for you. You are treating him as if he is still making rational decisions. In addition to managing the affairs, the POA job is to keep him safe. "Unrealistic travel plans" are not safe. To ease your mind, you can check a cruise line and see what their requirements are for mobility and independence.
Iris
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Iris, thanks.
I understand it's not denial - the behavior looks loosely like denial but I can tell that it is different. On the surface, he sounds rational, but when I bring up the issues he skips over them almost like he's not really listening to me or in a trance. A bit like some of the characters in the movie "Get Out" by Jordan Peele, if you've seen that.
I am talking with my sisters and his companion via side channels to figure out how to put up roadblocks. The big one is his companion simply saying she doesn't want to go. I might also conspire with his nurse practitioner to not medically clear him to travel. I might be able to work with the travel agent somehow as well. I will also keep in mind your suggestion about the cruise ships' mobility requirements. On past cruises, he has rented a power scooter from Scootaround, but he had much more mobility then. I could see it being a safety issue because he certainly couldn't participate in a lifevest / liferaft drill or heaven forbid a real emergency.
This anosognosia is new within the past few weeks, so I am just starting to learn and understand and recognize. The fact that he was and is a very intelligent person might be making things a bit more difficult to discern. This is also my first up close and personal experience with a person with dementia. But I can definitely tell that things are "off" and know well enough to come here for advice. Thanks again.
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Sounds like you have a good plan with some great ideas.
It is tough when your LO doesn't realize their limitations.
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You could also ask him where his passport is so he can confirm that it is valid. At that point, when you know where it is + if it IS still valid, you could ‘disappear’ it. He might not be able to even find it. To me, that is the easiest way to put a stop to this nonsense
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Yep, I'm going to try to disappear his passport (which is almost certainly current) tomorrow.
I also talked to his AL facility and his nurse practitioner and they're going to help put up roadblocks. The NP thought that the companion deciding not to go would stop it as well.
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Follow up if anyone is interested.
After a family discussion to make sure my sisters were on board, I was able to disappear two of his three forms of payment, reduce the credit line on his one remaining credit card, and put more notifications on that one remaining credit card. This closes the leak where he was able to spend that much without (enough) oversight.
I also ended up mailing a physical copy of the POA to the cruise company and they refunded all of his deposit back to his bank account. All in all, the cruise company was reasonable to deal with.
I went through his email and unsubscribed him from all the cruise and international travel email subscriptions he was getting.
His nurse practitioner did have a conversation with him at his next regular checkup and advised him not to travel due to his medical situation. Because of his history he's more likely to listen to a medical professional.
His companion has been good about declining invitations to go on trips, and to let me know behind the scenes when he starts bringing up more travel ideas.
He did want to go on another trip after the cruise. This time it was a bus trip to Plymouth Rock in Massachusetts being organized by his CCRC. I spoke with the activity organizer there and he agreed to help cancel that idea.
I never did find his passport and what happened to it is a bit of a mystery. But lost works for us.
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Good work. Does he have fulfilling activities to engage in?
Iris
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Great work! Missing passport may need to be reported to the authorities, just so no one steals his identity.
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He's in a CCRC and there are plenty of activities available. He mostly chooses not to participate, but does do some things. I've encouraged him numerous times to little avail.
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Frankly, he sounds like me. He likes to dream about and plan travels. I had thought about giving up my overseas travel plans, but I still have that desire. He and I are at the stage where we can't do all that we used to do, and don't feel up to trying a lot of things right now. Maybe later. I say later, but I'm working on getting myself used to the idea that "later" will never come. There is just now.
Iris
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You are absolutely on the ball, Victoria! Virtual travel is a great way to go! I love your links, there is such detail in the descriptions. I read a story about a disabled woman who traveled around the world via Google maps and street views. Who woulda thought?
Iris
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Iris and Victoria - this is profound. Both of you.
Iris, so true that "today", "right now" is the only reality we have in all honesty. Too many of us don't pay full attention in the moment (I know I often did not). AD surely changed that though I still feel anxious, guilty, or stressed sometimes about something that I can't go back and change, or that hasn't even happened yet (and might not). Need to work on that. Being focused on what "is"... and being more intentional about that is my goal more and more.
Victoria2020, this was really an unexpected gift of the pandemic for me too. Bringing the world right to my lap(top), anytime that AD gives me a break -- no matter what time of the day or night. You are right. WOW! Thank you for these great links. Truly appreciated
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Ive got a link to 12 museums with online virtual tours. Will try to send it tomorrow....
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Here it is though I can never remembvver how to make it a live link....
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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