Cognitive Challenges when Navigating a New City

This past June, I had the privilege of traveling to Europe with my mom and my stepdad Tim, who was diagnosed with multiple sclerosis in 2000. Tim has common symptoms of MS, including fatigue, sensitivity to temperature and numbness. But the symptoms Tim struggles with the most are cognitive. His difficulty with short term memory, word finding and delayed processing makes everyday activities challenging. Now, take all those problems and go to an entirely new city in a foreign country, and you can imagine how difficult it can be.

When it comes to MS, a lot of time goes into discussing the physical symptoms, although 50% of people living with MS experience cognitive symptoms.

Unfortunately, cognitive symptoms are commonly misunderstood. This misunderstanding can lead to tension between those living with MS and their families and friends. This is especially true when faced with a potentially frustrating situation, like traveling to a new city!

Cognitive symptoms of MS include:
  • Short term memory loss
  • Trouble concentrating
  • Strain in finding the right words
  • Difficulty problem solving
  • A slower ability to process information
As you can imagine, these symptoms often lead to stress and anxiety, especially when a person is out of his or her comfort zone. For example, while in Europe, the three of us spent a few days in Liverpool, United Kingdom. As Americans, we are used to gridded streets and clearly marked street signs, making map reading easy-peasy. While this beautiful Merseyside city is exciting once you know your way around, the roads are winding, and street signs are not always obvious.

At Tower Bridge in London!
When my mom and Tim had to find the post office in this new city, they wound up getting lost. That's when Tim's symptoms set in. Instead of calmly asking for directions, he began to get frustrated and emotional. He wasn't able to quickly problem solve, process the map information or find the right words to express how he was feeling. All the elements that can result in a total MS meltdown.
Luckily, my mom has a lot of experience walking Tim through his symptoms. They were able to regroup, talk it out and eventually made it to the post office. But how do you calm yourself or your loved one down when experiencing a cognitive episode like this?
Here are five tips from our experiences:
  1. Download an offline map pre-loaded of the city or region you’re going to. This gives everyone the ability to track where you are even if Wi-Fi isn't available.
  1. Make sure you have a procedure set in place for when a meltdown occurs. Maybe it’s a code word that means let's find a nearby place to sit for 10 minutes to calm down, or maybe it's simply catching a cab back to the hotel to regroup. My mom and Tim got better at this as the trip went along. It helps to remember that people with MS are not the only ones who have cognitive meltdowns!
  1. When going to museums, allocate more time than you think you will need (and make sure to get a wheelchair). It can take people with cognitive MS symptoms more time to process information, so it might take them longer to get through a museum. That's ok! Take your time and enjoy it! 
  1. Do not plan too many things in one day. It's hard to remember a long itinerary, and it can be hard to keep up with. That leads to stress, and stress leads to more symptoms. Take your time and absorb yourself in your new experiences. If a new place has a lot to do, prioritize and make sure to go to the sites you want to see the most first. That way, if you “poop out” half way through the day, you have at least seen what you wanted to see.
  1. Don’t get mad at each other. Traveling with MS is difficult enough, and we all buckle under pressure sometimes. If a meltdown occurs, take a deep breath and calm down before trying to discuss plan B. Your day will go much more smoothly if you don’t argue while MS is flaring its ugly head.
For those diagnosed and their friends and family, understanding the cognitive symptoms of MS can help everyone work better together and get through difficult times without anger. That's especially true when traveling! If you plan ahead by communicating about these symptoms, you should be able to get through anything a new city or region will throw at you. Who knows, you might return with a stronger relationship than ever!

But most importantly, have fun and don't let your MS stop you from enjoying yourself!
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Calysta Phalen

Calysta is a professional copywriter from Milwaukee, Wisconsin with a passion for travel. She has been an advocate for MS awareness since 2005 when her mom met her future step-dad, who was diagnosed with the disease in 2000.

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  • Marilyn1  Sep 12, 2017 2:21 PM
    I have minimal symptoms also, vertigo, some numbness and cognitive. This sounded so familiar. And it is so hard for family to grasp the concept meltdown. I tend to get yelled at for going ballistic, when I just need to be gently reminded to calm and slow down.
  • Carolyn cordon   Sep 12, 2017 7:35 PM
    Yes, my cognitive issues are mostly misunderstood, because I manage well enough most of the time. But the mental effort in getting to that state are great ...
  • leonhillyer  Sep 13, 2017 12:13 AM
    Exactly, going out for an adventure to a new place is stressful. It's just hard to keep up with everyone I go with. I don't lose my cool but being over stimulated just makes the world spin and I need to take a time out for a bit.
  • Kari   Sep 14, 2017 6:06 PM
    I completely understand. I was diagnosed in 1996 and have been doing fairly well until the past couple of years. My cognitive function is terrible. I finally gave up today and left my job of many years to go on FMLA and most likely disability. It is scary to now say that the fatigue, emotional and cognitive issues has got the best of me as far as holding a job. I guess the next chapter of my book begins.
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    nluthy  Sep 18, 2017 11:01 AM
    The five Tips are great. Much appreciated. I can think of so many Meltdowns that if I just took a minute before and realized it was MS related, I would have maintained relationships in a better fashion.
  • Stephanie   Sep 26, 2017 9:23 AM
    I really appreciate your post. I am awaiting MRI results and some of the symptoms ive been experiencing are cognitive related. I'm 42 and I get scared, anxious and frustrated when confusion sets in. Happened recently during a course for my doctorate. Suddenly I sound like an "idiot" when trying to express thoughts and when I am asked for my interpretation of a quote, I find myself saying, "I'm confused by it." I don't want to mention MS to my professors yet because it may not be that but I need to say something. I have had frustrating meltdowns with family and unfortunately, I can imagine they may occur in other situations soon. The post helps me understand that I'm not alone, and that I need to be kind to myself and take time to relax.
  • Jill   Sep 28, 2017 6:33 PM
    This article could not have come at a better time. I am an RN with a Master's in Nursing and a Master's in Criminal Justice. I have been working from home for the last several years as a supervisor of a team of RN claims reviewers. I have been noticing more and more cognitive symptoms over the last couple of years including trouble word finding, difficulty with focusing and problem solving. I finally went out on short term disability two weeks ago. I've been feeling so helpless and frustrated that my nursing career might be over. I was diagnosed with MS in 1998 and always thought that I would be able to work from home when I was no longer able to work on my feet all day. I really never planned on having cognitive issues. Thank you for your timely article and all the comments from others living with MS.
  • John   Nov 5, 2017 9:40 AM
    Calysta's articles are always right on the money. Her tips for making travel more accessible for people dealing with MS are always helpful and interesting. I hope she keeps them coming!