As a cultural attach\u00e9 for the US Department of State, Teresa Wilkin lived abroad and traveled the world, and she kept traveling, extensively, after retiring in 2004.<\/p>\n
But it wasn\u2019t until last year that Wilkin, 69, had what she wryly calls her \u201cfirst geriatric health challenge\u201d on the road\u2014a bout with deep vein thrombosis (DVT), a potentially life-threatening blood clot. She had traveled without incident on a long, multicountry tour with stops in Portugal, Rome and Crete, but the last leg, a four-hour flight from Chicago to Seattle, sent her to the emergency room.<\/p>\n
\u201cI was in a middle seat and didn\u2019t want to get up or bother anybody, so I slept the entire flight,\u201d she said. \u201cI knew something was wrong the moment I got off the plane.\u201d<\/p>\n
Wilkin is now in good health and still traveling\u2014she just got back from a trip to Martinique for Carnival. But as she\u2019s learned, travel becomes more problematic as we age. Even the most seasoned traveler must adjust for health issues, limited mobility or stamina, and take steps to avoid ailments like jet lag, motion sickness and DVT.<\/p>\n
For older adults who want to travel, or for younger adults who wish to travel with them, the key is thorough, needs-specific research and planning. How much walking or stair climbing is on the itinerary? Can wheelchairs be used? Does the hotel have an elevator? Will there be time to rest or nonstop activities? Will restaurants be able to meet dietary restrictions? Are trustworthy medical services available?<\/p>\n
Even a seemingly unremarkable situation can make a trip difficult and less enjoyable, said Michael Zimring, MD, director of the Center for Wilderness and Travel Medicine at Mercy Medical Center in Baltimore. On a recent trip to San Miguel de Allende in Mexico,
\nZimring saw how cobblestones and narrow sidewalks turned a simple walking tour into a hair-raising ride for an older man in a wheelchair who was in his tour group.<\/p>\n
\u201cOlder travelers really need to prepare,\u201d he said. \u201cThe last thing you need is to be stuck in an airport because you didn\u2019t bring the right documents for your medical syringe, or stranded in a foreign country without an adequate supply of an essential medication.\u201d<\/p>\n
Traveling in the Face of Ableism<\/strong><\/p>\n Older travelers must also confront ableism\u2014the tendency of airlines, hotels or other providers to overlook the needs of individuals with disabilities. Large hotel chains in the United States comply with the Americans with Disabilities Act (ADA); smaller hotels, both at home and in other countries, often are not held to similar standards. In some cities overseas, taxis that can accommodate wheelchairs are virtually nonexistent.<\/p>\n Often, ableism shows up as overlooked obstacles that are unintentional or careless, according to Debra Kerper, owner of Easy Access Travel, a Dallas-based agency that caters to older travelers and people with disabilities. She recommends using Google\u2014her favorite travel tool\u2014to find a travel agent or tour operator experienced in serving people with physical limitations.<\/p>\n \u201cA tour guide without that specialized experience is not going to look for curb cuts or notice seemingly small obstacles that are almost impossible to navigate on a scooter,\u201d she said.<\/p>\n If you\u2019re going overseas, find out what immunizations you\u2019ll need and have those shots at least six weeks before you set out.<\/strong><\/p><\/blockquote>\n Kerper prechecks each itinerary herself or contracts with local guides who\u2019ve already led disabled travelers on the route. An inexperienced guide might assume that a restaurant with a wheelchair ramp and wide aisles is accessible, not noticing that the only bathroom requires descending a flight of stairs. A cruise ship might be designed for accessibility, but if the ship anchors and passengers are tendered (transferred from ship to shore via a smaller boat), travelers with limited mobility might be unable to join the excursion.<\/p>\n Kerper, 68, knows what she\u2019s talking about, firsthand. She is a double amputee with a variety of medical conditions, including lupus; she travels along on all of the trips she organizes. Some of her clients have severe disabilities, but she says travel can be almost as challenging for people with \u201chidden disabilities,\u201d such as a person with diabetes who must stop often to check blood-sugar levels or a person with a bad back who can\u2019t sit still for long periods. Preparation is the best medicine.<\/p>\n Preparing for Medical Situations<\/strong><\/p>\n One of the most important considerations is the availability of trustworthy medical care. An emergency easily handled at home could turn into a costly nightmare in an unfamiliar city, Zimring said. A hospital outside the United States may refuse to provide service unless the patient pays up front, in cash. And remote areas might not have good medical facilities. Travelers should find out in advance what health care options will be at their destination.<\/p>\n Zimring\u2019s advice for healthy travel, especially overseas: consult a physician who specializes in travel medicine at least six weeks before your trip.<\/p>\n \u201cIf you wait until the last minute to think about immunizations, it may be too late,\u201d he said. A vaccination for Hepatitis B, for example, is normally given as a series over a period of six months, although it can be accelerated to a six-week period.<\/p>\n All adult travelers should be up-to-date on routine vaccinations: seasonal flu, measles\/mumps\/rubella (MMR) and tetanus\/diphtheria\/pertussis (Tdap). Additionally, the Centers for Disease Control (CDC) recommends the shingles vaccine for those 50 and older, and pneumococcal vaccines for those over 65.<\/p>\n Bring copies of your prescriptions. And before you leave home, make sure your meds are legal in the countries you\u2019ll be visiting.<\/strong><\/p><\/blockquote>\n Some destinations may require additional vaccines, such as polio or yellow fever; the CDC website maintains a list by destination<\/a>. These vaccines may pose risks for older people, and some travelers with health conditions, like diabetes, may require additional immunizations. To navigate these complexities, Zimring recommends consulting in advance with a physician certified by the International Society of Travel Medicine; travelers can visit ISTM.org to find a practitioner <\/a>in their area.<\/p>\n It\u2019s also crucial to make sure all prescriptions are filled. You may need an override from an insurance carrier to make sure you have enough medication for the entire trip, plus a few extra days\u2019 worth in case of a delay. Bring copies of your prescriptions when you travel, and make sure your medications are legal in the countries you\u2019re visiting. (Even a legally prescribed medication can lead to disastrous consequences\u2014a UK citizen was sentenced to three years in prison in Egypt for bringing in Tramadol, an opioid painkiller, for her husband\u2019s back pain.) Check with the embassy of the country you\u2019re visiting if you\u2019re unsure. If a traveler requires oxygen, be sure to check airline policies well in advance.<\/p>\n If you\u2019re traveling abroad, understand what your medical insurance will, or won\u2019t, cover and obtain supplemental insurance as needed. (Generally, Medicare does not cover overseas care.) Read the fine print. Some policies may exclude injuries related to specific, risky activities, like riding a motorbike in Southeast Asia. Be sure to pack information on how to use your policy if needed.<\/p>\n If you have specific medical concerns, such as heart disease, Zimring advises doing some advance research to find out if good quality, specialized care is available, even for domestic travel. Reputable tour operators are prepared to triage emergencies\u2014getting injured or ill travelers to a hospital, for example\u2014but beyond that, you\u2019ll need guidance to find good specialists. Most carriers who offer medical insurance for travelers have networks of clinicians and hospitals overseas and can assist if needed. Some credit card concierge services may also be able to assist.<\/p>\n Think about What You Might Not Know Before You Go<\/strong><\/p>\n Before traveling, Wilkin always signs up online for the US State Department\u2019s Smart Traveler Enrollment Program<\/a> (STEP) for every country she\u2019s visiting overseas. This allows her to receive safety and security advisories via email (including health-related alerts, such as Zika virus updates) and enables the US embassy to contact her should an emergency arise, whether natural disaster, civil unrest or family emergency.<\/p>\n