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Travel Tips for Elderly and those Requiring Special Assistance

by Lux Joseph 25. April 2014

Traveling for most people is one of the most rewarding experiences, whether it is visiting family and friends or exploring the world.  However, it is important to know that when traveling with individuals who are elderly or may have a particular disability there are some things that need to be considered. If you are not familiar with the resources and guidance available, you may face challenges that you didn’t anticipate. The tips we are about to share with you are important things to remember and will alleviate a lot of unnecessary stress and anxiety.

1.     Consult with the passenger’s primary care physician for travel approval and recommendations

One of the first steps you can do before travel is to make sure the passenger is cleared for travel by his or her primary care physician. A 22 year old healthy individual does not need to do this, but many individuals who are elderly or may have a disability should speak with their physician especially if the passenger is accommodating a current health condition such as dementia, Alzheimer’s disease, COPD, etc. You will want to make sure to ask the doctor about any necessary vaccinations or additional medication that may be needed for travel.

2.     Choosing the flight

If you go to Expedia, Orbitz, or Travelocity and plug in your destination hundreds of potential flights will come up. When traveling with the elderly and those individuals with disabilities you should choose the most direct flights possible. If there are no direct flights to the destination, keep in mind that you will need additional time for connections. Our rule of thumb is at least one (1) hour to two (2) hour connection time for domestic flights. Passengers traveling in a wheelchair may be the first to board the airplane, but typically they are the last to get off. Having a tight connection will add additional unnecessary stress to the traveler.

3.     Arranging special services 

Once the flights have been selected, contact your travel agent to add special services that you may need. If you booked your tickets on a travel website or directly with the airline, you can contact the airline directly. Each airline typically has a special number dedicated for passengers that require special assistance. If not, you can always request these requirements through the main reservation number. There are three different types of wheelchair requests. It is important that you let the agent know the

Wheel-chair for Ramp (WCHR) offers passenger who can ascend/descend steps and make own way to/from cabin seat, but requires wheelchair for distance to/from aircraft across ramp.

Wheelchair for Steps (WCHS) offers passengers who cannot ascend/descend steps, but is able to make own way to/from cabin seat, requires wheelchair for distance to/from aircraft and must be carried up/down steps.

Wheelchair for Cabin (WCHC) offers to passenger who is completely immobile. He requires wheelchair to/from aircraft and must be carried up/down steps and to/from cabin seat. (This device is accompanied to individual aircraft).

Today a lot of airlines have “paid seats” that include seats with extra leg room. After calling the special assistance desk, kindly ask them to assign seats for the passenger. Usually they will also accommodate one guest of the passenger with disability free of charge. Don’t pay for the seats until after you call the special service desk.

4.     Purchase travel insurance 

In an upcoming blog we will go into detail on the importance of purchasing travel insurance. All travelers should have travel insurance if they are traveling anywhere throughout the United States and worldwide. Make sure that the policy you get includes medical evacuation and medical services. A medical escort can cost up to $50,000 depending on where the patient is. An air ambulance will be even more expensive. This is not an expense you want to be paying out of pocket. Contact your travel agent to find the best policy for you. Many individuals think that nothing will happen to them, but if something does it is critical that you have insurance. Commercial Medical Escorts is a member of the US Travel Insurance Association. We encourage you to visit this link for FAQs on travel insurance:

5.      Useful tips for discomfort on the plane

Takeoff and landing of airplanes can sometimes cause uncomfortable sinus and ear pressure. It may also cause nausea. This can be problematic for elders with sinus problems, allergies or even a bad cold. Things like eating chewing gum, candy or a decongestant can help.

Dehydration can also be a concern when flying and can pose problems for seniors, especially those suffering from diabetes. Make sure that your elderly travelers drink plenty of fluids, especially water during the flight.

6.     Pack essential items in a carry-on back that is easily accessible.  

Pack any essential items in a light carry on that is easily accessible. Important things that you should include is medications, important documents and phone numbers, a travel pillow, boarding passes, your photo identification, a light sweater, and a few snacks. This should be in an easily accessible bag that is readily available instead of a roller suitcase.

7.     Choose the right type of transportation 

Keep in mind that every destination has a variety of transportation options for passengers with disabilities. You want to make sure the passenger is comfortable and so a taxi may not always be most appropriate. For example, a passenger may be able to get in/out of a taxi in New York City, but the traffic and how they drive could provide an uncomfortable ride for the passenger. There are wheelchair vans, town cars, limos, and SUVs in most locations. Limos are usually a good choice if the passenger may need to have a leg extended or elevated.

8.     Preventing DVT 

Sitting still for extended periods of time is a known risk factors for the development of blood clots in the veins of the legs. This condition is known as deep vein thrombosis (DVT). Some researchers believe that long-haul flights can be a risk factor in susceptible people.

Suggestions on how to reduce the small risk of DVT while flying include:

·         Consult with your doctor before flying. They may recommend that you take half an aspirin (150mg) on the day of the flight, and you may be advised to use elasticised stockings for the flight. Sometimes a self-administered injection of heparin is required.

·         Wear loose clothing.

·         Don't smoke.

·         Avoid alcoholic drinks and drink plenty of fluids to prevent dehydration.

·         Take strolls up and down the aisles when possible.

·         Avoid sitting with your legs crossed.

·         Perform leg and foot stretches and exercises while seated.

9.     Use A Travel Agent 

Booking your ticket on Expedia or Orbitz may seem easy and just a couple clicks away, but when something goes wrong with your flight, the fast efficient service comes to a halt. You may be forced to stand in long lines to rebook your travel and the agent on the phone or at the counter may not know all of your needs. Using a travel agent for elderly and those with special needs is very important. It gives the passenger a direct contact with someone who is knowledgeable about the passenger’s special needs. If a flight is canceled, they will look for the next best option for the passenger keeping in mind special requirements.

10.  Understand your rights and what is required at TSA 

Most travelers who are elderly or require special assistance can request a wheelchair at check-in. Even if they are traveling with another adult most likely they will be pushed through the airport by a “porter”. In a recent incident an elderly gentlemen was being taken through TSA at Fort Lauderdale Airport and the porter had him taking off his shoes and jacket. It is important for you to know what rules and policies are in place to assist the elderly. TSA has modified their screening procedures so that passengers 75 and older can:

·         Leave on shoes and light jackets through security checkpoints.

·         Undergo an additional pass through Advanced Imaging Technology (AIT) to clear any anomalies detected during screening.

TSA also has a help line to assist those travelers in need. Travelers may call TSA Cares toll free at 1-855-787-2227 prior to traveling with questions about screening policies, procedures and what to expect at the security checkpoint.

CME's Outlook on Hospitality

by Lux Joseph 18. April 2014

Within every industry a company can choose to settle with the status quo, or they can seek to differentiate themselves and be a product of innovation and excellence. Some individuals may classify the medical repatriation field as its own unique industry, but you could also say that our industry is part of a larger vision called “hospitality”.  Hospitality is about being hospitable to your guests or clients. It is about creating that memorable experience, and that is what we aim to achieve at Commercial Medical Escorts. Most people would say that being brought home with a medical escort after an injury or falling ill when you were on your vacation is not an enjoyable memory they want to remember, but at Commercial Medical Escorts our nurses and physicians go above and beyond to make the journey back home safe and comfortable each step of the way. Our bedside to bedside service is designed to take the stress, anxiety, and potential overwhelming process of getting a loved one back home away from the patient or companion and in the hands of our professionally educated logistics coordinators who will put together a smooth transfer.

American Airlines is taking that same approach to their product and delivering excellence in hospitality to each of their travelers. American Airlines believes that they know how to be an airline, and that isn’t what they want to be anymore. They understand that they are part of the hospitality industry and each and every traveler is their guest. Just like each and every patient we transport home is our guest. American Airlines has taken their philosophy of hospitality and applied it to the new designs of their 777-200 planes. What was once the galley that you walked through to get to your seat is now being transformed into a lobby bar. American Airlines doesn’t believe you should be going to your seat like you did before, but now going to your individualized suite that includes a comfortable duvet, a seatback that reminds the traveler of a bed in a luxury hotel. This new look is part of AA/US Airways merger and it is focused on the hotel in the sky (

A design of a product or service is just one part of hospitality and it is important to understand that service and hospitality are not the same. Service is the efficient execution of a series of actions. At Commercial Medical Escorts we deliver a service each and every day. Our service is about efficiently doing what our clients expect. However, hospitality is about doing what is unexpected and personal to your guest in a given moment. American Airlines has implemented new designs and new levels of service, but ultimately their level of hospitality needs to stay in alignment with their service.

Commercial Medical Escorts delivers our product to many assistance companies, hospital case managers, private clients, and hospitals worldwide, but hospitality is not what we do, but how we make others feel. A patient that is transported by CME back home with a nurse escort may not be able to describe the hospitality, but they will know it from the moment the transfer begins. Hospitality will not be found in what our operations staff or medical escorts are doing, but it will be generated in the atmosphere. It is the relationship between the patient and our company. American Airlines hospitality is the relationship between the traveler and AA. The ultimate goal that CME, American Airlines, and other companies in hospitality are striving for is to ensure our customers feel welcome, comfortable, and satisfied.

CBP to Add Additional Workforce

by Lux Joseph 14. April 2014

On every international mission that Commercial Medical Escorts (CME) does, our medical escorts interact with U.S. Customs and Border Protection (CBP). On a daily basis over a million individuals enter the United States and each individual arriving at a port of entry to the USA is subject to inspection by a CBP officer. As you can imagine, each international flight has approximately 200-300 passengers on board and some of these flights arrive to a destination at the same time or within minutes.  The high volume of passengers arriving into port of entries around the USA, does not always align with the right number of CBP officers on staff to handle the demand of screening required. This shortage of appropriate staff can affect travelers significantly and ultimately cause major frustration for frequent travelers and those making a tight connection within the USA.

U.S. Customs and Border Protection has announced it will be hiring 2,000 new officers in the near future. The project was made possible with Congress allocating $255 million to hire these officers. This increase in staff will significantly impact the CBP’s ability to meet the needs at 44 ports across 18 states in the United States of America. This increase in staff is a 10% growth for CBP, and hopefully the addition of new team members will help the department improve the travel and tourism industry. When Commercial Medical Escorts’ travel department looks for the best routing to transport a patient back home connection time is a key factor in consideration especially at hub airports. The cities that are expected to get an increase in CBP offices are Detroit; Buffalo N.Y., Houston; Los Angeles; New York; Dallas; New Orleans; Laredo, Texas; and Nogales, Ariz.

When any company or organization increases their workforce, looking at the areas of improvement is one of the first steps in ensuring the correct allocation of team members. For the U.S. Customs and Border Protection they are looking at delays in certain ports of entry and the time during the day in which it occurs. During our medical escort missions, some escorts have been delayed up to three hours awaiting CBP process screening. Imagine a delay like this and typically connection time is between 2-5 hours for international flights.  CME hopes to see that this increase in CBP officers will be allocated at current international airports that are struggling with handling the volume of travelers that are entering the USA on a given day.

We must understand that the 2,000 additional workforce will be divided between both airports and land ports of entry. Our travel department advised that although the CBP has not indicated how the force will be allocated, the travel industry is fighting for a significant amount to be positioned at airports, at least 1,000 at the gateway airports.

U.S. Travel has set a goal of having 80% of all arriving travelers screened within thirty minutes. Goals within every organization set a benchmark for achievement. This goal helps airports to staff accordingly to meet the metric based on their specific airport volume. The National Center for Risk and Economic Analysis of Terrorism Events, University of South California evaluated that adding a single CBP Officer equates to annual benefits of:

  • $2 million increase in Gross Domestic Product
  • $640,000 saved in opportunity costs
  • 33 jobs added to the economy

It is common knowledge that the current number of CBP Officers is insufficient. Additional CBP Officers will reduce wait times and meet the needs of the travel industry. At Commercial Medical Escorts, we look forward to improvements to processes that improve our medical escort process. 

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