If you use a wheelchair, or have some difficulty with mobility, travel can present some fairly unique challenges. It should come as no surprise then, that a little bit of good planning goes a long way. Planning can minimize many of the hassles and risks of travel, meaning that you have more time to enjoy yourself.
Where do I start?
Plan well in advance. If you are intending to travel overseas, a number of travel agents now specialize in assisting people with disabilities. They will be able to advise you regarding accessible hotels/motels, tourist attractions, and tours.
The World Wide Web (or internet) is also an enormous resource for gathering this information. (If you do not have access to the internet at home, try your local library.)
The Paraplegic and Quadriplegic Association of Queensland Information Service are another valuable resource. Many members of the association travel on a regular basis, and may be able to provide useful first hand information.
Don’t forget that you will need a passport for any overseas travel,and some countries require an entry visa. Your travel agent will be able to advise you of any special requirements.
When booking flights, accommodation or tours, communicate your specific needs very clearly, and in layman’s terms.
- Don’t assume that the person that you are talking tounderstands what it means to have paraplegia or quadriplegia.
- The word ‘accessible’ means different things to differentpeople — make sure that the person you are talking tounderstands what you mean by accessible. Ask if there aresteps, or if there is a ledge or step in the shower recess.
Make sure that you have travel insurance and that your equipment (e.g. wheelchair) is covered also.
Ensure that you have adequate supplies of your regular medication.
- A letter from your family doctor, outlining your regularmedications will be useful.
- Some prescription medications may be difficult to obtain insome countries, and some may even be illegal.
- It is also useful to travel with a complete course of the antibiotics that you most regularly take for bladder infections.
- See your doctor before you leave, and have the prescription filled before you leave home.
Ensure that you have adequate supplies of any consumable itemssuch as catheters, airdromes, drainage bags or bluesy. Have a few in reserves in case you are stuck somewhere a day or two longer than anticipated.
- Take a spare cushion cover so you can have one in the wash.
Take a spare tyre and tube for your wheelchair in case you get a flat. Better still consider having solid tyres put on your chair, so that punctures are impossible. Some people even like to travel with a spare axle.
Always investigate the climate of the country you are intending tovisit. This will assist you in planning for any problems if you have difficulty controlling your body temperature.
Talk to someone who is an experienced traveler— first handaccounts are invaluable.
Travel by Car
You should endeavor to relieve pressure every 100km, or every hour, whichever comes first. You will need to do this whether you are passenger or driver.
- Pressure relief can be achieved by pressure lifts or by leaningfrom side to side to remove pressure from the Ischia tuberosities.
If possible, you should use a pressure-relieving device for addedinsurance. A pressure-relieving cushion can be used, but many peoplefind that this sits them up too high in the car.
- If you use a Jay cushion, the fluid pad may be removed fromthe base and used alone to provide some protection.
- A piece of Velcro the same width as the base can be used tohelp maintain the shape of the pad.
- If you don’t wish to use a cushion in the car, a sheepskin will alsooffer some protection. Cushions or sheepskins are not asubstitute for regular pressure relief.
You should always wear shoes and socks when in a car. The floors of some older cars can heat up, causing burns to feet.
- If you are in the car for a long period, you should repositionyour feet from time to time also.
Take care not to have your feet directly under heating vents — hot air can also cause skin burns.
Be wary if the car has been sitting in the sun.
- Seat upholstery, belt buckles and other surfaces can hold a considerable amount of heat. If these surfaces come intocontact with your skin, burns can occur.
If you are travelling long distances in hot conditions, make sure that you drink plenty of fluids (water is best).
Brisbane City Council now operates wheelchair accessible buses onsome routes, with plans to expand the service and size of the accessible fleet over coming years. Contact them directly for details.
Queensland Rail is very conscious of the needs of passengers who have disabilities.
- Not all stations in the CityTrain Network are accessible, but abrochure is available detailing facilities available for passengersat all suburban and city stations.
- Trains are accessible by ramp, and Queensland Rail staff aretrained in how to assist passengers who use wheelchairs.
Accessible taxis are available in all Australian capital cities and most large regional centres. Contact local taxi companies for details.
1. Check in and transfers…
When you are checking your baggage, ask that you be allowed to remain in your wheelchair until boarding time. This will allow you to go to the bathroom before boarding, and means you can stay sitting on your cushion for as long as possible.
When checking in, also ask to be seated on an aisle where the armrest is removable – this will mean a safer, easier transfer when you are getting on and off the plane.
You will be first on the plane and last off. This can mean an extrahour or more on the plane, in addition to the flight time, so it is usually advisable to visit the bathroom before boarding.
Your wheelchair should be labeledwith a ‘gate check’ tag as well as the regular luggage destination tag. This will ensure that it is brought to the door of the plane at your destination, instead of being unloaded with the rest of the baggage. Ask for this at check-in also. Your wheelchair will travel in the hold.
At the door of the plane, you will have to transfer into an ‘aisle chair’. This is a narrow chair designed to fit up the aisle of the plane.
- If you require assistance to transfer, airline staff will beavailable to assist you.
- Make airline staff aware if you have difficulty balancing — theymay need to strap you in or have someone (maybe your travellingpartner) stay close by as you move down the aisle.
Always take your wheelchair cushion on board the plane with you, even if you don’t intend to sit on it. Parts of your wheelchair that are easily detached can be easily lost. If unsure, remove it and take it on board too (quick release wheels excluded).
Take care if you have to transfer or be lifted over the top of anarmrest when getting into your seat. Skin damage can occur if you aren’t careful.
If you use a power drive wheelchair, airline staff may enquire as tothe type of batteries the chair uses. For safe travel, all batteries must be a sealed variety. These are standard on most modern wheelchairs — if in doubt, check with the wheelchair supplier before you depart.
2. During the flight…
If you use a pressure-relieving cushion, it may be advisable for you to sit on it if the flight is longer than a couple of hours.
- If you use a Jay cushion, you can sit on the cushion as it is, orremove the fluid pad as described in the Car Travel section.
- If you use a Roho cushion, be aware that even in a pressurized cabin, the inflation of your cushion will change with altitude. Asthe plane ascends the cushion will seem to inflate and as youdescend, the reverse will occur. It is advisable to take yourpump on board to make the necessary adjustments. Wait untilthe plane has reached it’s cruising altitude before making anyadjustments. You will have to readjust when you land.
- On long flights, relieve pressure by lifting or leaning on aregular basis. Leaning forwards is also a useful way of relievingpressure.
Remember that your legs may swell during long flights.
- This can cause pressure problems in shoes and under leg bagstraps. Check this regularly during the flight, and elevate yourlegs at regular intervals if at all possible.
- Some people wear support stockings or use bandages to minimize swelling.
Managing your bladder on long flights…
If you have an in-dwelling catheter or use aurodome or other collecting device, management is relatively simple.
- Simply carry a 2 liter screw top plastic bottle in a small bag toempty the contents of your leg/drainage bag.
- Place a small amount of disinfectant in the bottom of the bottle,and carry some disposable hand wipes to clean your handsafterwards.
- If the bottle is full, your travelling companion can simply emptyit into the toilet.
- In-flight staff are not permitted to do this for you, for hygiene reasons.
If you perform intermittent self-catheterization, the duration ofthe flight is important. As you will be first on the plane and last off, it is advisable to visit the bathroom just before boarding time. For short duration flights, this will probably be sufficient.
For flights of longer duration, there are number of options available toyou:
- An in-dwelling catheter can be inserted for the duration of theflight, and removed once you have arrived at your destination.
– You can be shown how to perform this procedure yourself.
– While some people prefer this method, many find that it can upset their normal bladder routine, causing problems fora couple of days once removed.
- On large planes (e.g. 747’s, 777’s, A320’s), there is usually onetoilet that is reasonably accessible, having a door that swings open,rather than folding in the centre like other toilet doors.
– A collapsible aisle chair should be available on these flights, allowing you to travel to the toilet if you desire (you should check that there is one on-board before departure if you intend to use it).
– You will then have to transfer from the aisle chair onto thetoilet, and this may be a difficult transfer for some people.
– If you are travelling alone, in-flight staff can assist you in getting to the toilet.
- Another option is to perform your ICSC in your seat on the plane.
– If you are going to empty your bladder in this manner, it may be of benefit to request a window seat, so that you have greater privacy.
– If you have a travelling companion, this can usually beperformed discreetly behind a newspaper or under a blanket.
– It will usually be easier to urinate directly into a plastic bottle rather than the usual plastic bag, as these are more difficult to handle in such a confined space.
– Once again, your travelling companion will be able to empty the bottle as required.
– Some flights can be as long as 14 to 15 hours, so you mayhave to perform this procedure 2 or 3 times.
How to manage your bowels on long flights…
If your are travelling to destinations such as Europe or the USA/Canada, combined flight times can be as long as 36 hours.
As most people perform their bowel routine every 2 days, this should not represent a great change from normal.
It is advisable to perform your routine on the morning of your departure.
- This may mean performing your routine at home on 2 consecutive daysat home, giving you as long as 3 days before you should have to go173again.
- If you are concerned at having to wait so long, it may be of benefit toarrange an overnight stopover half way.
- You can also ask your family doctor to prescribe something such asLomotil to reduce the likelihood of any accidents.
If you require a shower commode to go to the toilet, it is probablybest if you take a padded collapsible one from home.
- If you sit directly on the toilet, make sure that you take someportable toilet seat padding, such as Jiffy Biffy Pads(manufactured by Otto Bock).
3. When you have reached your destination…
International car hire companies, such as Hertz and Avis will offer rental vehicles with hand controls at most major destinations. You should not have to pay any extra for this service, but should organizeit well in advance.
An alternative to this is to travel with your own portable hand controls, which are easily fitted to any hire car. Your occupational therapist will be able to advise you regarding suppliers of these devices.
Some other considerations…
Take adequate supplies of your regular medications in your carryon baggage —you will need these during long flights.
Packing is one of the keys to successful travel. Seal any bottles or tubes containing liquid/fluid in plastic bags — if a leak occurs, it effectsother items in your bag.
If you are taking a shower commode, remove any easily detached parts, and place them in your bag.
- Collapse the chair and tape it securely together.
- Protect any seat or backrest padding with cardboard so that it is notdamaged in transit.
- Attach a ‘fragile’ label.