. Travel With Grandma

February 24, 2011

Please share what you've learned from personal experience!

I'd like to change this site to make it more community oriented. If you have tips you'd like to share from your personal or professional experience, please do! I look forward to hearing from you.

Mom passed

Sorry i haven't been posting lately. my mom fell ill last spring, got better in September, became ill again in October and passed. I've been soooo busy, I haven't been able to give this site my proper attention!

March 11, 2010

Packing

Don’t wait til the last minute to think about what Grandma needs to bring. In addition to clothing and typical toiletries, she may have health-related items that take up space but need to come along.

If Grandma doesn’t have a suitcase and doesn’t travel much, try to find one for free at http://www.freecycle.org/. Make sure it's large enough for all her things, and keep in mind that it’ll probably be YOU who will be carrying it.

Keep in mind the planned itinerary and unplanned surprises when considering what to pack. Always consider her comfort. Grandma may have an idea of what she wants to bring, but make sure it's realistic. She should try things on if she hasn’t worn them in several months. To prevent falls, ensure that nothing is too long. If she has lost height or weight, things may be longer/looser than they were before. If you can, have her try things on while you’re there, so you can both weigh in on decisions. If she has tops and bottoms that can be mixed and matched to make several outfits, all the better. Items that don’t wrinkle easily are a plus. Remember that elderly people are often cold when the rest of us are comfortable. Bring layers!

Give a great deal of thought to shoes. Make sure her footwear fits securely and offers excellent support, with ties, straps or Velcro straps. No slides, no heels – unless she has good balance and mobility, and falling is not an issue! Check the soles - they should be non-slip. Ensure that her slippers are non-slip, too. Some good ones I have found have rubber soles: http://www.totes-isotoner.com/product/isotoner/women/slippers/ballerinas/terry+ballerina.do?sortby=ourPicks

If your itinerary involves dressing up, make sure Grandma has a pair of safe shoes to wear. I found nice-looking sandals in silver, which Grandma wore to our children’s weddings. There may be a shoe store in your area that caters to the disabled and carries brands that are especially good. In any case, a good fit and non-slip soles are a must.

Scroll down or see Blog Archive in left sidebar for other posts:
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)
Planning (Oct. 23)

February 17, 2010

Freecycle

You may need medical equipment, luggage or other supplies for your trip that might be available from someone who no longer needs it. Look for ads in your local paper or on sites like http://craigslist.com. And consider the internet-based recycling community, Freecycle: http://freecycle.org. It's an online bulletin board, where people list items they’re giving away or items that they need. I found a suitcase for Grandma on Freecycle. If you can't find what you're looking for, post a request for the item, and someone may respond. There may be a Freecycle group in or near your town. There's no fee to join. In fact, everything associated with Freecycle is totally free. And it’s a great way of getting rid of that extra “stuff” taking up space in your attic or basement.

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)
Planning (Oct. 23)

February 2, 2010

Renting a Car

If you're not going to have access to your own car, you may have to rent one. The ideal scenario is to rent the same car your loved one currently rides in – same year, make and model. If you can do this, there'll be no surprises, and you'll be certain that Grandma can get in and out of it. Don’t forget to consider whether or not others will be joining you, in which case you'll need a vehicle that will accommodate them, their luggage and other cargo, such as Grandma's walker, wheelchair and other equipment you’ll be transporting.

Once you know what your general needs are, one way to find a car is to take Grandma with you to one or two car dealerships. Have her attempt to get in and out of several models. Keep in mind that many cars are too high, too low or have bucket seats which are difficult for a mobility-challenged person to get in and out of. Once you've decided on a car, call a rental company, and ask if they carry that specific make, model and year, at the specific location where you need to pick it up. Just because a rental company advertises a particular car, it doesn’t mean it will be available at the location to which you’re going. If they can’t guarantee that they'll have it for you, call another company.

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)
Planning (Oct. 23)

January 13, 2010

Paid Caregivers

Should you bring Grandma’s aide with you or hire someone in your destination city?

"Bring-along" pros and cons:

Pros
  • Known entity - Grandma knows, trusts and likes her (and, hopefully, you do, too).
Cons

  • You'll pay for all transportation, food and lodging expenses for the aide's entire trip.
  •  This may not be a negative, but the person will be with you 24/7. Is that OK with you and Grandma? 
  • Will she need time off? (Don't assume anything; ASK.) If she does, you might need to hire a second person to fill in.
Hiring in destination city:

Pros

  • You can hire locally for specific hours and pay just for the time needed (plus meals) and, perhaps, cab fare.
  • If you've hired through an agency and the aide gets sick or can't come for some reason, the agency will get a replacement for you.
Cons

  • You’re taking a chance that the agency is reliable, thoroughly screens their employees, and that the aide will be competent, trustworthy, and nice. Ask for credentials and references for the person being sent to you!
To maximize the chances you’ll find the right person:

  • Begin your search months or weeks ahead.
  • Ask for recommendations from RESPONSIBLE people you know who live in that city.
  • If you'll be using an agency, call the social services department of the most reputable hospital in your destination city. Get the names of their most highly recommended agencies, call each one and ask a lot of questions. If they have a prospective aide in mind, ask if the candidate is well known to them, and for how long he/she has been in their employ. Ask for references.
We chose not to bring Grandma’s aide from home. A couple of months before our New York City trip, I called the social services department of one of the best hospitals in Manhattan, explained the circumstances and was given the names of 3 agencies. My first call was to an agency affiliated with a nationally-known nursing organization. The intake person took information regarding dates of service, what specifically I was looking for, and Grandma’s medical condition and limitations. I was told that someone would call me back in a few days. I waited and no one called back. I subsequently called them two more times over the next two weeks, and was told they were working on it and would contact me a couple of weeks before my trip. This didn’t sound right, and I didn’t want to wait that long to know that someone was definitely on board. I decided to try the other two agencies, which were much smaller. I spoke with the owner or manager of each. I told them all about Grandma, and why we were coming to New York. They each said they knew someone they thought would be perfect, and they would contact that person to check on her availability. They both got back to me within 24 hours, and I ended up going with the one who got back to me first. The person they sent was fabulous and I would highly recommend this agency:

     SelectCare
     Carla
     915 Broadway, Suite 1101
     New York, NY 10010
     Phone: 212-505-3640
     Fax: 212-505-5347

For our wedding in California, we happened upon an expert on elder care who had written an article that my husband discovered online. We emailed her and, to our surprise, she wrote back with a recommendation of an agency she had heard wonderful things about. We contacted them, told them how we found them, and they ended up sending us a fabulous lady. They also helped us borrow a raised toilet seat for the hotel - from a local “loan closet,” a service that lends medical equipment to those in need. (I guess we qualified, because we had flown in from out of town, and were unable to bring along our own equipment.) The loan closet was totally their idea. I was especially grateful and felt this was a selfless act, since if I hadn't gotten the loaner equipment, I would have had to hire an aide for many more hours to help Grandma in the bathroom.

     LivHome
     220 E. Figueroa Street
     Santa Barbara, CA 93101
     Phone: 805-687-8766
     Fax 805-563-1507

Before you contact an agency, know your needs and have the following information available:
  • Your loved one's medical condition, meds, limitations;
  • The exact hours/days you need service.
Dissect your itinerary. Really think about what your schedule will be, hour by hour, day by day. In our case, we were in town for our child’s wedding. I needed to consider: where and when our meals would be, handicap-accessibility of every single place Grandma would be going, when and for how long I would not be able to be with Grandma, going to the hairdresser, Grandma going to the hairdresser, meetings/entertaining, Grandma’s getting-ready time, my getting-ready time, how – and with whom – Grandma would travel to/from the wedding, how late I’d be at the venue, how late Grandma would be at the venue, whether or not someone should stay with her at the hotel until I returned from the venue, logistics of any and all probable commitments – including where, when, how to get there. Forcing yourself to list these details will help you make a decision regarding caregiving needs and save you from aggravation later!

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)
Planning (Oct. 23)

December 28, 2009

How to Select a Hotel

Know what your needs are, ask a lot of questions, and don’t assume anything. Try to ensure that you're dealing with someone at the reservation desk who knows the facts, and is not just guessing. What you find out will determine whether or not Grandma will be able to use the toilet herself or take a shower. Or eat. All hotels are not the same.

Book your reservation well in advance, since hotels have a limited number of handicap-accessible rooms, and not all of them are alike. Make sure the one you reserve has the amenities you need.

Here are some issues to consider in choosing a hotel:

Are there steps required to get into the building?

Where is your room located?
We stayed at one hotel that had some of their handicap-accessible rooms at the rear of the property. The room was lovely, but was adjacent to a railroad crossing. We were awakened every 2 or 3 hours by the loud blast of a train. Guests located elsewhere were not bothered by this.

Is there an elevator? How far is it from the room?

Is it safe for your loved one to have her own room?
What if she needs to go to the bathroom in the middle of the night (or anytime), or wants to retrieve something from the dresser? Is there a great risk of falling? Is she easily disoriented or have a mental impairment that would preclude her staying alone? (Don't forget, she won't be in an environment that's familiar to her.) If so, it might be best for you to share a room with her or have a paid caregiver do so. Ask the reservation agent about the configuration of beds in the room. Don't assume handicapped-accessible rooms have two beds! In my experience, most don't. And bring eyeshades and earplugs for both of you. They work great!

If you decide that Grandma can have her own room and you'll book the room next door, don't assume the rooms are connecting, with a door you can leave open between them. Check it out!

About the bathroom:
Most accessible rooms have low toilets with metal bars to hang on to. This is not adequate for my mom. She needs a higher seat or she can't get up by herself. Does the hotel have a raised toilet seat it can reserve for you? (Make sure you're talking to someone KNOWLEDGEABLE.) If they have one, ask if it's possible for someone to personally go look at it and call you back with a description. Many raised seats do not have arms, and if you're loved one is very frail, that will not do. The bottom line is, if you expect that Grandma will be going to the bathroom herself, you must evaluate her needs and ensure they are provided for. You don't want her to fall!

If the hotel doesn't own a raised seat, tell them they SHOULD have one, and ask if they can purchase one for their inventory. It would be a very useful amenity for future guests, as well. (Don't be afraid to ask. At the minimum, you are raising awareness, and you just might get them thinking about buying one or two for their stock!) The best kind is one with arms. (See photo below. This is actually a commode, but the pot is removable, so the item can be placed right over the toilet. It is a great thing to have, since it can be used over the toilet or on its own as a commode next to the bed.)


Do your research – familiarize yourself with the various styles, so that you'll be able to visualize what the hotel is telling you it has in its inventory. If it's not appropriate for your needs, ask if there's a rental company in the area that can deliver one to your room. If it appears that the hotel cannot or will not arrange for an appropriate seat, it is advisable that you bring one with you or stay somewhere else.

Is there a walk-in shower with a hand-held shower head, and is there a bath bench? Grandma has to be able to get in and out of the shower easily and safely. Don’t assume all handicap rooms have walk-in showers. They don’t.


Is there a restaurant or other source of meals in the hotel?
Will it necessitate going outside or climbing stairs? I was initially skeptical about staying at a certain hotel in New York City, because it didn’t have a restaurant. After looking into it, I found there was a lovely European breakfast buffet in the lobby each morning, and wine and cheese in the afternoon – all at no extra charge. Grandma loved it, and so did I. If it's necessary to go out for meals, where is the nearest restaurant – and is IT handicap-accessible? How close is it to the hotel, what are its hours and what kind of food does it serve? Don’t forget that taking a cab to a restaurant is costly, inconvenient and could be difficult for your loved one.

Does the room come with a refrigerator?
If not, some hotels have a few on reserve for guests who ask for one. I found this to be the case with one of our hotels, so I reserved a fridge at the time I made the reservation. When we checked in, it was already in the room and cooling nicely. (If it turns out that you can't get one, and you have meds that require refrigeration, bring a cooler with a double supply of ice packs, and make sure the hotel is willing to keep the extra packs in the hotel freezer for you - and that no one will toss them out. If you do this, you will always have a supply of frozen packs. If the hotel won't do this, stay somewhere else!)

Does the hotel have a wheelchair?
If yes, ask if it needs to be reserved and if it can be used outside the hotel (probably not). There could be a lot of walking from the room to the lobby, and you don’t want Grandma using up all her energy before she even leaves the hotel! You may even want to consider renting or bringing a lightweight (16 - 20 pounds) wheelchair from home. The chair shown below is called a transport chair. It folds up easily and is lightweight enough so that it can be taken around town in the car or in a taxi cab.

Hospitality rooms or suites
If  you are hosting a wedding or other event where other family members and friends will be staying in the same hotel, you might want to research whether or not the hotel offers a room where you can all gather and socialize, with or without food. A suite may be a real splurge, but in certain cases it could be a lifesaver. When one of our kids got married in New York City, I stayed in a handicap-accessible room with Mom, and my husband stayed in a small suite down the hall. We had several casual suppers with other family members in my husband's room, sitting around a coffee table, enjoying pizza and Thai food, which someone had gotten from a restaurant down the street. It was fun and low key, and enabled Grandma and me and the rest of the family (including our new inlaws!) to relax and hang out together, without going to a restaurant.

Bring a nightlight!

Two hotels that were very responsive to my requests:
In New York City: Hotel Giraffe http://www.hotelgiraffe.com/
In Marina del Rey (Los Angeles area): 
      Marina del Rey Marriott http://www.marriott.com/hotels/travel/laxmb-marina-del-rey-marriott/

In the end, if the hotel you are considering can’t provide you with the type of accessibility needed, go somewhere else if possible. The point is, do your research in advance, come prepared, and don’t assume anything!

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)
Planning (Oct. 23)

December 14, 2009

Meds, Meds, Meds

There is nothing more important than having a handle on Grandma's meds.

Make a list.
Be sure it’s complete, including dosage schedule. Make sure the list is accurate and up-to-date. If there’s any question, call the doctor(s) to make sure. If something happens and you have to take Grandma to the hospital, they'll ask to see the list. (Make sure you get it back from them!) . Keep the list in your or Grandma’s wallet, and make a copy to keep in the suitcase.

Pill Organizers
Chances are, if Grandma takes a lot of pills (and many people do), she already has a pill organizer. She may take pills on specific days, and at specific times during the day. If your trip is just for a day or two, you may get away with using the organizer Grandma already owns. But if you’ll be away for several days or more, purchase an additional one. Take one with you, and leave the other home so she'll have her meds all ready when she returns. Remember - Grandma may feel exhausted and a bit disoriented for a day or two after she returns, so it will be nice having her pills organized and ready.

Our Grandma takes pills at different times during the day, so the pill organizer shown below is perfect. Seven "strips," each for a day of the week, are contained in a plastic base. If she wants, she can remove a single strip and carry it in her  handbag in case she's away from the hotel all day. (By the way, I would make sure that the pills are put away, and not left lying on the counter or on the dresser in the hotel room.)




In case you can't see the detail in the photo above, each strip is labeled with the time of day: morn, noon, eve, bed.

Count out enough meds for the trip and the first few days back.
DO THIS SEVERAL DAYS OR A WEEK OR MORE before leaving, so that if you need to reorder, there's time to get the refills through the mail or from your local pharmacy. (Even if you use a local pharmacy, be aware that sometimes they run low on a particular med and have to order more!)

Once you know Grandma has all her meds in hand, help her load her pill organizer. It may or may not be necessary to actually do it for her, but I suggest being there, since this is something outside the routine, and she may become frustrated or nervous about it.

Refrigeration of Meds
Find out whether any of the meds require refrigeration. If they do, you should carry them in a size-appropriate, fabric-sided cooler, with one or more FROZEN freezer packs (whatever number it takes to keep the medication cold, plus extras). Freezer packs stay frozen for about a day. So if your trip is longer than that, you'll have to ensure that a refrigerator will be available to you. On one of my trips, our hotel did not have mini-fridges in the room, but the staff was happy to store the extra packs in the hotel freezer. (I had brought along two, so I could switch them out as needed.) We kept the medication in the cooler for the entire week, changing out freezer packs as needed. And I made sure there was a frozen pack ready for the day of travel home. (I just needed one, but your needs might be different!)

Sometimes a hotel does not routinely provide refrigerators in the rooms, but will deliver one to you upon request. One of my hotels had only 2 or 3 available, so I was glad I remembered to ask for one when I booked the room. When we checked in, it was in the room, all set up and fully cool.

Meds Other Than Pills
If your loved one takes an injectable drug or something other than a pill, find out whether or not it requires special permission for carrying through security at the airport, etc. Speak to someone at the airline, or research the TSA web site:
http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1059.shtm
And when you get to the security line, DECLARE these items for inspection.

Always carry meds in your carry-on when traveling on a plane.
The airline’s web site has useful information about this. Here are some tips from the airlines and the Transportation Security Administration:

Delta: http://www.delta.com/traveling_checkin/travel_tips/health/before/index.jsp
American: http://www.aa.com/i18n/travelInformation/specialAssistance/planningAhead.jsp
TSA: http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1059.shtm
TSA: http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1374.shtm

If travel involves a country outside the U.S., check the laws for that country.

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Expectations (Oct. 26)
Planning (Oct. 23)

October 26, 2009

Expectations

Before you book a single reservation or finalize anything, it's essential to discuss with all stakeholders exactly what you each envision for the trip. Communicate - don’t assume anything. Discuss the daily itinerary, timeline and hotels. Make sure people understand that there will be handicap accessibility issues, and considerations re Grandma’s stamina. Don’t assume that everyone is on the same page.

Make sure you understand Grandma’s physical, emotional and medical needs by consulting with whomever is most knowledgeable about her issues. You may be unaware of many details that keep her safe and healthy, so don't hesitate to speak to  her doctor and others who know her situation well, to be sure you are up-to-date on everything.

Once you have a good idea of her requirements and limitations, consider everyone’s expectations for the trip and make adjustments as necessary. For instance, is it realistic that you will be able to be up and out of the hotel by 9:00 in the morning? Is it realistic to assume that you won’t have to come back to the hotel until evening? Will Grandma be able to make it up the stairs at Aunt Mary’s house for that party? And how about the bathroom at Aunt Mary’s….. where is it? Always remember that wherever you are planning to go, you should keep the logistics of handicap accessibility in mind. It will make your life – and Grandma’s –easier. And don’t forget another thing: if Grandma’s typical day at home involves little activity, how will she be affected by the sudden physical demands of being on the go? The prospect of so much fun might be exciting, but you don’t want Grandma to overdo and become ill, which would be sad and scary for everyone, and undercut your plans as well.

I decided it would be a good idea to talk with Grandma about our probable itinerary and mutual expectations prior to our trips to California and New York. She had not travelled in several years, and the last time she went away with us, she was more able-bodied. She could easily walk with a walker, go up and down a few stairs, sit in any chair, walk on grass and so forth. She was much more frail now. I expected that we would have to hire an aide or companion for some or all of each trip, since it was unlikely I could be with her 24/7, and I didn’t feel comfortable leaving her alone in a strange hotel room.

For our trip to California, my initial thought (before discussing this with her), was that it would be a comfort to her if the person we hired was her long-time caregiver from home. She would be with us on the plane, and travel with us for the week. Wouldn’t being with someone she already knew and trusted be better than chancing it with a stranger referred to us by an agency in a town where we were strangers?

I was so totally wrong. Grandma didn’t want to be with an aide 24/7 during the trip. In fact, she said, she’d rather stay home. In fact, she said, we’d all be better off if she stayed home. You see, at home, she lived alone. She was used to it, was totally comfortable with the layout of her house, and had a daily routine. Her home health companion worked on a part-time basis, and Grandma was alone on weekends. Somehow, as frail as she was, she managed. She cherished her privacy and enjoyed being with people, but didn’t like the prospect of being with her aide all the time, even though she liked her. We both decided that the best thing would be to hire an aide in California (I will go into details in a subsequent post.). We did the same thing for our wedding the following year in New York City. It worked out well because Grandma had been brought up to speed about our needs and obligations, and appreciated that we were trying to mesh them with her needs and limitations. Our mutual goals were to have a wonderful time at the wedding and to have nothing bad happen.

When considering expectations, don’t forget to include your spouse, siblings, children and other stakeholders, including the event coordinator if you are hosting a wedding or other event. I am fortunate that my husband was adamant about Grandma coming to the wedding, so he was willing to be flexible and accommodating . He and I talked a lot about the trip and had a good idea of what we would be doing: spending time with our children and new family members, picking people up at airports and dropping them off; going to lunches and dinners (some planned by us at our convenience, others organized by others). There would be a lot of meeting and greeting, coming and going, and –hopefully – relaxing a bit, too. We both knew we couldn’t be with Grandma all the time.

When planning your trip, the bottom line is that everyone involved should have a good idea of the others’ expectations, and you should arrive at a consensus for what will be doable and what will not. Our resources and our ability to be somewhat flexible with our schedule allowed us to come up with a plan that would work for us. Everyone’s case is different, and you need to think hard about what will work for you.

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Planning (Oct. 23)

October 23, 2009

Planning

I can’t emphasize enough the importance of planning every single detail of your trip. And I mean EVERY DETAIL. If you want things to go well, you can't rely on luck. We live in Connecticut, and had two kids getting married: one in California, and one in New York City. Bringing Grandma was not just an afternoon out. The first wedding meant travel by plane and a whole week away from home, the other a weekend in the Big Apple. As her loving daughter and primary caregiver, I wanted Grandma to have a wonderful time and be safe. But as the mother of the child being married, I wanted to be able to enjoy myself, too, and remember it as a most happy occasion. Could I get both?

Being a detail freak can make you and everyone around you nuts, but in the end, things should go very, very well.

In future posts i will chat about packing, your flight (what to look for before you book it), going through airport security, arrangements for airport assistance, meds, your driving schedule, what car you rent, caregiving assistance, togetherness issues, what to look for in a hotel, amenities, eating out or bringing in, medical equipment (do you bring it, rent it or will it be there for you?), location and venue issues. There's a lot to think about, and if you do it ahead of time, you will be much happier later!!

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)