How a Carefully Planned Family Trip Helped My Mom Connect With Fond Memories After Her Dementia Diagnosis
For Diana Ballon, accommodating for her mother's dementia on a special trip to New Brunswick meant choosing familiar places to visit, including their home base for the adventure, The Algonquin Hotel (seen above), where her mum worked in the summer of 1952. Photo: canadabrian/Alamy Stock Photo
I was a little worried when we arrived at the Algonquin Resort in Saint Andrews, N.B. last September, and my mum, Heather, didn’t seem to remember anything about the hotel where she worked 69 years ago.
“It’s like a foreign country,” she said the first evening as we roamed the elegant grounds. We saw the silhouettes of six deer grazing in front of us, while the red slate roof of the 233-room, Tudor Revival-style hotel loomed in the background.
This trip was important to me and hopefully to her. A year and a half before, in a different world, my siblings and I had to cancel a family trip to Portugal with my mum because of COVID-19. She was 86 then, and had recently been diagnosed with possible early stage vascular dementia. It was relatively stable, but she had a very limited short-term memory and some difficulty recalling the more distant past. And while mum has always been agile, a painful back meant too much walking could be uncomfortable and tiring.
The night before we left Toronto, I called one of my sisters, Daphne, in a panic. “I’m worried that this dream may be more my dream than hers. What if this trip is too stressful for her?”
Daphne calmed me down: It was all going to work out, because I had planned the itinerary so carefully. When I searched online for guidance on travelling with someone with dementia, I found lists of tips, but no real stories about what that looks like. So, as a writer who specializes in both travel and mental health, I decided to write the narrative myself.
I had to consider how memory issues and related feelings of disorientation and anxiety could be compounded by unfamiliar surroundings. I decided to invite my husband and 16-year-old son for support. It would be fun, and we could split up if some of us wanted to do different things at different times. We arranged for a suite with a connecting door, so mum would be close, but have her own space and bathroom. The night before, I helped her lay out the things she needed to pack, and brought home anything that could derail the trip if forgotten: her pills, ID, vaccination record and new, portable wheelchair.
We scheduled main activities and tours in the morning, when she is most alert, with time for a rest in the afternoon. One added complication: I had suffered a tibial plateau fracture of my knee a few weeks before the trip and had just gotten off crutches, so my knee instability was stressing me out. But mum, as always, was reassuring. In an email before the trip, she wrote:
“Darling, you can cope with anything when you are determined! I am glad that the diagnosis has given you a path to follow, and since you are always 10 steps ahead of me anyway, it means that maybe I can keep up with you now! And now when I am tired, I can just say I am giving you a rest. I am confident we will have a ball!
Love you, and hug you (carefully).
– Old Mum”
The day of our flight, I booked mum an Uber to our house, and we took a cab to the Toronto airport. Although it was a busy travel day — with a two-hour flight to Fredericton, and then almost two hours in a rental car to Saint Andrews — mum took everything in stride. She seemed okay wearing her mask, although it was undoubtedly the longest period she would wear one. She took umbrage with the wheelchair, because she’s used to walking (and, in the end, rarely used it on the trip).
We didn’t get to the resort until evening. The original Algonquin Hotel was built in 1899, and although it has gone through significant renovations since mum worked there in the summer of 1952, the character of this “castle by the sea” has been preserved. It sits on a hill overlooking the Passamaquoddy Bay, an inlet of the Bay of Fundy, in the historic seaside town. Once upon a time, guests in long dresses and waistcoats arrived by train from Boston, Montreal and Toronto.
Mum remembered little of the hotel’s interior, but that’s because she wasn’t sure if she ever walked through the front doors. “I was such a minor staff member,” she said. “I served the senior staff in a staff dining room behind the main hotel.” She seemed to remember the tunnel under the hotel we saw on the “ghost tour,” which staff had used to get to and from work, out of sight of guests.
An old black-and-white picture in a dog-eared photo album shows the five other members of Room 6, a dorm in the residence behind the hotel, where mum stayed the summer after her first year at the University of Toronto. Mum, then 19, is behind the camera, and her co-workers are wearing their uniforms with white aprons, pointy collars and caps.
As we walked the grounds, she surprised me with a new story about dating the night auditor. “He wouldn’t get off work until about 10:30 p.m. God, he was dull. But I guess I wasn’t so exciting either. He was someone to go out with.
“The glamorous ones were the bellhops, but there weren’t enough of them to go around. They were the attractive ones, the top brass of the staff, and got huge tips.”
We drove to Katy’s Cove, the Saint Andrews’ beach where mum used to go to bonfires, and the Algonquin Golf Course where she used to play, but they didn’t look familiar. However, she did remember some details, like which golf clubs she had in her bag. “You must have had a driver?” my husband asked. “No, a three wood, dear,” she replied. “It was a short course. A five iron — I can hit anything with that — and a nine iron and a putter.”
Over four nights at the Algonquin, mum was as enthusiastic as any traveller. She shrugged off all but a couple of naps, saying she didn’t want to miss anything. When she did sleep, I left a note saying where we would be and when we would return, in case she woke up disoriented, but she was always freshly showered and dressed by the time we got back.
Admittedly, not everyone with dementia can or should be left alone, says Dr. Nathan Herrmann, a geriatric psychiatrist at Sunnybrook Health Sciences Centre in Toronto, since some people could become confused and leave the room if they felt panicky.
But having the opportunity to travel, and to visit places where the person has had positive experiences — of childhood, or growing up, for example — can evoke happy memories, since long-term memory can remain intact, even in moderate to severe phases of dementia. However, he cautioned that any changes to places or things may render some places unrecognizable.
For our trip, I chose activities I knew mum had enjoyed in the past, like being in nature and learning about history. Our first morning in Saint Andrews, we got a guided tour of Kingsbrae Garden, and mum sat in the front seat of the golf cart beside our guide. She marvelled at the Scents and Sensitivity Garden, where the textures and smells of the plants are designed for the visually impaired, and enjoyed the tranquillity of the Peace Garden.
We visited Ministers Island, the 200-hectare (500-acre) summer home of Canadian Pacific Railway president William Van Horne, a name and a company mum remembered. This time, she rode next to our tour guide in the passenger seat of the ATV as we followed bumpy trails through the wildlife reserve, unfazed by the choppy drive. She asked questions and was very engaged during our tour of the buildings.
Midway through our time in New Brunswick, we drove 35 minutes to Blacks Harbour and boarded the one-and-a-half-hour ferry to Grand Manan Island. It is beautiful and rugged, with fishing villages reminiscent of Newfoundland’s outports. It’s also the childhood home of Mina, the helper hired by mum’s parents when they lived in Toronto during the Second World War.
As we relaxed with a glass of wine at the Compass Rose Heritage Inn, mum called her 92-year-old brother Dave, in Toronto, to reminisce. “We’re looking out over the bay, and at the lovely inlets,” she said, describing the view from our room. Her thoughts turned to her childhood in Toronto and the wartime years, when food was scarce. “I’m remembering Mina with her long [bladed] racing skates, and how she taught us to skate on our rink in the backyard. And remember her boyfriend, Bob the Butcher? He had a lot of good meat that we couldn’t have gotten otherwise.”
“He couldn’t keep step, so he ended up a butcher,” Uncle Dave added, recalling Bob marching in the militia at the armoury in Toronto.
I am still learning about dementia, in all its forms and stages. Mum can’t recall the meal she just ate or what she did yesterday, but she knows the history of the CP Railway. She remembers the cuts of meat Bob the Butcher supplied to the family. When I hurt my knee, she is uncannily present and concerned about my struggles. And she is always up for a good laugh.
For many of us, COVID-19 flattened our experiences and limited our options. In some way, I think dementia does the same. With isolation and lack of stimulation, minds can become dulled and turn in on themselves. But travel opens us all to new worlds and experiences. My mum always loved to travel, but after having five children in five years (and with a husband who lacked her curiosity), she didn’t have the opportunity.
We have been back in Toronto for eight months and I can truly say we had a ball. As a travel writer, so many of my memories are tied to a sense of place. For my mum, who turns 89 in July, some of these tethers may slip. But while the details may be lost, mum remembers the trip and, of course, the strong mother-daughter bond, and our love will always remain.
Tips for Travel With People With Dementia
It is impossible to predict how people with dementia will handle travel, says geriatric psychiatrist Nathan Herrmann. Each type of dementia has mild, moderate and severe stages, which can vary from one individual to the next, as can their behaviour. With so many variables, travel can be anything from “fantastic to stimulating to agitating and distressing.”
People who have milder dementia without a lot of neuropsychiatric difficulties such as anxiety or depression are likely to have the easiest time. And it is key to plan a holiday that achieves a balance between stimulating and overstimulating. Here, some of his expert advice:
> Plan ahead, and don’t be overly ambitious. Consider a short bus trip, or a trip with a one- or two-hour flight to a destination with a minimal time difference, before trying an international holiday.
> A plane is an enclosed space with constant noise and movement. Think of ways to reduce stimulation; bring a sleep mask, noise-cancelling headphones, and favourite snacks and music. You may also want to bring calming medication that has worked for them in the past, but only after discussing it with their doctor.
> Consider travelling with one or two other family members or friends
to reduce pressure on the person with dementia to talk if they are tired
> Choose activities you know the person has enjoyed in the past. “People don’t lose appreciation for the beauty of nature, for children playing, for interacting with animals, even in later stages of the illness,” said Herrmann.
> Don’t leave the person with dementia alone. That means sleeping in the same hotel room or suite with them, and doing all activities together, unless you divide up your group and at least one person can be with them.
> Be sure to have medical coverage for emergencies.
A version this article appeared in the June/July 2022 issue with the headline ‘Travelling Back in Time’, p. 67.