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GENERAL PRINCIPLES

  1. Some older adults may face barriers to safe travel due to multimorbidity, functional issues, cognitive impairment, or medication management difficulties.

  2. While older adults and their caregivers often seek pretravel advice from physicians and other health professionals, most clinicians have received no formal training about preparing patients for travel.

  3. Exacerbation of chronic illness is a major risk for any traveler, and older travelers are particularly vulnerable to this phenomenon. Clinicians should provide anticipatory guidance to help travelers prepare, with advice focused on projected challenges based on health conditions and function.

  4. Health professionals should learn about resources that can help with clinical decision making, if assisting in medical emergencies during travel.

OVERVIEW OF TRAVEL CHALLENGES

Travel, for leisure and social connection, is aspirational for many older adults, particularly with an increase in flexible time during retirement. For even the most experienced traveler, travel requires significant preparation. For older adults with multimorbidity, functional challenges, or cognitive impairment, travel preparation may be extensive and overwhelming. Unfortunately, medical education does not train clinicians to prepare older adults for safe travel, and little data exist about the best methods to prepare older adults for travel in order to mitigate risks or health hazards.

Booking travel and navigating technology for trip planning are just the first of several hurdles faced by travelers. Older adults may have to consider additional trip preparation steps that include securing accommodations for disabilities, organizing medical management needs during the trip, gathering and packing all necessary equipment (eg, walker, oxygen, medications, medical documents), accessing hubs of transit (eg, airports, train stations, cruise docks), and considering destination challenges (eg, unfamiliar medical systems, limited access to health care, limited accessibility for those with disabilities, climate differences, food safety issues, time zone changes).

Most people have experienced the stress of navigating a busy airport, transporting luggage, and finding a gate on time. For people with cognitive impairment, travel is particularly challenging, as unfamiliar environments and jet lag can precipitate delirium. For people with extra equipment needs, such as walkers, portable oxygen, and medical devices, travel can feel particularly burdensome, as they arrange for transport of these devices and navigate unfamiliar environments. For many older adults, travel preparation is far more complicated, and their health risks can be amplified.

RESOURCES FOR TRAVEL PREPARATION

Resources for travelers and clinicians lack guidance for most geriatric issues but are useful for preparing for country-specific risks, such as pretravel vaccinations or possible safety issues. In the United States, the Department of State maintains a helpful international travel resource (http://www.travel.state.gov), in which travelers can search information by destination country and seek information on international health care coverage. Additionally, US citizens and nationals can sign up for the Smart Traveler Enrollment Program (STEP) to receive updates about the destination country and to identify oneself to an embassy in case ...

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