Q: I reserved an “accessible” room with a roll-in shower. When I got there, I couldn’t even get into the bathroom. What should I have done?

A: “Just phoning ahead and saying, ‘I want a roll-in shower’ doesn’t really work,” says Paul Murphy, director of the accessibility consulting firm Inspired Solutions International and a Thalidomide survivor. He says the only way to know for sure is to have the hotel send you digital pictures of the washroom from a variety of angles. “If it’s any type of decent hotel, someone should have access to a camera and have the ability to shoot a couple of digital photographs and send them to you — that way you know exactly what you’re rolling into.” Of course, if you don’t have Internet access, you can get them to send the photos to a friend who can deliver them at a later date.

However, if you get there and it’s not what you need, Murphy has another maneuver that has worked for him. “What I’ve done is say, ‘Show me your other accessible rooms that are available or your large regular room.’ I will go and assess those other rooms and if the regular room is better but it’s a door width issue, I’ll ask them to take the bathroom door off the hinges, so I can gain access.” Taking the door off its hinges typically gives an extra two or three inches of door width. Some rooms come with shower seats or transfer benches, so ask about those, but most of the time it’s best to bring your own. “The problem is, we do a great job on establishing rules on how the physical structure should be built,” Murphy says. “We don’t do a great job of training people on those facilities. The hotel really does want to help you, but they haven’t been empowered to know how to help you.” So, Murphy says, it’s important to take responsibility for your own access.

Q: What should I have in a wheelchair repair travel kit?

A: A wheelchair or scooter breakdown on vacation can send you into a panic and quickly ruin your trip, especially if it happens in the middle of nowhere. Some states or countries provide 24-hour emergency service, like California’s Easy Does It Emergency Services, Florida’s Mobility Transportation Systems, Canada’s Motion Specialties and Scotland’s Mobility Scotland. Problem is, these services aren’t necessarily nation- or statewide, they often cost two to three times more than a regular service call, and the wait time can be substantial. The more you can do yourself, the better, but there are only a few repairs that are practical on the road. One of the most common is replacing a tire. “If you’re building a travel kit, I’d recommend extra tubes, a ratchet and both an electric and hand pump,” says Tit Long of Medichair, an adaptive equipment dealer with locations across Canada. You’d also need to add a wooden block to elevate the wheel off the road. Extra batteries are harder to haul across borders and require additional storage in-flight, so they’re not recommended for most models, but at least make sure you’re carrying a charge with a portable ammeter. “The only time I’ve heard of people carrying extra batteries is when they have those foldable travel scooters and aren’t confident they can complete their journey on one battery,” he says. Other simple tools that are travel kit must-haves include screws, spokes and the Allen keys or screwdrivers necessary to screw them in. The most crucial thing to include is perhaps the most obvious — without your charger, you’re sunk before you even begin.

Q: I require an attendant when I travel. What are my options for reduced fares or other accommodations by airlines, trains, hotels, etc.? Also, can I take my attendant with me across state lines if she’s paid for by a Medicaid waiver?

A: Airlines in America seem to score a zero when it comes to discounts or complimentary tickets for attendants. All three leading passenger jetliners — American, Southwest and, the largest, Delta — ask patrons with disabilities and their attendants to pay full price, but they do provide side-by-side seating. Alaska Airlines also requests full price. “We don’t have any programs or discounts for disabled clients or attendants, but we will do everything we can to accommodate them once they come to the airport,” says Alaska Airlines spokesperson Bobbie Egan. Some reservationists asked their supervisors, but ultimately came back with nothing. “I checked, and as far as a discount, there isn’t one given, unfortunately,” said Delta’s clerk.

Meanwhile, both major Canadian airlines — Air Canada and WestJet do have programs that allow attendants to fly free. Air Canada requires that the flight be domestic and that the customer still pay the taxes on both tickets, except for the Airport Improvement Fee. They also will accept a change of attendant free with 48 hours notice. Though a complimentary flight isn’t available internationally, you may be able to receive discounted flights. They also recommend you phone their Medical Assistance Desk for more detailed program information (800/667-4732). WestJet’s One Person, One Fare Program offers the same deal with more stringent requirements. People with disabilities and their attendants must submit essentially a ‘Proof of Severe Disability’ form signed by the disabled person’s doctor, which will then be sent to WestJet’s Medical Desk to be ruled on. The complimentary tickets only apply on domestic flights, but it isn’t customary to offer reduced fares for international flights.

On trains, the U.S. does provide discounted fares to attendants. Amtrak offers a 15 percent discount to both attendants and people with disabilities. To qualify, the disabled person must present either a transit system ID, a doctor’s note or a membership card to a disability organization. They offer an accessible tie-down space for your wheelchair or scooter, transfer seats and accessible sleeper accommodations. Canada’s Via Rail provides a free fare to attendants with proof of need through a signed doctor’s note that is no more than nine months old, showing that the customer’s disability is permanent and that they need help with personal hygiene, eating or transferring. In the event the buyer wants to sit in a seat they will not be charged for the tie-down space or their attendant’s seat. They also stress that the dimensions and weight of the wheelchair should be given before the person books their ride.

As for hotels across America, there is no specific discount for those traveling with an attendant. However, the accessible rooms are typically priced less than the regular rooms. How much depends on the franchise and, in the case of those independently owned and operated, it depends on the individual hotel. Some hotels, like Best Western, offer a senior’s or AARP discount to people with disabilities, but it really depends on the hotel and the dates you plan to book. Generally, there’s no pricing policy specifically for people with disabilities at major hotels.

Medicare still prohibits its recipients from using its home-health services outside of the home, due to its stringent definition of “homebound”. Medicaid personal assistance is usually provided through waivers, and those rules can change state to state. So people using a Medicaid waiver should check with their providers.

Q: What do I do if I run out of medicine or lose my meds while on vacation?

A: A lot of how easy it is to replace lost medication has to do with your preparation beforehand. Dr. Lawrence Brown, associate professor of the College of Pharmacy at the University of Tennessee, recommends preparing a list of all of your medications to take on vacation. For each med, include the name of the drug, the prescription number, the pharmacy’s contact info, and your doctor’s name and contact info.
If you know you’re going to be gone beyond the time that your prescription runs out, you can go to your pharmacy in advance and request a vacation override. The pharmacy will call your insurance company and request extra supply to cover you during that time.

If you’re on vacation within your own state and you lose your meds, the process is relatively easy. If you get your medication from a chain pharmacy, like a Rite-Aid, just go into the one closest to you and they will be able to look up a record of your prescription and fill it on site. If you go to an independent pharmacy, the temporary pharmacy would simply call the person’s regular pharmacy, verify the prescription and fill it for them. “The prescription is essentially transferred to the new pharmacy, and then when they go home, their regular pharmacist will have to call and transfer it back,” Brown says. This also works if you’re vacationing in another state — just be sure the pharmacy accepts your insurance plan. Of course, getting a refill on a narcotic will always be a little more difficult. “Oxycontin and other painkillers are one-time prescriptions, so they’re next to impossible to refill,” says Brown. In those cases, you’ll have to call your doctor if you’re in your state, or get a prescription filled by another doctor if your in another state. “Your personal doctor may be able to recommend a clinic, and you should at least advise them of the situation, so they are not caught off guard when the new doctor calls.” It’s also recommended you carry proof of disability with you in case you are questioned.

“Before you do anything in another country, call the member services number on your insurance card to learn what they cover and don’t cover before you visit a local pharmacy or an emergency room,” says Brown. In other countries, you will have to pay full price for the medication and then the insurance company may reimburse you when you come back home. They may also advise you on where the nearest clinic or hospital to get a new prescription would be.

Q: I need to give myself injections. Can I fly with my syringes? Also, how do I keep my bio-meds cool on the airplane and in the hotel?

A: Airlines such as Southwest and American allow syringes past security and on their flights, as long as the medication that goes with them is in the person’s possession and the label on that medication is professionally printed with a manufacturer’s name or a pharmaceutical label. Some airlines, like Delta also require medical records and “proof of disability,” in case security or foreign officials have questions. American Airlines does not have refrigerators on its aircraft and neither does Delta. However, Delta and some other airlines have disposal units for used needles on board their flights and are happy to bring them to you if you notify the flight attendant. Instead of counting on a refrigerator being available on board aircraft, the airlines recommend that you bring a small cooler that fits inside your carry-on luggage. This also solves the problem if you are unable to use a fridge in the hotel room without paying for it. Most airlines also discourage the hanging of intravenous devices from the overhead compartments because of concern that they will interfere with the embedded oxygen masks.