Flying Over 60

Being a traveler over 60 bears more risk, but the rewards are great.

Susan W. travels alone to Madagascar frequently. She feels passionate about the disappearing ecosystem and wants to take as much in while she can. Susan is 77 years old.

There are other motivations for her to make the twenty-four-hour journey too. She told me, “Particularly in Asian and African countries I have traveled in, I have become more visible, which I am appreciating. At a certain age, women tend to become invisible in our country which is dedicated to staying young.”

Susan’s not alone, many people look forward to their retirement years as a chance to seek adventure through travel or knock off a bucket-list destination. The trouble is, travel-related illnesses and mishaps are more likely to happen to travelers over 60.

Long plane flights and active itineraries are stressful for anyone, but for the older adult, they can be dangerous. Blood clots, infections, bone injuries, and life-threatening cardiovascular events like heart attacks and stroke are more likely to occur in the older traveler. The fact is, mosquito-borne diseases and gastrointestinal illnesses in tropical regions, while awful for younger people, can be lethal for those over 60.

It goes without saying, but anyone with chronic medical problems should be extra prepared, and that should include attending to dental health!

A few key precautions will lessen the chances that an older person will spend their vacation in an unfamiliar hospital, emergency room or dentist chair. When I learned that a fellow traveler in Japan last month had suffered a large stroke only six months prior, I was amazed. But, fortune favors the prepared, and he had a marvelous time.

If you’re over 60 and planning a big trip, here’s a preparation timeline and checklist to give you the best chance for a wonderful experience.

3-6 Months Ahead

1. See your doctor. If you haven’t had your Annual Wellness Visit or yearly physical (if you’re between 50-65) in the last calendar year, get it done before you go. If you are being treated for a chronic condition, schedule a follow-up visit. Tell your doctor or nurse practitioner if you are travelling to altitude or will be exerting yourself more than usual on your trip. Obtain refills of all your medication. If you have lung disease, you may need your doctor to order compressed oxygen to fly or reside at altitude (>5000ft). If you have frequent urinary tract infections, ask your doctor to get you a short supply of antibiotics to bring with you just in case. If you have heart disease, obtain a copy of your latest ECG (electrocardiogram).
2. See your dentist. Make sure you have every little twinge or cold sensitivity checked out before you leave. Who wants to visit a dentist in a foreign country? Given that root canal is often prescribed for dental problems over age fifty, give yourself plenty of time before a planned trip to attend to your teeth!
3. Commit to a fitness regimen that includes strength training. This is especially important if the trip will involve hiking or biking, but is also a safeguard against falls in any situation.
4. Buy Travel Insurance. It’s not inexpensive but could be life-saving. Susan W. says she always purchases it when she travels now. First and foremost, travel insurance should include medical evacuation. Because many policies require that you purchase them around the time you make a deposit on your trip, attend to travel insurance while you are booking. Check out this helpful guide.
5. Contact your airline if you’ll need special assistance in the Terminal, like a wheelchair or help getting through security. All airlines are required to provide medical assistance, but some have special add-on services for older travelers, and there are also third party concierge services. This is an excellent blog post about airport navigation for a solo elderly traveler.

1 Month Ahead

1. Update your Advance Health Care Directive. Make sure your Health Care Power of Attorney (POA-HC) is designated. If you are traveling with your POA-HC, specify a back-up emergency contact, and make sure they are listed as a back-up power of attorney. Remember, car accidents are one of the biggest causes of injury and death while traveling, so wear your seat belt and carry a copy of your Directive.
2. Create a Medication Card with a list of all your medications and doses. Be sure to use the generic name, not the brand name for each medicine as the brand names may different abroad. Consider having it laminated at a FedEx Kinkos store or Office Max. Put it in your wallet or passport holder.
3. As stated above, if you have heart disease, it’s a good idea to obtain a copy of your most recent electrocardiogram. Fold it up and bring it with you. A doctor you see may thank you.
4. Visit a Travel Specialty Clinic if you are visiting the tropics or a developing country to get the required vaccines. Some of them must be given at least two weeks in advance. You may also be offered preventative medicine for malaria and traveler’s diarrhea. If you will be traveling or hiking above 8,000 ft, ask about whether you should take acetazolamide (Diamox) for high altitude sickness.
5. Start wearing any shoes you’ve purchased for your trip to make sure they don’t make any foot, knee, hip or back pain worse!
6. Think about buying and using a walking stick if walking or hiking more than five miles per day is part of your itinerary.

One Week Ahead

1. Make sure you have enough medication for your trip plus a few days in case of delays or missed flights.
2. Buy compression socks if you don’t already own some. They help a lot by reducing swelling in the lower legs on long car and airplane rides and one review of studies showed they helped prevent DVT (deep venous thrombosis).

Days Ahead

1. Start to drink a lot of water if you are expecting to be on the airplane for six hours or more. Consider avoiding alcohol up to 48 hours before traveling.
2. The conventional wisdom has been to take a baby aspirin (81 mg) a day ahead to prevent DVT, but one review of the scientific literature showed aspirin does not show evidence of preventing blood clots related to travel.

In-Flight

After you put on your compression socks, drink plenty of water or other non-alcoholic liquids. After taking your seat, be sure to get up at least once every two hours of the flight and walk the aisle or do these exercises to prevent blood clots and keep your joints from getting stiff.

After Landing

Jet lag is the bane of a traveler’s experience. Susan admits it’s much harder to adjust her body clock than it used to be. While many people use sleep aids to get them through long plane rides or sleepless first nights, older travelers are also prone to reactions associated with sleep aids (eg. Benadryl (diphenhydramine) or Ambien (zolpidem)/Lunesta (eszopiclone) ). If you need to take something, most sleep experts recommend a small dose of melatonin (0.5mg) in the early days of a trip and upon return. Note: Melatonin, a brain hormone is not well studied or regulated.

However, some people should not take melatonin at all, like those on blood thinners, seizure medications or immunosuppressant drugs. Another complication of travel for seniors can be constipation. Researchers wonder but have not established whether melatonin might help with traveler’s constipation too.

Pay Offs

Traveling can be essential for older adults who can pull it off. Admittedly, it takes more work to plan a big trip for those past age 60 or who have chronic medical conditions. However, the rewards are vast and unpredictable. Aside from the pleasure it brings to the visitor, resource-starved/stressed destinations may find unexpected gifts from the older traveler with some moxie and means. As Susan wrote to me in an email:

So, use this guide to get out in the world. It might do more for you and the places you visit than you imagine.