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Flying with a Hidden Disability

Flying with an invisible disability

Read on for information about travelling with hidden disabilities, including what airlines and airports are doing, travel advice for common hidden disabilities and some FAQs.

Lufthansa aircraft

What is a Hidden Disability?

A hidden disability is a disability that is not immediately apparent to others. Also called invisible disabilities, the term covers not only neurological conditions, but also physical and mental conditions which aren’t immediately obvious to onlookers. Some common hidden disabilities are dementia, autism or IBD, which will be explored later in regards to air travel.

Invisible Disabilities when Travelling

Although having a hidden disability provides challenges in any aspect of life, travelling can often be even more difficult. Not only are there more challenges that come with unusual and new situations, but paired with the fact your needs may not be apparent to others as your disability is invisible to others can make airports and flying confusing and challenging environments.

Travel Guidance for Passengers with Hidden Disabilities

Even if you are not travelling to an airport in the UK or US, where there may not be procedures for passengers with hidden disabilities in place (such as those below from the UK CAA and US DOT) to accommodate for your needs, there are a few things you can do to help make air travel less of a challenge.

Inform People

When you are planning a flight, there are a number of people you should contact to inform them of your hidden disability with specific details of what special needs you may have. People to consider contacting is the booking agent (Us if you made the booking with us!), the airline you are flying with and the airport you are travelling to. In addition, it is worth reminding people when travelling to ensure they are aware, including people such as check-in staff, ground staff at the gate and cabin crew. If you need assistance whilst travelling, find out more on our Accompanied Travel and Flying page.

Allow Plenty of Time

Make sure you allow plenty of time when travelling. This is because for some passengers, it may take more time to get through the airport and complete airport requirements such as check-in or airport security. Although not all points are applicable to every traveller with hidden disabilities, you can also read our blog to see how to make your airport experience more seamless.

Be Prepared

Make sure you are prepared for different situations, whether that is by ensuring you have enough medication to last you for your travels, or to be prepared in the case of flight delays. Consider all possibilities, thinking of triggers for certain conditions, and prepare accordingly.

Make sure you do research

Research the airport, the airline to know what to expect and what they can provide to help you during your flying experience. It is helpful to be able to plan the trip more thoroughly.

Booking with Alternative Airlines?

If you have booked, or are thinking of booking with Alternative Airlines, you can contact us to let us know about your hidden disability, and what additional needs you may require. Alternatively, if you are completing the booking process, you can add this information to the ‘Additional Requests’ section on the booking reservation. We will pass this information onto the airline who will process any needs you may have.

Types of Hidden Disabilities and Travel Advice

Travelling with Autism and ASD

Autism, a hidden disability, is a mental disorder which can affect how people experience the world and also communication with others. Travelling can be challenging for people or children with autism, as it is a new and uncertain experience which involves changes to routine. Read our guide to flying with autism to get information and tips on air travel preparation.

Flying with IBD

If you suffer with Crohn's disease or ulcerative colitis, commonly collectively known as Inflammatory bowel disease (IBD), you can still use air travel with some additional considerations. Travelling with IBD poses some increased risks, such as a relapse in the condition resulting from a change in diet, gastro-intestinal infections contracted from travel, forgetting to take medication or unavailability of medication. Additionally, people with IBD may be at increased risk of getting an infectious disease due to having weaker immune systems.

Before booking your trip, it may be better to consider booking at a time when your IBD is stable. Although flare-ups can occur at any time, they are less likely to occur when it is stable, and can also reduce insurance costs. You should also be sure to obtain the relevant medical certificates, checking with the airline and airport that you have all the documents you need for travel.

On the day of travel, you should make sure you set reminders to take your medications on time and not to forget it. In addition, your doctor may be able to provide you with some antidiarrheal medication, so that you may not need to use the toilet during your flight. You should also make sure that you pack additional medication and supplies of what you may need, so you still have enough should you lose, misplace or run out. Make sure you also pack some hand sanitizer, to reduce your exposure to germs on the plane. However, make sure they fit within the liquid rule when taking it in your hand luggage.

As with the other hidden disabilities, you should contact the airport you are departing and arriving at, along with the airline you are travelling on to see what they can do to assist you in your travels. You can also ask the airline to have a meal that will be appropriate for you, with food that will not make you ill. Alternatively, if you’d prefer you can choose to pack your own food for your flight to ensure that you will be able to eat. Check our page here to see what food you are allowed to take with you on the plane. Passengers may also prefer to request a seat with the airline in an aisle seat near the toilet so that they can easily access it if they need to during the flight.

Flying with a Stoma Bag

Passengers who have a stoma from an Ileostomy, Colostomy or Urostomy are still able to travel despite their initial concerns. With a bit of planning and preparation, people with a stoma are still able to fly and travel.

When booking your flight, it may be a good idea to book yourself an aisle seat on the plane near the toilet, as it will give you peace of mind that you can access the toilet whenever you need to. If you feel uncomfortable and uneasy about flying with a stoma bag, you may find it useful to book short-haul flights, or ones with a stopover if you need to go a further distance.

Passengers will need to make sure they take plenty of supplies for their travels, especially if going on a long-haul flight. Bupa recommends people to take double supplies what they would normally use, including disposal bags, wipes and any other care items you usually use. It is a good idea to carry these items in both your hand luggage but also checked baggage, so that they are with you on the plane and in your suitcase when you land. Bupa also recommends that people change their stoma bag immediately before boarding to limit the amount of the air in the new stoma bag. You will not be allowed scissors in your hand luggage, so it is a good idea to cut all your baseplates before you travel so you are prepared.

You may find that going through security makes the scanner alarm go off. You will not have to show your pouch or remove any clothing, but you may be asked to rub you hand against the pouch over your clothes. You should show them your documents of your condition which explains it, and also tell them of any medical supplies you have on you.

During the flight, it is important that you stay hydrated when on the plane, but avoid fizzy drinks as that combined with changes in cabin pressure can result in wind. You should also take precautions for looking after your wider health, such as avoiding catching a stomach bug. You can read our page about wellness for flights here for tips on staying healthy on the plane. In addition, you may find that your stoma bag inflates due to cabin pressure changes. If it does, you can simply go to the toilet and let the air out of the bag.

Flying with ADHD

Attention deficit hyperactivity disorder (ADHD) is a medical condition which affects the brain’s development, affecting the person’s attention, ability to sit still and self-control. For children and adults with ADHD, air travel can be daunting with the thought of the confined space and having to sit still for a number of hours.

One common symptom of ADHD is having difficulty estimating timings of activities, such as packing your bags and getting to the airport. Do plenty of research and work out timings that these activities will take you with the help of a friend, if needed, so that you can arrive at the airport on time. You should also plan to get to the airport early, before other passengers will get there so that you can avoid the busy times and spend less time queuing. This also can be applied to making sure you get to the boarding gate on time, so that you don’t miss your flight!

Passengers should also take entertainment for the long waits at airports and also for the flight. This could include a laptop, iPad, books or magazines.

As with any hidden disability, passengers should ensure they do plenty of research and create a back-up plan for when things don’t go to plan. People with ADHD may struggle with changes to plans, as this may lead to extra stress for the travel experience. Creating this back-up plan will help passengers in this situation. Additionally, if travel plans do get changed and they are out of your control, you can talk to airport staff to see what they can do for you whilst you wait, as there may be a quieter space for you to wait, away from crowds of people.

Flying with Dementia

Dementia is a condition in which people experience memory loss and difficulties with thinking, problem-solving and language. For people with dementia, there may be extra considerations and planning that need to go into the booking and research process for travel.

For example, when choosing where to go, people with dementia may find it useful and comforting to visit a place they have previously been to, especially if it is somewhere they were familiar with before the onset of dementia. Similarly, it may be worth avoiding connecting flights, or at least avoiding connecting flights with a short layover where you may be rushed.

Another tip for travelling with someone with dementia is to write a very detailed itinerary of your travel experience, including what time you will need to leave for the airport, what time you will arrive at the airport and what time you should be checked-in by etc.

Additionally, you should contact the airline and airport before you travel, as they can help in many ways (detailed above for general hidden disabilities). They may be able to help you through the airport, such as making sure you get to the right place on time or assisting you through the security process.

Flying when Deaf or Hearing Impaired

Although airports are generally good with visual aids for things such as security, check-in and toilet signs, flying when deaf or hearing impaired can prove challenging. There are many aspects of travel that are not accessible to people with hearing difficulty - imagine raising suspicion when you don’t stop at security because you didn’t hear the alarm go off, or panicking when you don’t understand the announcement of the captain mid-flight. However, there are some tips you can follow to help ease these complications and have an enjoyable airport and flight experience.

As with all hidden disabilities, you should always contact the airport and airline you are using as soon as possible, giving at least 48 hours notice. You should be able to get a lanyard or something similar, as described above to help staff identify your additional needs when travelling.

On the day of travel, you should inform staff about your being deaf if they do not notice from your lanyard or other identifier. This is especially important at checkpoints such as check-in, security, ground staff at the boarding gate, and also especially the cabin crew. This will help people communicate with you, making sure that you understand and announcements and procedures that may take place. Depending on the airline you are travelling with, you may be allowed to board before other passengers where you will have your own personal safety briefing. In some airports, there may be hearing loops provided. You should ask staff before travel to see whether this can be available to you.

Another good tip is to download the app of the airline you are travelling with. This is because gate announcements are sometimes made vocally, meaning that they may be missed if you are not constantly checking the screen. The British Airways app is recognised as being particularly good, giving passengers a notification when their gate has been announced.

Flying when Blind or Visually Impaired

Passengers who are blind or visually impaired can still use air travel, even if it is with a bit off assistance. The airline and airport should always be contacted well in advance, usually giving 48 hours notice before you are due to travel. They may be able to meet you when arriving at the airport, and guide you through the airport, helping you through steps such as check-in, security and boarding. Alternatively, airports such as Gatwick have begun trialling the AIRA app, which aids visually impaired and blind passengers independently through the airport using their smartphone.

Many airports are now ‘silent’, meaning that there will not be audible announcements for things such as boarding commencing, or gate closing. Therefore, if you have arranged airport assistance, the assistant will help communicate this to you and get you where you need to be.

At security, if your bag gets search you should always request that your bag is repacked in your specific order so that you can locate any essential items you may need to.

If you are travelling with a special assistance dog, you may wish to seek further advice about which option is the best for you, however further information on travelling with special service pets can be found here.

UK CAA Airport Guidance on Hidden Disabilities

In 2016, the UK’s CAA (Civil Aviation Authority) published information and guidance on setting industry standards for airports providing assistance to people with hidden disabilities. This forced many airports in the UK to change their standards by 2017 to be able to provide a consistent and high-quality service to all disabled people, including those with hidden disabilities, which also resulted in other European airports following and improving their services too. To improve the service and overall experience, UK airports have implemented the following:

Receiving information about specific needs

The CAA notably made it obligatory for UK airports to have systems which transfers information from airlines about specific passenger needs to ensure their needs are met at the airport and assistance is provided when needed.

Staff Training

Making sure customer service, security and assistance staff are fully trained on awareness and assisting people with both visible and non-visible disabilities. Training focused on better-informing passengers on what to expect during the security search process

Website Information

Adding information on the assistance available in airports, making sure that it is accessible to all. For example, this includes visual guides and videos to demonstrate the assistance available.

Signage and Accessible Routes

Airports were advised to provide quieter routes and quieter waiting spaces for passengers to avoid the busy and congested routes with lots of people. These are particularly useful for passengers with sensory issues, as the busy spaces with loud noises, glaring lights and shiny floors can cause difficulties. Airports are also not allowed to separate passengers with disabilities from their accompanying person at any part of the airport, unless both parties have approved.

Lanyards or wristbands

Lanyards, wristbands or other discrete identifiers are now optionally worn universally by people who may not need airport assistance for their whole stay, but may wish to easily identify themselves to staff to get extra help or assistance, especially at stressful or difficult parts of the passenger journey such as security search and boarding.

UK CAA Airline Guidance on Hidden Disabilities

In 2018, the UK’s CAA provided guidance for airlines to follow similar advice as was given to airports, as detailed above. Guidelines put in place included making sure airlines have in place a clear and accessible pre-notification system which allows passengers to request special assistance when booking. It also means airlines have to share this information about any assistance needs with their own company, the airport, and with ground handling agents. Airlines should also make sure that passengers with hidden disabilities are sat next to their travelling companion at no additional cost to them, and that these passengers are looked after in the event of any delays or cancellations to your flight. Finally, the CAA recommends airlines invest in significant training of staff for hidden disability awareness and assistance.

USA Dot and Hidden Disabilities

The United States’ Department of Transportation have advised that airlines must be accommodating to the needs of passengers with both visible and invisible disabilities. The US Air Carrier Access Act has made it illegal for airlines to discriminate against passengers because of their disability. This act applies to all flights to or from or within the United States. In addition, airlines must ensure that they provide assistance to those who need it, including mobility assistance around the airport or on the plane and seating arrangements.

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