How to Select a Hotel

Know what your needs are, ask a lot of questions, and don’t assume anything. Try to ensure that you're dealing with someone at the reservation desk who knows the facts, and is not just guessing. What you find out will determine whether or not Grandma will be able to use the toilet herself or take a shower. Or eat. All hotels are not the same.

Book your reservation well in advance, since hotels have a limited number of handicap-accessible rooms, and not all of them are alike. Make sure the one you reserve has the amenities you need.

Here are some issues to consider in choosing a hotel:

Are there steps required to get into the building?

Where is your room located?
We stayed at one hotel that had some of their handicap-accessible rooms at the rear of the property. The room was lovely, but was adjacent to a railroad crossing. We were awakened every 2 or 3 hours by the loud blast of a train. Guests located elsewhere were not bothered by this.

Is there an elevator? How far is it from the room?

Is it safe for your loved one to have her own room?
What if she needs to go to the bathroom in the middle of the night (or anytime), or wants to retrieve something from the dresser? Is there a great risk of falling? Is she easily disoriented or have a mental impairment that would preclude her staying alone? (Don't forget, she won't be in an environment that's familiar to her.) If so, it might be best for you to share a room with her or have a paid caregiver do so. Ask the reservation agent about the configuration of beds in the room. Don't assume handicapped-accessible rooms have two beds! In my experience, most don't. And bring eyeshades and earplugs for both of you. They work great!

If you decide that Grandma can have her own room and you'll book the room next door, don't assume the rooms are connecting, with a door you can leave open between them. Check it out!

About the bathroom:
Most accessible rooms have low toilets with metal bars to hang on to. This is not adequate for my mom. She needs a higher seat or she can't get up by herself. Does the hotel have a raised toilet seat it can reserve for you? (Make sure you're talking to someone KNOWLEDGEABLE.) If they have one, ask if it's possible for someone to personally go look at it and call you back with a description. Many raised seats do not have arms, and if you're loved one is very frail, that will not do. The bottom line is, if you expect that Grandma will be going to the bathroom herself, you must evaluate her needs and ensure they are provided for. You don't want her to fall!

If the hotel doesn't own a raised seat, tell them they SHOULD have one, and ask if they can purchase one for their inventory. It would be a very useful amenity for future guests, as well. (Don't be afraid to ask. At the minimum, you are raising awareness, and you just might get them thinking about buying one or two for their stock!) The best kind is one with arms. (See photo below. This is actually a commode, but the pot is removable, so the item can be placed right over the toilet. It is a great thing to have, since it can be used over the toilet or on its own as a commode next to the bed.)

Do your research – familiarize yourself with the various styles, so that you'll be able to visualize what the hotel is telling you it has in its inventory. If it's not appropriate for your needs, ask if there's a rental company in the area that can deliver one to your room. If it appears that the hotel cannot or will not arrange for an appropriate seat, it is advisable that you bring one with you or stay somewhere else.

Is there a walk-in shower with a hand-held shower head, and is there a bath bench? Grandma has to be able to get in and out of the shower easily and safely. Don’t assume all handicap rooms have walk-in showers. They don’t.


Is there a restaurant or other source of meals in the hotel?
Will it necessitate going outside or climbing stairs? I was initially skeptical about staying at a certain hotel in New York City, because it didn’t have a restaurant. After looking into it, I found there was a lovely European breakfast buffet in the lobby each morning, and wine and cheese in the afternoon – all at no extra charge. Grandma loved it, and so did I. If it's necessary to go out for meals, where is the nearest restaurant – and is IT handicap-accessible? How close is it to the hotel, what are its hours and what kind of food does it serve? Don’t forget that taking a cab to a restaurant is costly, inconvenient and could be difficult for your loved one.

Does the room come with a refrigerator?
If not, some hotels have a few on reserve for guests who ask for one. I found this to be the case with one of our hotels, so I reserved a fridge at the time I made the reservation. When we checked in, it was already in the room and cooling nicely. (If it turns out that you can't get one, and you have meds that require refrigeration, bring a cooler with a double supply of ice packs, and make sure the hotel is willing to keep the extra packs in the hotel freezer for you - and that no one will toss them out. If you do this, you will always have a supply of frozen packs. If the hotel won't do this, stay somewhere else!)

Does the hotel have a wheelchair?
If yes, ask if it needs to be reserved and if it can be used outside the hotel (probably not). There could be a lot of walking from the room to the lobby, and you don’t want Grandma using up all her energy before she even leaves the hotel! You may even want to consider renting or bringing a lightweight (16 - 20 pounds) wheelchair from home. The chair shown below is called a transport chair. It folds up easily and is lightweight enough so that it can be taken around town in the car or in a taxi cab.

Hospitality rooms or suites
If  you are hosting a wedding or other event where other family members and friends will be staying in the same hotel, you might want to research whether or not the hotel offers a room where you can all gather and socialize, with or without food. A suite may be a real splurge, but in certain cases it could be a lifesaver. When one of our kids got married in New York City, I stayed in a handicap-accessible room with Mom, and my husband stayed in a small suite down the hall. We had several casual suppers with other family members in my husband's room, sitting around a coffee table, enjoying pizza and Thai food, which someone had gotten from a restaurant down the street. It was fun and low key, and enabled Grandma and me and the rest of the family (including our new inlaws!) to relax and hang out together, without going to a restaurant.

Bring a nightlight!

Two hotels that were very responsive to my requests:
In New York City: Hotel Giraffe http://www.hotelgiraffe.com/
In Marina del Rey (Los Angeles area): 
      Marina del Rey Marriott http://www.marriott.com/hotels/travel/laxmb-marina-del-rey-marriott/

In the end, if the hotel you are considering can’t provide you with the type of accessibility needed, go somewhere else if possible. The point is, do your research in advance, come prepared, and don’t assume anything!

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)
Planning (Oct. 23)

Meds, Meds, Meds

There is nothing more important than having a handle on Grandma's meds.

Make a list.
Be sure it’s complete, including dosage schedule. Make sure the list is accurate and up-to-date. If there’s any question, call the doctor(s) to make sure. If something happens and you have to take Grandma to the hospital, they'll ask to see the list. (Make sure you get it back from them!) . Keep the list in your or Grandma’s wallet, and make a copy to keep in the suitcase.

Pill Organizers
Chances are, if Grandma takes a lot of pills (and many people do), she already has a pill organizer. She may take pills on specific days, and at specific times during the day. If your trip is just for a day or two, you may get away with using the organizer Grandma already owns. But if you’ll be away for several days or more, purchase an additional one. Take one with you, and leave the other home so she'll have her meds all ready when she returns. Remember - Grandma may feel exhausted and a bit disoriented for a day or two after she returns, so it will be nice having her pills organized and ready.

Our Grandma takes pills at different times during the day, so the pill organizer shown below is perfect. Seven "strips," each for a day of the week, are contained in a plastic base. If she wants, she can remove a single strip and carry it in her  handbag in case she's away from the hotel all day. (By the way, I would make sure that the pills are put away, and not left lying on the counter or on the dresser in the hotel room.)

In case you can't see the detail in the photo above, each strip is labeled with the time of day: morn, noon, eve, bed.

Count out enough meds for the trip and the first few days back.
DO THIS SEVERAL DAYS OR A WEEK OR MORE before leaving, so that if you need to reorder, there's time to get the refills through the mail or from your local pharmacy. (Even if you use a local pharmacy, be aware that sometimes they run low on a particular med and have to order more!)

Once you know Grandma has all her meds in hand, help her load her pill organizer. It may or may not be necessary to actually do it for her, but I suggest being there, since this is something outside the routine, and she may become frustrated or nervous about it.

Refrigeration of Meds
Find out whether any of the meds require refrigeration. If they do, you should carry them in a size-appropriate, fabric-sided cooler, with one or more FROZEN freezer packs (whatever number it takes to keep the medication cold, plus extras). Freezer packs stay frozen for about a day. So if your trip is longer than that, you'll have to ensure that a refrigerator will be available to you. On one of my trips, our hotel did not have mini-fridges in the room, but the staff was happy to store the extra packs in the hotel freezer. (I had brought along two, so I could switch them out as needed.) We kept the medication in the cooler for the entire week, changing out freezer packs as needed. And I made sure there was a frozen pack ready for the day of travel home. (I just needed one, but your needs might be different!)

Sometimes a hotel does not routinely provide refrigerators in the rooms, but will deliver one to you upon request. One of my hotels had only 2 or 3 available, so I was glad I remembered to ask for one when I booked the room. When we checked in, it was in the room, all set up and fully cool.

Meds Other Than Pills
If your loved one takes an injectable drug or something other than a pill, find out whether or not it requires special permission for carrying through security at the airport, etc. Speak to someone at the airline, or research the TSA web site:
http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1059.shtm
And when you get to the security line, DECLARE these items for inspection.

Always carry meds in your carry-on when traveling on a plane.
The airline’s web site has useful information about this. Here are some tips from the airlines and the Transportation Security Administration:

Delta: http://www.delta.com/traveling_checkin/travel_tips/health/before/index.jsp
American: http://www.aa.com/i18n/travelInformation/specialAssistance/planningAhead.jsp
TSA: http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1059.shtm
TSA: http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1374.shtm

If travel involves a country outside the U.S., check the laws for that country.

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Expectations (Oct. 26)
Planning (Oct. 23)

Expectations

Before you book a single reservation or finalize anything, it's essential to discuss with all stakeholders exactly what you each envision for the trip. Communicate - don’t assume anything. Discuss the daily itinerary, timeline and hotels. Make sure people understand that there will be handicap accessibility issues, and considerations re Grandma’s stamina. Don’t assume that everyone is on the same page.

Make sure you understand Grandma’s physical, emotional and medical needs by consulting with whomever is most knowledgeable about her issues. You may be unaware of many details that keep her safe and healthy, so don't hesitate to speak to  her doctor and others who know her situation well, to be sure you are up-to-date on everything.

Once you have a good idea of her requirements and limitations, consider everyone’s expectations for the trip and make adjustments as necessary. For instance, is it realistic that you will be able to be up and out of the hotel by 9:00 in the morning? Is it realistic to assume that you won’t have to come back to the hotel until evening? Will Grandma be able to make it up the stairs at Aunt Mary’s house for that party? And how about the bathroom at Aunt Mary’s….. where is it? Always remember that wherever you are planning to go, you should keep the logistics of handicap accessibility in mind. It will make your life – and Grandma’s –easier. And don’t forget another thing: if Grandma’s typical day at home involves little activity, how will she be affected by the sudden physical demands of being on the go? The prospect of so much fun might be exciting, but you don’t want Grandma to overdo and become ill, which would be sad and scary for everyone, and undercut your plans as well.

I decided it would be a good idea to talk with Grandma about our probable itinerary and mutual expectations prior to our trips to California and New York. She had not travelled in several years, and the last time she went away with us, she was more able-bodied. She could easily walk with a walker, go up and down a few stairs, sit in any chair, walk on grass and so forth. She was much more frail now. I expected that we would have to hire an aide or companion for some or all of each trip, since it was unlikely I could be with her 24/7, and I didn’t feel comfortable leaving her alone in a strange hotel room.

For our trip to California, my initial thought (before discussing this with her), was that it would be a comfort to her if the person we hired was her long-time caregiver from home. She would be with us on the plane, and travel with us for the week. Wouldn’t being with someone she already knew and trusted be better than chancing it with a stranger referred to us by an agency in a town where we were strangers?

I was so totally wrong. Grandma didn’t want to be with an aide 24/7 during the trip. In fact, she said, she’d rather stay home. In fact, she said, we’d all be better off if she stayed home. You see, at home, she lived alone. She was used to it, was totally comfortable with the layout of her house, and had a daily routine. Her home health companion worked on a part-time basis, and Grandma was alone on weekends. Somehow, as frail as she was, she managed. She cherished her privacy and enjoyed being with people, but didn’t like the prospect of being with her aide all the time, even though she liked her. We both decided that the best thing would be to hire an aide in California (I will go into details in a subsequent post.). We did the same thing for our wedding the following year in New York City. It worked out well because Grandma had been brought up to speed about our needs and obligations, and appreciated that we were trying to mesh them with her needs and limitations. Our mutual goals were to have a wonderful time at the wedding and to have nothing bad happen.

When considering expectations, don’t forget to include your spouse, siblings, children and other stakeholders, including the event coordinator if you are hosting a wedding or other event. I am fortunate that my husband was adamant about Grandma coming to the wedding, so he was willing to be flexible and accommodating . He and I talked a lot about the trip and had a good idea of what we would be doing: spending time with our children and new family members, picking people up at airports and dropping them off; going to lunches and dinners (some planned by us at our convenience, others organized by others). There would be a lot of meeting and greeting, coming and going, and –hopefully – relaxing a bit, too. We both knew we couldn’t be with Grandma all the time.

When planning your trip, the bottom line is that everyone involved should have a good idea of the others’ expectations, and you should arrive at a consensus for what will be doable and what will not. Our resources and our ability to be somewhat flexible with our schedule allowed us to come up with a plan that would work for us. Everyone’s case is different, and you need to think hard about what will work for you.

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Planning (Oct. 23)

Planning

I can’t emphasize enough the importance of planning every single detail of your trip. And I mean EVERY DETAIL. If you want things to go well, you can't rely on luck. We live in Connecticut, and had two kids getting married: one in California, and one in New York City. Bringing Grandma was not just an afternoon out. The first wedding meant travel by plane and a whole week away from home, the other a weekend in the Big Apple. As her loving daughter and primary caregiver, I wanted Grandma to have a wonderful time and be safe. But as the mother of the child being married, I wanted to be able to enjoy myself, too, and remember it as a most happy occasion. Could I get both?

Being a detail freak can make you and everyone around you nuts, but in the end, things should go very, very well.

In future posts i will chat about packing, your flight (what to look for before you book it), going through airport security, arrangements for airport assistance, meds, your driving schedule, what car you rent, caregiving assistance, togetherness issues, what to look for in a hotel, amenities, eating out or bringing in, medical equipment (do you bring it, rent it or will it be there for you?), location and venue issues. There's a lot to think about, and if you do it ahead of time, you will be much happier later!!

See Blog Archive in left sidebar for other posts:
Packing (March 11)
Freecycle (Feb. 17)
Renting a Car (Feb. 2)
Paid Caregivers (Jan. 13)
How to Select a Hotel (Dec. 28)
Meds, Meds, Meds (Dec. 14)
Expectations (Oct. 26)