Senior travel or travel by older adults has become a reward of having more free time and more discretionary income. Since aging produces physiological changes as well as increases the probability of having an underlying medical condition, travel for older adults poses special risks that other age groups do not experience. Following certain precautions can help ensure a safe and enjoyable trip.
In 2007, the American Association of Retired Persons (AARP ) and Focalyst released a study of 30,000 Boomers (people born between 1946 and 1964) and Matures (people born prior to 1946). The study indicated that older adults represented a viable target market for the travel industry. Retired adults encompass a large portion of this industry, but the biggest segment is composed of Boomers who travel
with their minor children. Boomers also tend to travel in larger groups and spend more money per trip.
Travel contributes to the quality of life and overall health of many older adults. Some seniors may travel to see children and grandchildren or connect with friends, while a number of seniors travel for career-related conferences and personal research or for special interests, including hobbies, sports, education, and spiritual activities. During the later part of life, many adults seek out places they have never seen before, such as the ocean, a tropical locale, or other countries.
Obtaining travel information
Travel opportunities for many older adults is not usually difficult. A travel agent or website can provide suggested destinations, hotels, and methods for travel. Travel magazines, documentaries, or travel presentations at local venues can also inspire travel plans. Many seniors rely on information from organizations such as the AARP or the American Automobile Association (AAA). Once a destination is determined, the senior traveler can plan their itinerary.
One study on the travel habits of seniors found that word of mouth and personal experience were far more important sources of information to older adults when deciding on a travel destination. This was echoed by the AARP and Focalyst 2007 study and emphasized that there was no brand loyalty regarding transportation, accommodations, or even destination activities. The study also found that life stage was a major factor in travel decisions. Finances, work status, and household composition were the most influential factors.
Travel can be mind-broadening and soul-expanding, but it can also be stressful, especially if the travelers have an underlying medical condition or mobility issues . It is a good idea for older adults to discuss their travel plans with their physician, preferably prior to making travel arrangements. The physician can determine if the senior is fit to travel and engage in the activities they have planned. The physician may suggest changes in destination, transportation arrangements, or activities. For example, if a person with a respiratory disorder plans to hike in the Rocky Mountains, the physician may suggest a different destination. The thinner air of higher altitudes would make breathing more difficult for the patient with lung problems.
|source: CDC 2008 Yellow Book for the Public, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for|
Disease Control and Prevention, U.S. Department of Health and Human Services
|(Illustration by GGS Information Services. Cengage Learning, Gale)|
|√ Consult a health-care provider before embarking on a cruise if you have health conditions that might increase the potential for injury or illness. Special cruises|
are now available for travelers who have certain medical conditions, including those on dialysis.
|√ Inform the cruise line of special medical needs, such as wheelchair access, oxygen tank, dialysis, in advance of travel.|
|√ Ensure you have adequate medical insurance coverage for receiving healthcare overseas and medical evacuation.|
|√ Obtain a written summary of your medical history, including pertinent diagnostic data such as EKG and chest x-ray, to facilitate medical care, should it be|
|√ Consult a healthcare provider for destination-specific recommended and required vaccines (e.g., yellow fever), as well as prevention medication (e.g. malaria|
chemoprophylaxis) if needed; and routinely recommended age- and medical condition-specific immunizations, such as influenza vaccines.
|√ Consult a healthcare provider for appropriate options for motion sickness based on your medical history and current medications.|
|√ Practice good health habits and disease prevention practices during travel by washing hands for at least 20 seconds with soap and water or, if soap and water|
are unavailable, using an alcohol-based product containing more than 60% alcohol, and using tissue to cover coughs and sneezes.
|√ Take food and water intake precautions; checking that foods are thoroughly cooked and the appropriate temperature.|
|√ Use mosquito prevention (using DEET-containing repellents and wearing clothing that provides coverage over exposed areas of the body), as necessary.|
|√ Keep a record of your medical pre-travel preparation, medications taken, duration of travel, countries visited, and shoreside activities to facilitate any medical|
care needed upon your return home.
|√ See your healthcare provider if you become ill after returning home, even many months after travel, let your physician know where you have traveled. In|
particular, a fever after traveling in a malarious area should be considered a medical emergency.
The physician may also suggest ways to manage the stress of travel, minimize the pain of arthritis or recurrent bursitis , or adjust to a different time zone. If there is a chronic disorder such as diabetes or cardiovascular disease, the doctor may suggest how to manage the disease in a different part of the country or part of the world.
Travelers with a heart condition may find it necessary to travel with a copy of a current cardiogram. If the traveler has a symptoms, such as shortness of breath, chest pain, or nausea, which may indicate a heart problem, having a prior reading can help emergency room doctors determine treatment more accurately.
Traveling with medications
Before departure, older travelers should check their current medications and make sure they pack enough for the trip. It is a good idea to keep an extra week of medication on hand in case plans change or a travel emergency occurs. Some physicians give their patients an extra written prescription to take along in case something happens to their medications.
Travelers should pack medications in their carry-on luggage. Medications should remain in the original bottles that clearly identify the patient, the doctor, the type of medication, and how it should be taken. Medications can be transferred to daily pill reminder containers when the traveler arrives at their destination. On the trip home, all medications should once again be packed in their original containers for travel. This is important to determine what medications are being taken if the traveler has a medical emergency.
Some medications must be kept cool. Travelers should put them in a small insulated container with a gel ice pack. If flying, travelers should keep these medicines separate in their carry-on until aboard the plane; then ask the flight attendant for help with keeping the medications cool.
It is very important to keep a written list of all medications (including generic equivalents), dosages, and the medical conditions for which they are being taken. If the patient is traveling with hypodermic syringes, needles, narcotics, or other controlled substances, it is wise to carry a written letter from the patient's physician. Travelers should keep the list of medications and the doctor's letter with their other travel documents and put a copy in their checked luggage.
Traveling by plane
Flying poses some unique challenges for older adults. Increased airport security often causes travelers with pacemakers , artificial joints, and implanted cardiac defibrillators (ICDs) to off airport metal detectors. Patients with these devices usually carry a wallet card that identifies the type of devices they have. Travelers with ICDs or pacemakers should present the ID card to the security personnel and ask for a hand search or to use a handheld wand, passing it over the location of the device for no more than a few seconds and to wait thirty seconds before passing it over the device again.
Some international airports use radiation detectors. These are sensitive enough to pick up radioisotopes used in nuclear medicine scans. Patients who plan to fly within thirty days of having a thyroid, bone, or heart scan should carry documentation regarding the date and place that the procedure was done.
Oxygen and air pressure is in lower concentration as the airplane reaches higher altitudes. This thinner air may be problematic for people with serious lung or heart problems. If the person can walk upstairs without becoming short of breath, then flying should not be a problem.
Airline passengers should drink plenty of water. The dry cabin environment can cause symptoms of dehydration . Travelers should avoid alcohol because it can further dehydrate the body.
Some people may feel bloated when they fly. This happens because the gases within the intestines are sensitive to air pressure similar to the ears and the sinuses. This is normally a minor inconvenience, but if the traveler has recently had abdominal or chest surgery, the expanded gas can stretch surgical stitches, causing added discomfort.
Travelers who are prone to airsickness should not eat before flying. They should sit upright and minimize movement of the head. Motion sickness can be worsened by reading or watching videos so these activities should be avoided. Over-the-counter motion sickness medications are available, such as dimenhydrinate (Dramine) or meclizine (Bonine). These medications are taken before the flight. Patients should check with their physician prior to taking these medications.
In the event of a medical emergency on board, all airlines have emergency medical kits and automated external defibrillators to treat cardiac arrest.
Avoiding deep vein thrombosis
Sitting for long periods can cause blood to settle in the lower legs and feet, resulting in swelling. Sometimes, sluggish blood flow from the feet back to the heart can cause tiny blood clots to form. Often, these clots dissolve via the body's own natural clot busters. For some people, the clot continues to travel up through the leg, blocking blood flow. This is called deep vein thrombosis and can cause leg pain. If the clot breaks away and continues to pass through the circulatory system and enters the lungs, it can cause a pulmonary embolism , which is life-threatening. This condition can occur in younger travelers, but it is especially problematic in older adults whose circulatory system may already be sluggish due to arteriosclerosis, high blood pressure , diabetes, or medications that slow the heart rate. People who have cancer , are recovering from surgery or an injury, smokers, women taking estrogen replacement therapy, men taking medication for prostate cancer , and those who have had a clot before are at increased risk.
Travelers can avoid deep vein thrombosis by stretching frequently, doing leg exercises, or wearing compression stockings. Alternately flexing and pointing the feet and doing ankle rotations for thirty seconds every half hour are helpful if the traveler does not get up and move around. Passengers may walk up and down the aisle of the airplane or through the cars of a passenger train. If traveling by car, travelers should stop every hour and walk around. Travel by bus may be more problematic, since stops are determined by the bus schedule. Risk of deep vein thrombosis may persist after the plane has landed or the bus has reached its destination. Travelers should continue to walk and exercise daily.
When traveling outside of the United States, older adults need to make sure their immunizations are up to date. A physician can determine what immunizations are necessary based on the destination. Information is also available from the Center for Disease Control and Prevention (CDC) and the U.S. State Department.
Going through customs with medications or hypodermic syringes and needles is much easier if all medications are kept in their original containers and are carried in carry-on luggage. A written note from the traveler's physician explaining that a medical condition requires the traveler to take narcotics or use hypodermic syringes and needles for injections will make having them in the traveler's possession understandable. A list of medications and the conditions for which they are taken verifies why the traveler has them. This list should also include over-the-counter medicines and supplements. Some countries have different laws about controlled substances than the United States and may regulate what is in some over-the-counter products.
Travelers should take enough medication for their trip, as well as enough extra for a few days in case something happens to their medications or there is a change in plans. Patients taking generic medications may not be able to find equivalent drugs abroad if they run out. In some cases, their physician may not be able to find generic equivalents in other countries or even be able to identify specific equivalents if they are available.
Food and drink can be major sources of illness for travelers. Raw food should be avoided, particularly fish, meat, shellfish, and unpasteurized dairy products. Raw vegetables, salads, and fruit may be eaten only if the traveler is assured that they were washed in clean water and prepared under sanitary conditions. Food from street vendors should be avoided. Travelers should also avoid drinking local water and anything made with water, including lemonade, fountain sodas, fruit juices made from concentrate and mixed with water, alcoholic beverages mixed with water, and ice. Bottled water, bottled soft drinks, beer, and wine are the safest to drink. Coffee and tea made with rapidly boiling water may also be safe. The CDC travel website provides updated information about food-borne and water-borne illnesses in specific countries and how to avoid them.
Seeking medical help away from home
Accidents can occur anytime and at any age, but older travelers with underlying medical conditions should plan for the event of a medical emergency. Before leaving on a trip, the traveler should locate the local clinic or hospital near their accommodations. Academic medical centers are good sources of care. If the traveler has a specific medical condition and will be away from home for more than two weeks, a physician may be able to suggest an appropriate specialist near the traveler's destination.
If older travelers become ill when abroad, they can call the front desk at their hotel. Many large hotels have a physician on call or have a list of physicians who cater to international patients. Travelers can also call the U.S. embassy or consulate in the country where they are staying and ask for a local medical referral.
Many major medical insurance policies restrict out of state coverage and may not offer any coverage for treatments outside of the United States. Medicare does not pay for medical treatment abroad. Temporary supplemental insurance policies can be purchased for the duration of travel. These are good investments if travelers will be away more than a week or two.
Compression stockings —Support hosiery used by men and women to prevent deep vein thrombosis, swelling, or leg pain.
Deep vein thrombosis —A blood clot that forms in a vein in the lower leg or thigh.
Implanted cardiac defibrillators (ICDs) —Small devices placed in the chest below the collar bone that monitor the heart and can send a small jolt of electricity to restore normal rhythm. They are most often prescribed for rapid or irregular heartbeat but can be used as a pacemaker for a slower heart rhythm.
Pulmonary embolism —A blood clot that occurs in the lung and is often fatal.
Radioisotopes —Small amounts of radioactive material used in medical imaging scans.
At the destination
Travel is supposed to be enjoyable, especially as adults grow older. Seniors should pace their daily activities and balance them with healthy meals and rest.
A change in climate often puts stress on the body. As adults grow older, the ability to cool the body and maintain hydration is slowed down. Some older adults may not feel hot when the outside temperature is reaching dangerous levels. They also may not feel thirsty, even if their bodies are already dehydrated. It may be tempting to linger in the sun, but older adults should seek shade and a cool drink, preferably something without alcohol or caffeine . In warm climates, wearing a hat and light-colored, lightweight clothing that fits loosely around the body is recommended.
In addition, older adults should try to avoid infection. Frequent hand washing or use of alcohol-based hand sanitizers before eating and after being around crowded places such as the airplane, train, or tour bus helps to avoid disease transmission.
Returning from abroad
Travelers, especially those who visit developing countries or who remain abroad for several weeks or months, should be vigilant when they return to the United States. Travel-related illnesses may take time to develop. This usually depends on the destination, how long the person was out of the country, what kind of accommodations they had, any underlying medical conditions, and exposure to potential infection. A fever of any kind that occurs a few days to several months after a trip abroad is cause to seek medical attention. The traveler should tell the physician where he or she has been and for how long, as well as the activities engaged in or if the traveler had a tattoo, body piercing, or had an injection. The length of time between return home and the appearance of fever can be a crucial indication of a particular infectious disease. Dengue fever, for example, appears three weeks or more after the traveler returns home. Malaria may take 6 to 12 months to show symptoms.
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Air Travel and Your Health.” The Harvard Medical School Family Health Guide. October 2006 [cited April 14, 2008]. http://www.health.harvard.edu/fhg/updates/update1006b.shtml.
“The Sky's the Limit: Travel Trends among the Baby Boom Generation & Beyond.” Focalyst Insight Report June 2007 [cited April 14, 2008]. AARP. http://www.aarp.org/research/family/travel/travel_trends.html.
“Travel Tips for Older Adults.” Center for Aging Research and Clinical Care. [Cited April 14, 2008]. Cornell University. http://www.cornellaging.com/tips.html.
American Association of Retired Persons (AARP), 601 E Street NW, Washington, DC, 20049, (888) 687-2277, http://www.aarp.org.
Janie F. Franz