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Before Booking Flights


Air travel regulations regarding assistance to air travelers with hidden disabilities differ from country to country.  You must determine which regulations apply to your circumstances.  The details in this section apply to U.S. air travel regulations.
(** indicates a policy/program that has been changed or removed by the Trump administration)

Preparations before booking a trip:

1. Consider the needs and behaviors of your person living with dementia
  • A passenger is required to travel with a safety assistant (PCA, travel companion physically able to assist with these functions) when: 
    • ​The passenger is unable to understand or respond to safety instructions.
    • The passenger has both hearing and vision disabilities that prevent communication with airline crew during safety briefings. 
    • The passenger has mobility limitations that would prevent them from evacuating independently in an emergency. 
  • A passenger who requires supervision, assistance inside the lavatory, administration of medications or feeding during flight, will need to travel with an assistant. 
  • ​In the airports, airlines (i.e. the airline’s wheelchair contractor) do not provide custodial care or a personal escort to remain with someone. They will not escort anyone to meet a specific party or check that party's identification. If a passenger requires personal or continuous assistance, they should travel with a ticketed caregiver or personal care attendant.  
  • Airlines do not provide inflight assistance with actual eating or drinking.
  • ​Airlines do not provide inflight assistance with medication.
  • Airlines do not provide inflight assistance within the lavatory or with elimination functions at a customer seat.
  • ​If they are traveling alone, can they contend with the problems that may occur?
See: FAQs: Should I travel alone, if I have dementia or cognitive impairment? (link)
  • If you or someone else in your family is the travel companion, can you/they contend with problems that may occur?  
  • Should you have an additional travel companion (PCA, professional travel companion, family member, etc. accompany you on this trip?)
  • ​Do you or the person living with dementia require assistance in the terminal from a non-ticketed companion? If so, determine the airline and airport policies on issuing gate passes.  
See also: FAQs: About Gate Passes  (link)

2. Do any of the travelers in your party require a Medical Clearance to Fly?  

3. Are any of the travelers in your party required to provide advance notice as a condition of traveling on the airline or receiving services?

4. Inform yourself about accessibility resources in the airports:
Accessibility resources vary between airports and airlines, so it is important to align your needs with the available resources for your travel. Before booking flights, inform yourself about airport resources including  airport volunteer services available to assist travelers from arrival at the terminal to departure. Investigate airport(s) in departing/connecting/arrival cities.
  • Examine airport maps to locate family or single user restrooms w adult changing table/hoist, quiet areas, etc.
  • Does the airport offer personalized 1:1 assistance to travelers?
  • What Intra-airport transportation is available?
  • Does the airport participate in the Hidden Disabilities Sunflower Program?
  • Does the airport offer information sessions or rehearsal trips so the person living with dementia can be familiarized/desensitized to airport/airplane experience?

5. Inform yourself about accessibility resources from the airlines 
Before booking flights, inform yourself about airline resources. Resources provided by any carrier may also vary depending on the type, age, and size (seat count) of the aircraft. If you are traveling on an itinerary involving a partner airline, remember that the partner airline may have different guidelines for requesting assistance and have different resources available.
U.S. airlines differ significantly in accommodations offered to passengers with disabilities. Scroll through this document to determine what your airline may offer.

Also, be aware that if your flight is delayed and you are ‘stranded’ at the airport, airline policies differ about what they will do for delayed passengers waiting at the airport. There are no federal requirements regarding these amenities or services. Before you book your flight, examine the Airline Cancellation and Delay Dashboard comparison chart and check the web sites of the larger carriers for their voluntary Customer Service Plans, which list the amenities that those airlines will provide to passengers. For additional information see: Plane Talk: Coping with Flight Delays | US Department of Transportation

6. Investigate travel companion services for hire
See Tools for Travel - 4. Travel Companion Services 

7. Investigate other dementia-related travel resources:  
See Resources for Travel  

Travel Well with Dementia: Essential Tips to Enjoy the Journey 
by Jan Dougherty

8. It is also worthwhile to explore whether enrollment in any of these airport security tools will facilitate your travel experiences.  9. Consider enrolling in MedicAlert and Alzheimer’s Association Safe Return or a comparable service before traveling. MedicAlert and Alzheimer’s Association Safe Return is a fee-based, nationwide, 24/7 emergency response service that facilitates the safe return of individuals living with Alzheimer’s disease or another dementia who wander or have a medical emergency. The Alzheimer’s Association, in collaboration with MedicAlert® Foundation, provides membership plans with 24/7 Wandering Support.

10. U.S. Passports
The U.S. State Department announced in June [2022] that it was taking steps towards adding a third gender marker for nonbinary, intersex, and gender-nonconforming people. **
​Updated 1/17/2026

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