A terminal diagnosis often brings with it a renewed sense of urgency about one’s life.
Patients may feel a strong desire to make the most of the time they have left. This might include visiting family members across the country. For some it means catching up with old friends at one last high school reunion. Still others might wish to see a favorite vacation spot one more time or check off a few items from their “bucket” list.
These are just a few reasons someone may want to travel as they approach their final days. Many families try to schedule something soon after the diagnosis, while the patient still feels well enough to travel.
In many cases, it is possible to plan a fun and memorable experience while accommodating your loved one’s needs. For starters, always make sure appropriate medical care will be available at your destination. If you will be traveling by plane, familiarize yourself with special considerations for passengers with serious medical conditions. Finally, patients who are in hospice can usually continue their care while visiting a different city.
Before Your Trip
Check with your loved one’s doctor to make sure it’s safe for them to travel. Ask what to do in case of emergency or if their condition worsens while away from home.
Research your destination ahead of time. Is there an emergency room or urgent care center close by? Are vaccinations required before traveling to the area? Take a copy of the patient’s medical records with you in case an out-of-town physician needs to see them.
Prioritize comfort and accessibility when making travel plans. Will your loved one need assistance getting on and off a plane or bus? Will their hotel room be accessible? Will you be able to keep all medications at the appropriate temperature? Will you be able to bring along supplies like oxygen or syringes?
Be prepared to change plans in case your loved one’s condition changes unexpectedly. Think about different modes of transportation such as a road trip versus air travel. If the patient’s condition is deteriorating, consider a shorter trip or invite family and friends to visit them instead.
During Your Trip
There are many ways you can help your loved one stay safe and comfortable during your travels.
First, think about the patient’s energy level. They may have periods of fatigue or exhaustion as their condition progresses. One way to deal with this to allow plenty of time to rest between planned activities. Include non-strenuous outings, such as watching a theater perfomance instead of hiking up a mountain. Purchase plenty of bottled water to keep them hydrated.
Keep all medications close at hand at all times, always stored in the original containers. When traveling by air, place them in carry-on bags, not checked luggage. Make sure you have enough for the duration of the trip, plus an extra supply in case of delays. Take along a letter from their doctor that documents the need for syringes or needles.
Your loved one may have a compromised immune system, which makes them more susceptible to infections. Wash hands frequently and bring along hand sanitizer in case running water is not readily available. Carry disinfecting wipes to clean surfaces such as airline tray tables and hotel room door handles.
People receiving chemotherapy and other medical treatments may be more vulnerable to sunburn. If you are going to the beach or another sunny destination, bring along plenty of sunscreen with an SPF of at least 30. Reapply every few hours and immediately after swimming. Have your loved one wear a wide-brimmed hat and light, protective clothing when the sun is out.
Never hesitate to call your loved one’s primary health provider if they don’t feel well or if you have questions.
Air Travel and Serious Illness
If you will be traveling by plane, contact the airline about providing a more comfortable experience for your loved one. Noisy, crowded airports can be unsettling for someone who isn’t feeling well, so planning ahead can help to reduce stress levels and lower the risk of picking up an infection.
The Air Carrier Access Act of 1986 actually prohibits discrimination against airline passengers on the basis of disability or medical condition. Be sure to review TSA screening policies for travelers with disabilities or special medical needs. Check with the airline to arrange for accommodations such as a wheelchair, early boarding or seats with extra leg room.
As noted above, medications should be kept in their original containers and placed in a carry-on bag. Obtain a letter from your loved one’s doctor confirming their need for medical supplies such as oxygen or syringes.
Effects of Flight on the Body
Even for healthy individuals, flying in an airplane has physiological effects on the body. These symptoms can be more uncomfortable for people with serious medical conditions such as brain tumors or heart problems. Flying also lowers oxygen levels in the blood, so some patients may need supplemental oxygen even if they don’t in other situations. Wearing loose-fitting clothing and staying hydrated are good ways to increase comfort.
Sitting for long periods of time may raise the risk of blood clots, so encourage your loved one to get up about once per hour during a long flight. Do seated exercises together, such as flexing and then relaxing your ankles. Choose an aisle seat for your loved one if possible to allow a little more room to move around.
If your loved one has a compromised immune system, consider having them wear a face mask. Use hand sanitizer before eating any in-flight snacks, and use disinfecting wipes to clean off seatbelt buckles and tray tables.
Health Conditions that May Preclude Air Travel
There are few health conditions that would prohibit someone from flying, but there are some that do.
For example, it’s best to delay air travel after having surgery or other medical procedures. Make sure your loved one’s incisions are completely healed and all drains removed. Approximate wait times include about 10 days after a colonoscopy, 2 to 4 weeks after chest surgery, 6 weeks after brain surgery and 2 weeks after most other surgeries. Of course you’ll want to talk to the patient’s doctor for a more personalized recommendation.
There are other conditions that may preclude air travel depending upon their severity. These may include oxygen needs of greater than 4 liters per minute, unstable angina, valvular heart disease or a gastrointestinal obstruction.
For patients who are receiving chemotherapy, decisions about flying are made on a case-by-case basis. A lot depends on the patient’s individual regimen and side effects. Other considerations include their individual risk of infection, red blood cell count and risk of bleeding.
Hospice Care While Traveling
In most cases, patients receiving hospice services can arrange to continue their care while traveling. Under the Medicare Modernization Act of 2003, most patients receiving the Medicare Hospice Benefit are eligible to use another Medicare-certified hospice at their destination.
Contact your loved one’s hospice agency, also known as their managing hospice provider, to let them know about your travel plans. Their managing hospice will identify a qualifying agency in your destination area, in consultation with the patient’s attending physician. The hospice providing temporary care in your destination city is referred to as your contracted hospice provider.
Contact your contracted hospice when you arrive at your destination. They will provide the same services your loved one receives from their managing provider. This includes medical care, nursing care, personal care assistance, social services and spiritual support.
If you or a loved one is receiving hospice care and would like to travel, please contact us at Crown Hospice. We will answer your questions about finding suitable care while away from home so you can enjoy a safe and memorable experience.
Feel free to call us at 361-575-5900 or contact us online at any time.