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Simple tips traveling by air with TBI, aging, and other physical and mental challenges

24 May

Do not let your physical and mental challenges stop you from traveling when you want or need to. You can get preferential seating by Air Carriers Access Act.  Feeling confined or not in control of your symptoms may keep you from traveling by air. Do not let fear control you.  Control whatever you can.  Consider what you need to continue traveling in comfort.  Are there really things one can do?

Singapore Airlines (SIA/SQ) Airbus A380 (9V-SK...

Singapore Airlines (SIA/SQ) Airbus A380 (9V-SKA) landing on 20C at Singapore Changi Airport. Taken with a Nikon D80 and AF 70-300 f/4-5.6G lens. (Photo credit: Wikipedia)

A reader offered some excellent suggestions to help get over the fear of traveling by air and how to be comfortable with your daily challenges.  It was through these suggestions one felt like there were more options for traveling by air.

The Air Carriers Access Act protects people with challenges

The carrier cannot refuse service based upon your disability.  They can refuse service  only if you are safety hazard to others but carriers are required to provide a written explanation of what they perceive as the safety hazard.

If you are challenged you are not required to give advance notice, but if unsure you may inquire how the airline can help you.  There is a request of at least 48 hours when special seating is required.  Always plan ahead. Travel can be stressful for those without challenges, and it adds to daily life challenges for those with disabilities.  Only you know your needs.  Do not abuse this, but use it effectively so you can travel.

There is no limit as to how many people with disabilities can travel at one time.  Most airlines need advance notice if special medical equipment is needed during flight such as: respirator and electric wheelchair.  

Challenged people cannot can travel alone.  If the carrier requires an attendant to travel with the person and the person disagrees about the necessity attendant the airline cannot charge the attendant for their flight.

Movable aisle armrests are on 50% of aisle seats.  Newer and larger aircraft must have accessible lavatories.  They must have space for storing the folding wheelchair in the cabin otherwise it must be approved by you to have them check it in storage.  This can be risky, because if it is put in storage and damaged you may arrive without a working assistive device.  That is definitely a downside to letting them check mobility devices.  Most aircraft with more than 60 seats have an on-board wheelchair to assist those to an inaccessible lavatory.

Personally, I have found the assistance with boarding, deplaning and making connections beneficial.  This is an excellent opportunity if you move slower than others.  With invisible injuries coordination is often impaired, especially when rushed.

English: A collection of pictograms. Three of ...

English: A collection of pictograms. Three of them used by the United States National Park Service. A package containing those three and all NPS symbols is available at the Open Icon Library (Photo credit: Wikipedia)

Connecting flights may be tricky.  Moving quickly, distractions, and disorientation are common in airports.  Make sure you let them know you will need assistance with connecting flights. You do not need to provide any information. If you feel you need to give an explanation let them know you deal with “cognitive problems“, hence you are a bit slower they will not question you further.  Many people in all age groups deal with varying degrees of “cognitive problems”, visual, and hearing deficits of varying degrees …  and can benefit from a little help.

Assistance with

  • Boarding
  • Deplaning
  • Making Connections

Luggage needs to conform with FAA rules with stowaway and carry on luggage.  All assistive devices do not count against limits on carry on baggage.  Wheelchairs and assistive devices take priority for on-board and checked in baggage.   Some airlines accommodate more than others.

There is no extra  fee for extra packaging of batteries used in electric wheelchairs.  They can charge an extra fee for oxygen and other services.  Check with the airlines if you have a medical condition that warrants a possible delay or extra service.

There are a number of other provisions that includes service animals, security screening, medical certificates, mobility and assistive devices, and others.  Make sure if you have certain allergies, medications (especially injectables-sharps) or nutritional restrictions you notify the airline carrier in advance.

Seating

ACAA give the qualified party ‘BUMP’ authority. This means you can take a seat already assigned to a non-ACAA passenger. The 48 hours before flight time limit for these rights are the problem.

Some airlines are not as accommodating so you need to improvise.  A few suggestions here are to: read, use a laptop, pull a hoodie or blanket over your head, close your eyes, use sleep blinders, dark sunglasses, or other compensatory methods you have learned.

Limiting distractions and decreasing confusion

  • Read
  • Use laptop
  • Pull hoodie or blanket over head
  • Close eye
  • Sleep blinders
  • Dark sunglasses

The bulkhead area offers the best visual and physical space.  Also good for leg room, no rows directly in front of you and less distractions.  You can also request an aisle seat.

Bulkhead aisle seats are ultimately the best when dealing with visual and physical space problems frequently seen in TBI.  Expect that while claiming disability, they can fight you because those seats are often exit rows. If you have the physical strength to manipulate emergency exist doors you can tell them that you are exit row qualified (able to operate an exit door), otherwise you will need to use another strategy to compensate for comfort.  Never jeopardize the safety of anyone regardless of your personal situation.

The ACAA requires asking for preferential seating more than 48 hours before the flight. Usually the airline holds these seats for VIP passengers who prefer last minute seating and first off deplaning.  Because of this they do not release them except at the gate.

  • ACAA “bump status”- 48 hour notice request seating
  • Bulkhead area
  • Aisle seat
  • Exist rows require physical strength to manipulate quickly emergency exit doors

TBI & Other Medical Diagnosis with Cognitive challenges

A reader provided an explanation that many with TBI endure, “The visual problem I experience is rows and rows of the tops of seats and the backs of heads. This is a serious visual overload.”  This person finds it helpful to use medical terms, such as telling the attendants you have a “visual processing disorder” that causes problems when you “have too much clutter (seat backs and heads) in your visual field.

Unfortunately, there are many people who make life difficult by using wheelchairs unnecessarily, especially in airports.  Below in related articles are writings covering these topics.

Take a look at the comprehensive Air Carrier Access Act that apply to all U.S. air carriers that provide commercial transportation.

For the full version of the Air Carrier Access Act visit http://www.dotcr.ost.dot.gov/asp/airacc.asp

Another tip for the EFD crowd (executive functioning dysregulations).

Don’t try to wrangle with those blinking/moving “locate your gate and arrival/departure time” boards. Go to the counter, tell them you’re dyslexic and have trouble reading the signs and ASK them to direct you where you need to go (any gate – doesn’t have to be your carrier – which you may need help locating in the visual overwhelm of a busy airport).

Even workers at crazy/busy times have been more than gracious about helping me with my “dyslexia” – and saying “I have [fill in your disorder here] and need help” doesn’t always garner the same cooperation. Many too many hear that as an “excuse” rather than a bona-fide problem.

Medications while traveling

We all know to keep meds with us and not in our checked baggage, but if your meds are controlled substances BE SURE to include prescription documentation – WITH your medication, ideally. It’s a good idea for all meds, actually, especially if you will be traveling for a long enough time that you need to take enough with you that it might arouse suspicion.

EVEN if you make sure to keep your doctor’s name and number at the ready (DO this, btw), if you end up being someone whose carry-on luggage is searched, it may not be possible to reach your doctor before you miss your flight.

The advice is to carry medication IN the bottle it was packaged in by the pharmacy – label with your name on it right on the container. “I have always used another method, since I don’t want to carry more medication than I will need for the trip, and need those M-T-W etc. medication containers to track whether or not I’ve taken today’s meds.”

“On returning from the pharmacy (while it’s still “fresh”) I carefully peel the label off the bottle and affix it to an index card I place in my wallet – then I parse my medication into a month’s worth of M-T-W reminders. #4 is hot pink, btw – the others are translucent and uncolored (helps remind me that it’s time to go get a new script – we have to jump through those hoops monthly and its common for ADDers to notice when they’re running low ONLY once they’re totally out, thanks to a kludgy sense of time – if we let ourselves run out, you would not BELIEVE how difficult it is, unmedicated, to jump through the hoops to get them back on board)”

“When I travel, I put my card in a zippered container WITH one or two pre-filled M-T-W meds containers (I think it was designed to hold purse-sized Kleenex™ in an old piece of luggage – it has velcro™ on the back . If I hadn’t run across the zipper dealie I use, I would probably stick both in an eyeglass holder (the fabric kind with an open top). Also helps me locate my meds easily when I’m traveling, since my usual systems are blown on the road.”

“BTW – this is *especially* important when traveling with meds by car or train, btw. – even across town. Some states even have laws requiring same, and the best advice is to assume that ALL states do when traveling across state lines. Check the laws in your state if you, like I, carry a small container of “back up meds” in your purse. You might be able to prevail in a court of law, should you be stopped, but who wants the hassle?! Better safe than sorry.”

“Neurotypicals” have no IDEA how many niggling little details we must remain aware of, systematize and be sure to track, huh?”

***The above suggestions and new ideas regarding Medications were quoted from comments to help others. This is from the resource addandsomuch.com where everyone deals with multiple issues everyday and everywhere.  Take some time to look over the site as it’s definitely an educational and enlightening experience.

Related articles

**********All material presented on Brain Injury Self Rehabilitation (BISR) is copyright and cannot be, copied, reproduced, or distributed in any way without the express, written consent of Edith E. Flickinger, BSN RN. 

 

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15 responses to “Simple tips traveling by air with TBI, aging, and other physical and mental challenges

  1. behindthemaskofabuse

    May 24, 2013 at 3:06 pm

    this is very interesting and helpful. i live with C-PTSD and get very overwhelmed with crowds, rushing,trying to find my way in airports, even being groped in security…wow i feel panic just typing this. i wonder if they would make accommodations for someone like me?

     
    • brain injury self rehabilitation (BISR)

      May 25, 2013 at 9:57 pm

      C-PTSD is also challenges/disabilities in their own right. When anyone needs special assistance, they qualify. I highly recommend boarding first so you are not rushed to create anxiety. You don’t have to identify what your problem is. Just take care of yourself. Keep the anxiety level down, by taking care of yourself first. You don’t need a wheelchair or walker or cane … they will call your connecting flight so you don’t need to rush or they will get you there if you need to avoid the hustle, crowds, and others. People are rude when others are slow. I’m another slow one, like many of us … and we look fine! That’s what makes it hard. I just don’t listen to rude comments when I board with assistance, but I haven’t traveled by air for quite awhile. Take care and stay safe.

       
      • behindthemaskofabuse

        May 25, 2013 at 11:10 pm

        this is great to learn, i think my biggest anxiety if i’m flying on my own is finding my way around the airport and finding connecting flights. i hate the groping at security too, but i know that can’t be avoided, even sitting so close to others on the plane is hard but i know that can’t be avoided either. it nice to know i would have the option of help and not being rushed!
        have you actually heard nasty comments when you preboard? if so that’s really sad! you’re right just because you can’t see a physical issue doesn’t mean there’s not an issue! xo

         
      • brain injury self rehabilitation (BISR)

        June 11, 2013 at 10:19 pm

        I highly recommend to avoid the anxieties for those with PTSD and other brain dysfunctions of all sorts to do the pre boarding and get the help you need. People can be nasty, but if you hold them up they are not nice either. Do what is best for yourself. If it avoids other problems, that’s the route you need to take. It’s all about taking care of yourself because if you don’t (other then hubby) no one will. Take care and stay safe.

         
      • behindthemaskofabuse

        June 11, 2013 at 10:27 pm

        Very true, I’m realizing I need to learn what taking care of myself means. Ugh so much to learn so little time..lol

         
  2. Madelyn Griffith-Haynie, MCC, SCAC

    May 26, 2013 at 3:05 am

    GREAT article, Edie. Another thing to mention is meds concerns. We all know to keep meds with us and not in our checked baggage, but if your meds are controlled substances BE SURE to include prescription documentation – WITH your medication, ideally. It’s a good idea for all meds, actually, especially if you will be traveling for a long enough time that you need to take enough with you that it might arouse suspicion.

    EVEN if you make sure to keep your doctor’s name and number at the ready (DO this, btw), if you end up being someone whose carry-on luggage is searched, it may not be possible to reach your doctor before you miss your flight. I know someone who missed the first day of a conference due to same.

    The advise is to carry medication IN the bottle it was packaged in by the pharmacy – label with your name on it right on the container. I have always used another method, since I don’t want to carry more medication than I will need for the trip, and need those M-T-W etc. medication containers to track whether or not I’ve taken today’s meds.

    On returning from the pharmacy (while it’s still “fresh”) I carefully peel the label off the bottle and affix it to an index card I place in my wallet – then I parse my medication into a month’s worth of M-T-W reminders. #4 is hot pink, btw – the others are translucent and uncolored (helps remind me that it’s time to go get a new script – we have to jump through those hoops monthly and its common for ADDers to notice when they’re running low ONLY once they’re totally out, thanks to a kludgy sense of time – if we let ourselves run out, you would not BELIEVE how difficult it is, unmedicated, to jump through the hoops to get them back on board)

    When I travel, I put my card in a zippered container WITH one or two pre-filled M-T-W meds containers (I think it was designed to hold purse-sized Kleenex™ in an old piece of luggage – it has velcro™ on the back . If I hadn’t run across the zipper dealie I use, I would probably stick both in an eyeglass holder (the fabric kind with an open top). Also helps me locate my meds easily when I’m traveling, since my usual systems are blown on the road.

    BTW – this is *especially* important when traveling with meds by car or train, btw. – even across town. Some states even have laws requiring same, and the best advice is to assume that ALL states do when traveling across state lines. Check the laws in your state if you, like I, carry a small container of “back up meds” in your purse. You might be able to prevail in a court of law, should you be stopped, but who wants the hassle?! Better safe than sorry.

    “Neurotypicals” have no IDEA how many niggling little details we must remain aware of, systematize and be sure to track, huh?

    xx,
    mgh

     
    • brain injury self rehabilitation (BISR)

      June 12, 2013 at 5:35 pm

      Madelyn,

      I also copied this medication information at the bottom of my page on Air Travel as I’m thinking it will be very helpful to many. I’ve also added a quick note to refer others to your website. Thank you and I appreciate any input. I’m resting in a surgical waiting room (my least favorite place in the world!) as my friend is being transferred to ICU. It’s all about advocacy but I just can’t be here as much as I like. Prayer will get her through. Blessings, Edie

       
      • Madelyn Griffith-Haynie, MCC, SCAC

        June 12, 2013 at 5:36 pm

        My prayers are with you BOTH.

        Thanks, btw, for taking time to do the above, and to let me know about it — over and above!
        xx,
        mgh

         
  3. Madelyn Griffith-Haynie, MCC, SCAC

    May 26, 2013 at 3:14 am

    Another tip for the EFD crowd (executive functioning dysregulations).

    Don’t try to wrangle with those blinking/moving “locate your gate and arrival/departure time” boards. Go to the counter, tell them you’re dyslexic and have trouble reading the signs and ASK them to direct you where you need to go (any gate – doesn’t have to be your carrier – which you may need help locating in the visual overwhelm of a busy airport).

    Even workers at crazy/busy times have been more than gracious about helping me with my “dyslexia” – and saying “I have [fill in your disorder here] and need help” doesn’t always garner the same cooperation. Many too many hear that as an “excuse” rather than a bona-fide problem.

    xx,
    mgh

     
  4. brokenbrilliant

    May 26, 2013 at 10:05 am

    Good points. When I travel, I rehearse everything in my head a hundred times before I leave for the airport, and I have a very detailed list of everything I need and what I need to do, and when I need to do it. I start using my list three weeks before I go, and I keep track of my status with the different items. It is easy for me to lose track of things if I don’t write them down, and I have forgotten to do important things that either delayed or jeopardized my trips… because I didn’t use my list. Especially with international travel, I am really OCD about things, but the more neurotic I am, the better the result. Compulsiveness has its place with me.

    I have not had much luck with accommodations from airlines. The food requirements I tell them are never honored. Oh, well. I can usually eat something they give me. As for seating, I tend to just wing it, then use my eye mask and noise-cancelling earphones to block out the world. I never sit on the inner seats if I can help it. Aisle seats are best for me, because I can (usually) get up and move around. One trip, I was so sensitive and overwhelmed, I wore a “flu mask” to keep people from talking to me. It worked! Everyone kept their distance, and I had a very quiet and peaceful 7-hour flight. Unfortunately, it also worked on the flight attendants, who pretty much ran from me. Not the best service, I have to say 😉

    Travel can be great fun — and in my case, the more carefully I plan it and stick with my plan, the better it turns out. It can be really exhausting, so the less I have to think about, the better.

    Happy — and safe — travels, all.

     
    • brain injury self rehabilitation (BISR)

      August 30, 2013 at 5:17 am

      I love the idea of a “flu mask”! Eye mask and noise cancelling earphones are also great ideas. I think these ideas could be helpful most anywhere when we need to decrease stimuli! Thanks for these tips.

      I haven’t personally traveled via airlines recently but it certainly is an idea. I use to put a blanket over my face until I saw someone blow their nose into a blanket and I have never taken one again!

       

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