Disembarked?

[sprinkles]

Okay bear with me, lol.  I had to pick a tag that would get views.  Hoping this doesn’t get moved to the medical section.  Here we go, has anyone ever personally seen OR have actual knowledge of the following scenario (just picture the scene).    This is actually a serious question for me, as I’m sure others have had to face (traveling with family), ok I’ll even settle for rumors.

Elderly patient (undiagnosed dementia coupled with fear of flying - like has refused to step on a plane for over 30 years) goes on a cruise round trip US.  Has a medical emergency and is air evacuated.  Now imagine an absolutely insane person loosing their mind.  Will/can the ships doctor tranquilize (which is exactly what it would take) the patient?  Then on the other end, hopefully that person can get tranquilized again to board a plane to get home from Hawaii.  See where I’m going with this?   
 

Thank you

 

 

[Gsel]

Your question is a hard one! After flying and cruising with DH with Alzheimer's and dementia I would not allow that person to get on a plane or ship if I could. It is not only dangerous for the person but the fellow travelers. Probably not the answer you wanted, sorry for your problem, but there comes a time when all of us should not travel.

[CruiserBruce]

From a medical point of view, the first issue is the degree of "tranquilized". Are we talking a mild drug like valium, or "knock them out cold".

 

The person might need to be seriously tranquilized to be removed from the ship, in order to protect the patient and the rest of the people on board. However I don't see a serious tranquilizer to fly home, unless you are talking a private plane medical transport.

 

Why are we even proposing that putting this person on a ship or plane is even remotely a good idea? 

[Gsel]

Exactly!

[SJSULIBRARIAN]

Have not seen or heard what you propose. I agree with others, a person such as you describe should not cruise or fly.  I suspect a person in such a condition would be put off a ship somewhere and the family would have to figure out how to get the person home. Not a situation I care to handle.

[FOPMan]

Airlifts from ships are not usual occurrences and are used primarily when there has been significant trauma. In those situations, the patient is likely to be at least somewhat sedated.

 

Airlifts are generally to the closest ground facility that can provide care to the patient. Once ashore, the patient is placed in the care of the hospital. Medical repatriation may occur based on the individual patient’s condition, medical needs, and the capabilities of the local facilities. The patient is made as comfortable as possible for travel.

 

There are some medical risks associated with sedation at altitude and respiration.

[sprinkles]

Okay, I was hoping that my time on this board would offer me some grace for being bold enough to ask what I KNOW for fact, others have had to ask themselves.  I know this for fact, because hubby and I spend a substantial amount of time hanging out in the (gasp, lol) smoking section.  So we tend to get to know others in that section very well.  So I have been seeing more and more passengers in (that condition).  Sometimes family members will let us know, sometimes we just figure it out).

 

That being said, it only makes sense that we will see more and more of this (like my own two sets of parents, who began cruising in the 70’s.  I started cruising in the 90’s.

 

So trying to keep this honest and sincere.  I had a second scenario.  Take out the dementia.  Let’s just say EXTREME fear of flying (yes total knockout, Valium didn’t work 30 years ago for her).  I have cruised Hawaii many times and have talked with MANY cruisers who do that cruise because they would not fly.  I do know there was a ship that disembarked all its passengers in Hawaii after coming in with mechanical trouble.  
 

So back to my parents, it has been 9 years since my Dad has been anywhere.  My fathers dream has been to go to Tahiti.  I’m leaving in two weeks, then going again in February.   My Dad knows this may be his only chance to go, with my husband and I.  Where we could help watch out for her.  My Dad could go off ship with my husband and I can stay on the ship with her.  Also I did not say she acts insane!  The irrational insanity would be if someone tried to put her in a basket to be airlifted.

 

I have so much more to say as I expected that I would have to explain more and more.  I guess I’ll see where the questions keep going.  Probably a few more have popped up while I typed this.

[DE Solo]

Asking a stupid question, but .... assuming the person unable to travel is your mother, and your father is able bodied with no medical problems, why not hire someone to stay at home with your mother, and take your father on the trip with you? That way you have no risk of encountering problems. 

[Mary229]

I repeat this often - talk to the personal physician.  That MD might prescribe a medication for the eventuality.  
 

if this is dementia - Also that MD should be allowed a weighty vote in whether the person is fit to travel.  I have seen some terrible situations onboard where a person would very distressed just being out of their routine and overstimulated by all of the cruise ship “buzz”. It can be too much for some people.  The physician will be able to guide you.

 

If it is not dementia still seek medical advice for a calming prescription.  

[sprinkles]

FopMan- Thank You

 

DeSolo, not a stupid question (this will also address Mary’s statement).

 

Unfortunately, I have had too much experience with dementia in my life.  This is all about my Step-Mother, who lost her Mother to dementia.  So my Step-Mom will only talk about her physical ailments.  My Father went to their doctor and referenced his suspicions.  The doctor ordered a brain MRI, but step-mom refused, saying I’m not crazy (she has feared this diagnosis her adult life).  You cannot make anybody do anything.  So no, no official diagnosis and from my experience (my former profession and personal associations) you cannot make anyone do anything unless they are a danger to themself or others.

 

So, I am talking about someone who would be clean, well dressed and well behaved in public (other than repeating herself or possibly getting lost on the ship if left alone).  Much like many of the cruisers I referenced in an earlier post.  Someone that you would have to spend substantial time with before “figuring it out”.

 

DeSolo, believe me, we are looking into it (short answer).  It may be the only chance my Dad has to take his dream trip.  
 

okay, now back to my initial question.

 

 

[BermudaBound2014]

Hi, 

 

First, my sympathies for what you are going thru. This is a difficult road. I have also dealt with dementia and wish this on no one. 

 

My arm chair addition is that I believe that @DE Solohas provided the best course of action. Being a caregiver (your dad) is never easy and giving him a break is probably a wonderful idea.

 

I hired caregivers for my mom. The trick was to have her become familiar with the caregiver before leaving her alone with the caregiver. It's also key to screen the caregiver and make sure you have a back up person also. There are companies that will help (albeit costly), but they have back up people and more resources.  Knowing how my mother was, I feel like a cruise would have been way too much stimulation (she was fine with flying) and being out of her element caused lots of anxiety the deeper into the disease she got. 

 

Of course, as @Mary229 stated, none of us can give advice other than your personal Dr. 

 

I applaud you for wanting to make your fathers dream vacation a reality. 

 

Best to you and your family,

[cbr663]

I have never verified this information with an airline and I suggest that you reach out to an airline for confirmation.  As someone who suffers from motion sickness and needs to take drugs to fly and also sail on ships, it has always been my understanding that you are never to take anything when flying that will knock you out entirely.  In the case of an emergency the flight crew have to have the ability to awaken you.

 

 

[PROCRUISE]

2 hours ago, Mary229 said:

I repeat this often - talk to the personal physician.  That MD might prescribe a medication for the eventuality.  
 

if this is dementia - Also that MD should be allowed a weighty vote in whether the person is fit to travel.  I have seen some terrible situations onboard where a person would very distressed just being out of their routine and overstimulated by all of the cruise ship “buzz”. It can be too much for some people.  The physician will be able to guide you.

 

If it is not dementia still seek medical advice for a calming prescription.  

As a retired ER nurse, this is probably the best advice I've read here. I am assuming that her private care physician knows the patients history and circumstances and would be in the best position to advise and possibly write a Rx for medications that might help. I think it would ease your mind also to have the physician lay out a plan of action if a problem arose during the cruise. Wishing you the best.

[Host Kat]

 

4 hours ago, sprinkles said:

Okay bear with me, lol.  I had to pick a tag that would get views.  Hoping this doesn’t get moved to the medical section.  Here we go, has anyone ever personally seen OR have actual knowledge of the following scenario (just picture the scene).    This is actually a serious question for me, as I’m sure others have had to face (traveling with family), ok I’ll even settle for rumors.

Elderly patient (undiagnosed dementia coupled with fear of flying - like has refused to step on a plane for over 30 years) goes on a cruise round trip US.  Has a medical emergency and is air evacuated.  Now imagine an absolutely insane person loosing their mind.  Will/can the ships doctor tranquilize (which is exactly what it would take) the patient?  Then on the other end, hopefully that person can get tranquilized again to board a plane to get home from Hawaii.  See where I’m going with this?   
 

Thank you

 

Hello @sprinkles

 

Thank you for your new thread. However, it was off topic where posted. So that other cruisers with ability differences of all types can see your question and possibly help with replies, your thread has been moved to the Special Interest Cruising - Disabled Cruise Travel forum where it will be on topic. 

 

I sincerely hope this will be helpful and glad to have you aboard Cruise Critic! 

 

Happy sails,

 

Host Kat

[sprinkles]

2 hours ago, BermudaBound2014 said:

Hi, 

 

First, my sympathies for what you are going thru. This is a difficult road. I have also dealt with dementia and wish this on no one. 

 

My arm chair addition is that I believe that @DE Solohas provided the best course of action. Being a caregiver (your dad) is never easy and giving him a break is probably a wonderful idea.

 

I hired caregivers for my mom. The trick was to have her become familiar with the caregiver before leaving her alone with the caregiver. It's also key to screen the caregiver and make sure you have a back up person also. There are companies that will help (albeit costly), but they have back up people and more resources.  Knowing how my mother was, I feel like a cruise would have been way too much stimulation (she was fine with flying) and being out of her element caused lots of anxiety the deeper into the disease she got. 

 

Of course, as @Mary229 stated, none of us can give advice other than your personal Dr. 

 

I applaud you for wanting to make your fathers dream vacation a reality. 

 

Best to you and your family,

Thank you for your kind response.  I wonder if you would have seen my post where it has now been moved to?

[sprinkles]

1 hour ago, cbr663 said:

I have never verified this information with an airline and I suggest that you reach out to an airline for confirmation.  As someone who suffers from motion sickness and needs to take drugs to fly and also sail on ships, it has always been my understanding that you are never to take anything when flying that will knock you out entirely.  In the case of an emergency the flight crew have to have the ability to awaken you.

 

 

Thank you for your kind response.

[sprinkles]

1 hour ago, PROCRUISE said:

As a retired ER nurse, this is probably the best advice I've read here. I am assuming that her private care physician knows the patients history and circumstances and would be in the best position to advise and possibly write a Rx for medications that might help. I think it would ease your mind also to have the physician lay out a plan of action if a problem arose during the cruise. Wishing you the best.

Thank you for your kind response.

[sprinkles]

Well okay, let’s see if I get any answers to my original question here.  By the way, I myself have been traveling with MS for years.  Please I am not looking for advice re dementia.  Although very kind, I really am well versed on the subject.  My fathers choices are very limited, they have been married for 46 years.  I really am looking for answers to my original question.  
 

Although this may be a place where this starts a better conversation.  As I really have been seeing more and more people on the ships with this “issue”.

 

Happy Sailing Everyone.

[chengkp75]

I'll just chime in on the air evacuation from the ship.  The decision to do one is not made by the ship's doctor alone.  The ship's Captain, the helicopter flight crew, and the government agency's flight surgeon will all have a say in whether or not an air evacuation is warranted, and whether it happens.  If the flight surgeon or flight crew know that the patient could become violent during either the basket lift, or the flight in a crowded helicopter, my suspicion is that an air evacuation would be ruled out.  The first thing the government agency looks at is a risk/reward calculation as to whether the patient is better off for an extended period in the well stocked medical center onboard, or whether the risk of an airlift and flight in a helicopter with limited resources to the patient is outweighed by the shorter time to get the patient to the hospital.  Part of that calculation is risk to the flight crew, and a potentially violent patient just ups that risk.  I doubt that either the ship's doctor, nor the flight surgeon would recommend tranquilizing a patient to unconsciousness for an airlift, as just so much could go wrong in that scenario.

[happy42cruise]

I'll add my 2 cents, I really doubt that flying would be a good idea if she has refused to fly for 30 years.  You aren't going to be able to fool her about going on the plane.  Is there anyone that she would be comfortable staying with or have staying with her (family member, friend or possibly your husband)?  Can you discuss this with her at all?  Your Dad might also refuse to go if he worries about leaving her.  Is this a cross-country flight or a flight to Tahiti?  You don't need to answer that but if it is to Tahiti she would probably have a total breakdown & nobody would want that.  If this is the 32 day RT Los Angeles could you drive or take a train down?  Good luck, talk to your Dad & if possible your step mom then make a plan.  I hope it works out for all of you!

[chengkp75]

OP, on one hand, you are talking about Hawaii (RT from West Coast?), and on the other, you are talking about taking your father to Tahiti (is this also RT from West Coast?).  Which is the plan, because these are two very different scenarios.  What medical emergency are you contemplating your mother having?  Because, it is 2700 miles from Hawaii to Tahiti, and once outside of about 400-600 miles from Hawaii (a day to a day and a half), there would be no air evacuation until Tahiti, and maybe not even then.

[sprinkles]

5 hours ago, chengkp75 said:

I'll just chime in on the air evacuation from the ship.  The decision to do one is not made by the ship's doctor alone.  The ship's Captain, the helicopter flight crew, and the government agency's flight surgeon will all have a say in whether or not an air evacuation is warranted, and whether it happens.  If the flight surgeon or flight crew know that the patient could become violent during either the basket lift, or the flight in a crowded helicopter, my suspicion is that an air evacuation would be ruled out.  The first thing the government agency looks at is a risk/reward calculation as to whether the patient is better off for an extended period in the well stocked medical center onboard, or whether the risk of an airlift and flight in a helicopter with limited resources to the patient is outweighed by the shorter time to get the patient to the hospital.  Part of that calculation is risk to the flight crew, and a potentially violent patient just ups that risk.  I doubt that either the ship's doctor, nor the flight surgeon would recommend tranquilizing a patient to unconsciousness for an airlift, as just so much could go wrong in that scenario.

Thank You for the best response to my original post yet.  

[sprinkles]

Okay, since there seems to be interest in this, I’ll expound.

 

I really do not want to get too specific for privacy issues.  So maybe keep this as a hypothetical question (as this thread is no longer on a specific lines forum) Yes, I am specifically talking about round trip from US.  A cruise that leaves the west coast, heads to Hawaii then continues to multiple ports and returns to the US.  Not as long as the 51 day, Tales of the South Pacific that I am leaving on in two weeks.  I have every intention of asking this question and having this discussion with staff on board.  But yes, a ship that gets as far as Tahiti (do I really need to list the exact ship and every port to discuss this)?  
 

Also, like I talked about above.  Take the dementia out of it, I was also asking about people with severe fears of flying.  But for my family, no one is talking about trying to make her go on a plane.  Their last cruise was 9 years ago, a round trip Hawaii (I had these concerns 9 years ago).  She made it without incident.  They have literally been no where, not left their city in 9 years. 

 

What type of “medical emergency” specifically for her?  
Heart Attack.  By the way, as of late last night, my Dad may have found someone to stay with her and is talking about hopefully going without her (the obvious best solution, however she goes back and forth about wanting to go).  
 

Also, like I stated above, I have had more and more personal experiences meeting cruisemates with obvious dementia (I personally have a friend who travels with their spouse with dementia) and believe I will be seeing more and more as the OG cruisers from the 70’s continue to age.

 

Okay, now that this is in this section (still looking for first hand knowledge) let’s switch the scenario.  Let’s just talk about extreme fear of flying.  Let’s take the air lift out of the scenario.  The patient has been stabilized in the ships infirmary and is forcibly disembarked at the next port of call…….okay lol, this could go on forever,,,,,I definitely will have some fun discussing this stuff with crew (might cost me a couple of bottles of wine 🤣).

 

Doesn’t anyone see where I’m going with this?  Think mental health, what if the patient is a 25 year old with no known medical issues?  My point is, this is not about “they shouldn’t get on a ship”.  The bottom line is “they” do.  
 

Happy Sailing Everyone

 

 

 

 

 

 

 

[chengkp75]

Okay, let's take your young person with no known medical condition that is medically disembarked in a foreign country, who has an extreme fear of flying.

 

You would have two choices:

1.  The person continues to receive medical care in the foreign country until they could book another cruise to return to the US

2.  A medical charter flight, with doctor and nurses, might accept a patient who needs to be unconscious to fly, but again, depending on the length of the flight, this may not be feasible.

[sprinkles]

9 hours ago, chengkp75 said:

Okay, let's take your young person with no known medical condition that is medically disembarked in a foreign country, who has an extreme fear of flying.

 

You would have two choices:

1.  The person continues to receive medical care in the foreign country until they could book another cruise to return to the US

2.  A medical charter flight, with doctor and nurses, might accept a patient who needs to be unconscious to fly, but again, depending on the length of the flight, this may not be feasible.

Thank you, Happy Sailing