Narrative:

I was informed of a problem with a passenger. We were about 3.5 hours from our destination. The chief purser called the cockpit and advised me that we had an elderly passenger; flying with her granddaughter; experiencing some confusion. She advised me that the passenger has a history of dementia and that her granddaughter had also advised her of that ms. X was experiencing some confusion and anxiety. She has some difficulty seeing (was told that she was somewhat blind but could see light and some shapes); in addition ms. X didn't speak english. We found someone to interpret; but ms. X was unresponsive; uncooperative and was unable to understand what was going on. I was flying; so I had the last break; so I (the captain) went back to see what assistance I could offer. I found ms. X agitated and not responding to verbal commands. I was advised that she wanted to open the door and get out; she kept telling the interpreter that she wanted to see her daughter 'right now' (the daughter was waiting for ms. X to connect to another flight; and was going to pick her up). I observed her trying to go for the door; and she became somewhat combative; in addition she began to 'chant' out loud. I talked to the doctor and nurse who had offered to help and asked their advice. It was decided that we would let her stand in the aisle way and try and tire herself out (she refused any liquids or medication). I requested an F/a to remain at the door. I didn't want to force her to sit down; and I didn't want to have to restrain her; due to her frail stature and age. I had requested the two pilots in the cockpit to contact dispatch and advise them of the situation; and our desire to have medical meet the airplane. I discussed the option of diverting with the doctor and the nurse; they thought that she could be managed; and that they would keep an eye on her. I elected to continue the flight. I ordered the cabin lights to be turned on in the hope that she would feel a little more secure. I returned to my seat and tried to resume my break. A few minutes later I was advised that she was becoming agitated and aggressive again. I returned to the cabin and after a discussion with the doctor and nurse; I ordered her to be put in an aisle with three seats so that the nurse could sit on one side and the interpreter could sit on the other and keep her secure. It should be noted that by this time she had become a little more familiar with them and was responding somewhat to their voices. She did not want to sit down; so we had to hold her hands down while we physically put her in the seat. This was done with the help of myself; the doctor; the nurse; her granddaughter and another F/a. We got her into the seat and buckled her in; while the nurse and translator positioned themselves on either side of her. Ms. X calmed down; but did experience a few more episodes of agitation and aggressive behavior. I again questioned them of their ability to keep her calm. If the situation continued; or got worse; I was going to divert and get her off the airplane. They assured me that they could handle her; and there was no further incident for the rest of the trip. When we arrived; the paramedics were standing by and had to restrain her to get her out of the jet. We thanked all who were involved; and told them how much we appreciated their assistance and consideration. I elected not to call for a security level 1 or 2; after discussing it with the crew. Ms. X was clearly confused and suffering from dementia; I did not feel she was a threat to the flight; only to herself. Her agitation and aggressiveness appeared to be due to her confusion and fear; I witnessed no malice or desire for violence. Because of her advance age and frail stature; I saw no real or immediate threat. The event was one of medical nature; and not a security threat.

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Original NASA ASRS Text

Title: B777 Captain reported a passenger with dementia and poor eyesight experienced confusion and anxiety on an international oceanic flight. A physician; nurse; and her granddaughter were able to calm her sufficiently to complete the flight successfully.

Narrative: I was informed of a problem with a passenger. We were about 3.5 hours from our destination. The Chief Purser called the cockpit and advised me that we had an elderly passenger; flying with her granddaughter; experiencing some confusion. She advised me that the passenger has a history of dementia and that her granddaughter had also advised her of that Ms. X was experiencing some confusion and anxiety. She has some difficulty seeing (was told that she was somewhat blind but could see light and some shapes); in addition Ms. X didn't speak English. We found someone to interpret; but Ms. X was unresponsive; uncooperative and was unable to understand what was going on. I was flying; so I had the last break; so I (the Captain) went back to see what assistance I could offer. I found Ms. X agitated and not responding to verbal commands. I was advised that she wanted to open the door and get out; she kept telling the interpreter that she wanted to see her daughter 'right now' (the daughter was waiting for Ms. X to connect to another flight; and was going to pick her up). I observed her trying to go for the door; and she became somewhat combative; in addition she began to 'chant' out loud. I talked to the Doctor and Nurse who had offered to help and asked their advice. It was decided that we would let her stand in the aisle way and try and tire herself out (she refused any liquids or medication). I requested an F/A to remain at the door. I didn't want to force her to sit down; and I didn't want to have to restrain her; due to her frail stature and age. I had requested the two pilots in the cockpit to contact Dispatch and advise them of the situation; and our desire to have medical meet the airplane. I discussed the option of diverting with the Doctor and the Nurse; they thought that she could be managed; and that they would keep an eye on her. I elected to continue the flight. I ordered the cabin lights to be turned on in the hope that she would feel a little more secure. I returned to my seat and tried to resume my break. A few minutes later I was advised that she was becoming agitated and aggressive again. I returned to the cabin and after a discussion with the Doctor and Nurse; I ordered her to be put in an aisle with three seats so that the Nurse could sit on one side and the interpreter could sit on the other and keep her secure. It should be noted that by this time she had become a little more familiar with them and was responding somewhat to their voices. She did not want to sit down; so we had to hold her hands down while we physically put her in the seat. This was done with the help of myself; the Doctor; the Nurse; her granddaughter and another F/A. We got her into the seat and buckled her in; while the Nurse and Translator positioned themselves on either side of her. Ms. X calmed down; but did experience a few more episodes of agitation and aggressive behavior. I again questioned them of their ability to keep her calm. If the situation continued; or got worse; I was going to divert and get her off the airplane. They assured me that they could handle her; and there was no further incident for the rest of the trip. When we arrived; the Paramedics were standing by and had to restrain her to get her out of the jet. We thanked all who were involved; and told them how much we appreciated their assistance and consideration. I elected not to call for a Security level 1 or 2; after discussing it with the crew. Ms. X was clearly confused and suffering from Dementia; I did not feel she was a threat to the flight; only to herself. Her agitation and aggressiveness appeared to be due to her confusion and fear; I witnessed no malice or desire for violence. Because of her advance age and frail stature; I saw no real or immediate threat. The event was one of medical nature; and not a security threat.

Data retrieved from NASA's ASRS site and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.