By Cindy Schaeffer, M.S., R.N., A.P.N., Travel Care & Logistics Inc. 
As a flight RN, I have assisted hundreds of seniors with air travel over the past 12 years, and I have come to recognize that many misconceptions prevail. While you can no longer “book a ticket and run,” it’s quite possible-with adequate planning-to arrange for even frail individuals to travel safely. The reality is that they both want and need to do so.
Many elderly travelers are moving closer to family members because they are no longer able to live alone. Others are simply traveling for the fun of it! They are attending weddings, bar mitzvahs, graduations of their grandchildren-participating in the lives and celebrations of their loved ones. Some even travel for vacations. The dynamics of a cruise ship, with its medical support, meals, etc., are ideal for seniors who want to get away, yet cannot put out the effort and planning that are required for a standard vacation. Most of these seniors have saved their entire lives to be able to do these things, and we should empower them to fulfill their dreams.
The first step is to assess their medical issues. Sometimes adult children have not kept up-to-date on their parents’ health details. Especially when living in different regions of the country, they may hear only about primary health concerns. Poor ambulation, incontinence, forgetfulness are all topics that seniors prefer not to discuss, but they can affect travel. If addressed appropriately, though, they need not be impediments.
Don’t focus only on today’s medical issues, though. For instance, previous experience with a leg clot may indicate a tendency that could be exacerbated by a long flight. Other previous experiences to investigate include urinary tract infections, heart disease, pneumonia, COPD, asthma, diabetes, arthritis and degenerative joint disease, strokes and TIAs, to name a few.
Memory and behavior issues can lead to disorientation and paranoia. Choose a time of day when they are most alert and airports are least busy. Travelers who experience high levels of anxiety can work with their physicians to obtain medications to calm them, but as a rule, they should be used sparingly. If the traveler becomes too tired, transfers will be difficult, toileting becomes impossible, and very sleepy people will alarm the flight crew. All medications should be kept in a carry-on bag so that they’re handy. Ask the doctor about adjustments, such as withholding a diuretic until landing or skipping stool softeners on the day of travel.
Parkinson’s disease presents special concerns. If crossing time zones, the timing of medications needs to be adjusted in short increments. In addition, such individuals often require oxygen supplements when traveling in a pressurized commercial plane. These are easy issues to address, but they require time and planning.
In general, pack food for the traveler to eat onboard, since airline meals seldom meet the dietary needs of seniors. Be prepared with sweaters and caps for warmth. Shoes and socks will not only stave off the chill, but are safer than sandals for uneven surfaces. Since feet may be subject to swelling, choose shoes that can be opened up.
Working with the Airline
Photo identification is an issue that should be addressed by adult children early in their travel planning. Many seniors no longer have a driver’s license, which can present a problem when going through airport security. Be sure that the individual has state ID, military ID, passport, or similar credential.
Reservation agents can assist with special needs if given adequate notice and clear instructions. It’s best to contact them about a week before flight. If necessary, they may refer you to a special needs coordinator.
When asking for assistance boarding and deplaning, be explicit about your traveler’s capabilities. Know their weight, since many airlines will not allow their staff to assist with transfers for people weighing over 200 pounds.
Explain wheelchair requirements in detail. Will one be needed to board the plane? If the traveler will have their own, the airline will need information concerning model, make and battery.
If a senior is nervous about an upcoming trip, let them vent and answer their concerns. Be honest, but don’t highlight all the possible challenges. Be calm and optimistic. Plan ample time at the airports for bathroom stops and snacks and to ensure you aren’t rushing someone who needs extra time to pre-board.
Talk with gate agents as soon as they arrive, since they can assist with seating, boarding, oxygen check-in and other issues. Then sit by the window and look outside. By not watching all the people running around, you’ll help to keep a senior calm. Once on the plane, talk to the flight crew about any concerns. They are usually very willing to help make everyone’s trip as pleasant as possible.
Most of all, remember that all this preparation is worthwhile. Once in their plane seat, your loved one’s anxiety will drop by half. Focus on the great things waiting at your destination and, if possible, allow your traveler to sleep. It will make everyone’s trip shorter and more enjoyable.