Air travel provides the fastest and safest way for people to make a long journey, but those with disabilities face obstacles when dealing with crowded airports, cramped airplane seating and security lines. However, air travelers with developmental disabilities can travel by air if they make the proper plans and follow smart precautions.
Air travelers with developmental disabilities have the ability to fly under provisions of the Air Carrier Access Act (ACAA), enforced by the U.S. Department of Transportation. The ACAA makes it illegal for airlines to discriminate against passengers because of a disability. The law applies to flights to, from, or within the United States.
Flight nurses who work with non-emergency medical transport (NEMT) companies can help air travelers with developmental disabilities make long journeys by coordinating the trip and providing medical care during the flight.
Rights Under the ACAA
The ACAA mandates that airlines provide air travelers with developmental disabilities certain types of assistance. They offer online videos and information to airline employees on the details of these services. For those with disabilities who plan to travel, it’s helpful to read and watch the material to get a better understanding of the support they have when traveling.
The areas of assistance include:
Wheelchair or other guided assistance to board, deplane, or connect to another flight
Seating accommodation assistance that meets passengers’ disability-related needs
Assistance with the loading and stowing of assistive devices
Some of the areas where a NEMT flight nurse can benefit a traveler with disabilities is helping them overcome these common challenges.
Assistance for those with wheelchairs. A report from the DOT listed this as the No. 1 complaint they receive from disabled travelers.
Bathroom access. For those who use a wheelchair, a special request often must be made in advance to have a narrow wheelchair that can allow people to get down the aisle to the bathroom.
Service animals. Some mistake a service animal for an emotional support animal – they are not the same. However, this can cause confusion in airports at times.
Flight schedules also can cause issues, especially making a connection with little time available. A highly valued service for air travelers with developmental disabilities comes from RN flight coordinators who handle every aspect of travel plans, including working with airports and airlines for any needed special accommodations.
Those accommodations include special seating considerations and letting the airlines know about any medical equipment they plan to bring onboard. During the trip, flight nurses manage all the traveler’s medications and equipment. They also are specifically trained to provide any needed medical treatment at high altitudes.
Other Tips for Air Travelers With Developmental Disabilities
Arrive early. Get to the airport with plenty of time – at least a couple of hours – to check in, get through security and reach your gate.
Check in. At check-in, let the airline personnel know you have arrived and ask for any assistance through the airport, if needed.
Security. TSA has a hotline and other resources people can use for information about going through security with a disability.
At the gate. Check in at the desk to ensure that you’re on the list for pre-boarding.
At the destination. Prearrange transportation to pick you up at your destination.
Air travelers with developmental disabilities can still enjoy travel by planning ahead. They also can benefit from getting support during their journey from experienced NEMT flight nurses and RN flight coordinators.
Patient elopement is a common issue that often stems from other behavioral issues, including dementia. Elopement patients can present many problems for their loved ones, especially during elopement patient travel. Such situations usually go better with medical professionals involved, strong guidelines to follow and a focus on patient safety.
Much like air travel for dementia patients, elopement patient travel requires a different approach than regular non-emergency medical transport (NEMT). Physicians may recommend that elopement patients not travel at all. They may feel more inclined to allow it if medical professionals are on hand.
What Is An Elopement Patient?
The term “elopement patient” refers to someone who leaves a care facility, including hospitals or nursing homes, without permission. These unauthorized decisions put the patient in danger of injury or worse.
In most cases, the term refers to those with dementia leaving a safe area, most often their home or a care facility, according to Very Well Health. Elopement patients may decide to leave intentionally, although in many cases it is unintentional. The patient simply walks with a destination in mind, but soon becomes lost (a situation called “wandering”).
In many cases, an elopement patient leaves a building if they do not have constant supervision. They may decide to leave when sent to another area to get a blood test or medical procedure, or while going to the bathroom.
Most medical facilities have procedures in place to manage elopement patients. Writing about the issue for Health Leaders Media, a nurse recommended that nurses always immediately identify those at a higher risk for elopement. They include those with severe psychosis, dementia, or drug and alcohol withdrawal.
But elopement can happen with anyone. Warning signs of those at a high risk for elopement include:
A history of attempted elopement or wandering
Talking about leaving, wanting to go to work or go home
Restlessness and agitation
Showing signs and symptoms of dementia
The ability to move freely, with or without a wheelchair or walker, when they have other signs on this list
Those able-bodied enough that people may mistake them for a visitor
Elopement Patient Travel
All the above precautions and signs also apply to elopement patient travel. As elopement patients typically have some level of dementia, the rules offered by the Alzheimer’s Association for travel apply in this situation.
The association recommends planning ahead, not overloading the person with too much information, and sticking with familiar destinations. People should avoid elaborate tours or sightseeing, both of which could overwhelm or confuse a person with dementia. They also recommend that those traveling with a person who has dementia to stay with them at all times.
People can benefit from having a trained nurse on the journey who can watch the patient closely during their trip. They also manage medication and equipment and provide any medical services required during the trip. A trained flight nurse can provide both the patient and their family peace of mind.
Having an experienced medical professional while traveling with an elopement patient is key to having a calm trip. While elopement patient travel presents unique challenges, proper care and planning can allow everyone involved to enjoy the trip.
It’s possible for a bedbound patient to fly on a commercial airline, but only with certain international airlines and only on select flights. Doing so requires extensive planning with the airline so they can prepare the plane to safely transport a bedridden passenger. This requires contacting the airline well in advance of the planned trip.
It’s an area where a flight nurse can provide a great deal of help. An RN flight coordinator working for a non-emergency transport company (NEMT) will make all the travel arrangements for a client. That includes booking flights and arranging any special accommodations.
However, transporting a bedridden patient is typically not possible on a domestic flight. And even on an international flight, providing accommodations for bedbound patients are often very difficult to set up.
Types of Bedridden Patients
A bedbound patient may want to fly for a number of different reasons. Many of those most common situations involve medical reparation (someone flying back to the U.S. on an international flight after getting injured while on vacation) or experiencing a medical event, such as a stroke. Other postoperative patients may travel after recovery from surgery.
People need to remain bedridden during a flight, typically on a stretcher, because they are unable to sit up in a standard airplane seat during taxiing, takeoff and landing. They almost always fly with an experienced medical professional who can oversee their care during the flight.
Are Bedbound Patients Allowed on a Domestic Flight?
There are no stretcher options to fly someone domestically. The only airlines who offer stretcher service are outside the United States: Lufthansa, Korean Air, Qatar, and Emirates. And even these airlines only do so on select international flights.
While other international airlines may state they offer stretcher service, the logistics of getting it set up are extremely difficult and often not possible.
Domestic airlines require that passengers be able to tolerate sitting for up to 15 to 20 minutes. For bedbound patients, that is often not possible.
For those who can tolerate sitting up, a NEMT company provides a safe, low-cost alternative to an air ambulance. However, bedbound patients may have difficulty flying without using an air ambulance.
Hospital to hospice travel is difficult under the best of circumstances. For those who need a commercial airline flight, it can add an extra layer of complexity and stress. However, it’s not something people have to do alone.
Non-emergency medical transportation services provide an option for families searching for ways to safely transport a loved one from hospital to hospice. Given the situation, it’s one of the more demanding journeys a family can make. Having a flight nurse travel with a patient can make the journey less stressful.
For seniors looking to reduce the stress of travel, NEMT can offer assistance in any situation involving travel for the elderly, including making the journey from hospital to hospice.
Elderly Transport From Hospital to Hospice
The first consideration in transporting people from hospital to hospice is practicing kindness and respect toward the patient. For those searching for NEMT services in this area, make sure that the treatment from the outset reflects this mindset.
When researching NEMT companies to provide hospital to hospice transport, focus on companies that address the following areas.
Making all travel arrangements, including any special services needed to help the patient easily get through the airport and on board the plane
Any special accommodations needed in-flight
Medical services when required throughout the flight, including keeping track of medications and medical equipment
Going over the trip plan in advance to prepare the patient and family
It’s helpful to work with those who have experience working with airlines and airports at both domestic and international destinations, making it easier to set up any special accommodations. Nurses who fly with patients from hospital to hospice should also have years of experience in providing care and hold the necessary certifications to provide medical care at high altitudes.
Flying Angels recently had the honor of working with Jill Connaway in transporting her mother from a hospital in Missouri to Jill’s home in California. She found Flying Angels while doing research. As she wrote in a Facebook post, she heard from CEO Bob Bacheler within an hour after reaching out through the Flying Angels website.
“He was clear and upfront about what the estimated cost and process to get mom home would be. He was extremely patient and flexible as the plan continued to change as mom bounced between the hospital and rehab center for a month,” she wrote. “When it finally went time, he had our travel coordinated within 48 hours, including a ticket for me, so I could be on the same flight with mom.”
She said the flight nurse who traveled with her Mom, Elise, “was awesome.” She visited the day before the trip, setting expectations and preparing the pair for the trip. Jill wrote that Elise did everything possible to make the difficult trip “smooth and seamless.”
“She coordinated all of the details with the hospital. And she is just a very kind, congenial person,” she wrote. “Her attention to detail is superb. And the fact that she managed our travel so well really took a lot of the stress off of me and my mom. Plus she was very encouraging, especially at the very end of the trip when mom was so exhausted; she really cheered her on and kept her going.”
Expertise in Medical Transport
Flying Angels has years of experience providing non-emergency medical transport (NEMT) to patients in all types of situations. They include people injured while traveling who need to get back home, seniors relocating to a new home, and those with disabilities or medical conditions that make it difficult to travel on their own.
However, traveling from hospital to hospice is one of the most special journeys a person can make when using NEMT. The nurses and staff at Flying Angels feel gratitude for being asked to provide medical care during such an important time.
Jill summed up the company’s approach in her Facebook post. “I am so pleased that I reached out to Flying Angels,” she wrote, “I am grateful that there are people like Bob and Elise in the world who care so deeply and take such good care of people who are often in the most vulnerable places in their lives.”
Unless you’re seated in first class, sleeping on a plane is a tough task to accomplish. And even those in the best seats might still find it hard to tune out the plane noise and conversations going on around them, as well as find a comfortable position. It’s a problem.
Fortunately, it’s a problem with solutions. Years of trial and error have helped people develop travel hacks, including ways to get good sleep.
Even for those who still plan to wear masks during long flights, it’s possible to catch a little airborne sleep time. As Bob Bacheler, managing director of Flying Angels, told the Washington Post about sleeping on overnight flights, it’s “nearly impossible” to sleep well with an N95 mask, because the masks aren’t designed for comfort or to work on long flights. He told the Post: “The key to sleeping with a mask is to find one that’s comfortable to wear.”
Why Is Sleeping On a Plane So Hard?
For people with anxiety about flying on an airplane, it’s easy to understand why they might have difficulty dropping off while in the air. But most people eventually relax, especially on an overnight flight or other long flight. But relaxing on a plane is one thing. Sleeping on a plane is another. Plenty of roadblocks stand between you and getting good sleep while in the air, especially on overnight flights.
Sitting up. The human body is incredible, but there’s one thing it’s not made to do: sleep while sitting straight up. Especially when you’re sitting straight up in a narrow plane seat right next to someone you may not even know.
REM sleep. About 70 minutes or so into sleep, your body moves into REM sleep, a deep sleep state. One of the features of this state is that the body shuts down voluntary muscles. That means your head might flop over onto your seatmate or you might slide against the window – movements that jolt you awake.
Fluctuating temperatures. Swings in temperature can wake you up under the best of circumstances. On a plane, those swings can be dramatic and happen often.
Noise. Jet engines make plenty of noise, of course. There’s also the sales guy chatting up the whole row behind you and the baby crying across the aisle. Planes have dozens of noises that can jar you back to consciousness.
Tips for Sleeping on a Plane
Even with the above obstacles, there are ways to get sleep on an overnight flight. They range from what you wear to technology that can help. All of them can give you a better chance to get good sleep while flying.
Dress in layers. Handle those temperature changes by bringing a light jacket or hoodie that you can easily slip into or out of, depending on the temperature. They also make for great temporary pillows.
Light-blocking mask. Someone always decides it’s time to read, even on an overnight flight, and flips on their overhead light. Cabin lights may also come on. Protect yourself from those sleep-killing factors by wearing a light-blocking mask over your eyes.
Watch what you eat. High altitudes cause gas to expand, which can lead to a lot of discomfort in the stomach. Stay mindful about what you eat before a flight, sticking with items such as bananas, fruit smoothies, fresh bread, and crackers.
Try pink noise. White noise broadcasts all frequencies that humans can hear, but all equal in strength. Pink noise decreases the volume of higher frequencies. It’s a sound experience that resembles listening to rain or sea waves and is great at promoting restful sleep.
Add a pillow. Use a support pillow for your lower back, which can help reduce the risk of experiencing pain. Also, putting your elbows on the seat rest can alleviate pressure on your back.
Stay hydrated. The air in plane cabins, which typically has only about 20 percent humidity, can make it difficult to sleep by drying out your nasal passages and throat. Drink plenty of water (about 8 ounces for every hour you’re in the air) and use nose drops to add moisture.
These tips can help lead to better sleep on a plane, which means you will enjoy yourself much more when you land, rather than rushing to find a place to lie down and make up for lost sleep.
Few things are as frustrating as having a flight canceled after you’ve made all the arrangements to take a trip. If you find yourself caught in this situation, there are steps you can take to make the situation more bearable.
It’s especially important to learn tips for canceled flights as weather conditions have become more unpredictable in recent years and airlines canceled more flights during the global pandemic. And the other causes of flight delays are still in play, including computer glitches and staff shortages.
The following looks at some tips for canceled flights to keep in mind as you seek to avoid common air travel mistakes. You want to have options in case the worst happens, and you must deal with a cancellation or lengthy delay.
Tips for Canceled Flights
You’ve booked your flights and the hotel at your destination. You’ve rearranged your schedule to accommodate some time away from home. You might even have already arrived at the airport. Then comes the bad news: the airline has canceled your flight.
It’s an inconvenient situation, to say the least. Once you’ve gotten over the anger and frustration (this may take a few moments) consider the following tips for canceled flights.
Always Make a Last-Minute Check
This first tip actually addresses what happens before a cancellation. That’s because while news of a flight cancellation is unwelcome in all circumstances, it’s far worse when you’ve left your home or hotel and are sitting in the airport terminal. It’s also typically easier to make new arrangements from home than it is at the airport because of the crowds.
A good way to know about cancellations or delays early is by signing up with your airline’s text alerts. That typically ensures you will be among the first to know if an airline cancels or delays your flight.
This is the first and most important decision. Should you seek a refund on your flight and try another time to make your trip? Or should you immediately try to book another flight? Each travel itinerary has its own details, but factors for this decision generally include when the next flight is available, whether the trip included a connecting flight that you can still make, and if a delay will require making changes to your return plans (and require you to pay the dog sitter for another day or two).
Act As Quickly As Possible
If you decide to immediately book another flight, now is not the time for hesitation. Once you see the notification of a cancellation, immediately get into line to talk with an agent while you (or someone else in your party) also calls the airline. You want to pursue every avenue to book a new flight as quickly as possible. While it may not seem fair, this is a “first come, first served” situation.
Keep in mind that most airlines will rebook you on the next flight to your destination for free if your flight is canceled. Also, if you work with a flight coordinator, they can help you quickly make new arrangements.
Do The Research
Using your phone, you or someone in your party can start looking up alternative flights to your destination as you wait in line to talk to an agent or wait on hold on the phone. Knowing your options when you talk to the agent will help them work more quickly to solve your problem. Also, as pointed out by CNN Travel, having a good attitude will make an agent who hears nothing but complaints all day work harder and faster on your behalf.
Know Your Rights
A step too few people take when they fly is to review the cancellation policy of the airline. U.S. law requires airlines to refund passengers for unused tickets caused by canceled flights. For a long delay, they may not have to offer a refund, depending on the cause of the delay (such as anything deemed an “act of God,” like bad weather). However, most airlines make every effort to accommodate passengers, so read the cancellation policy of your airline to know the steps to take.
These tips for canceled flights can make the experience slightly less terrible, and also help you get to your destination as quickly as possible should you choose to continue with your trip. Flight cancellations and delays are more common than ever lately, but preparation is key to handling them in the best way possible.
