Many of the logistical challenges faced by disabled travelers can be overcome with careful planning. Individual physical readiness to travel should be discussed with a primary care provider in advance of seeing the travel medicine specialist. Online resources (see list below) provide detailed information for travelers with disabilities. Travelers who prefer to work with a travel agent should choose one who is experienced in the use of disability coding, which is an internationally standardized code found in computerized reservations systems that is used to classify disabled travelers and their needs.
Traveling by Airplane
Individuals traveling by air should read the detailed information for travelers with disabilities given on the website of each airline. All instructions on giving the airlines required notice (online or by telephone) and details of limiting disabilities should be followed closely to avoid any misunderstanding of what is required, especially for those with mobility issues (e.g., need for wheelchair, motorized or not; crutches; cane; assistance entering or leaving the aircraft or reaching seats or restroom entrance; assistance with luggage; or specific seat location onboard). A clear understanding of exact requirements, including whether a companion will also be traveling, should be documented.
Those traveling on a code share flight should know the procedures for both the ticketing airline and the air carrier that operates the flight. Always confirm reservations and special arrangements the week before departure, and reconfirm a few days before the trip. Get written confirmation for everything the airline says it will provide.
Airport screening: In the U.S., the Transportation Security Administration (TSA) has established a program for screening persons with disabilities and their associated equipment; this includes all categories of disabilities (mobility, hearing, visual, and hidden). All disability-related equipment, aids, and devices are allowed through security checkpoints once cleared through screening.
Permitted prescription liquid medications and other liquids needed by persons with disabilities include:
- Prescription and over-the-counter medications (e.g., liquids, gels, aerosols), including petroleum jelly, eye drops, and saline solution for medical purposes
- Water, juice, or liquid nutrition or gels
- Items used to augment the body for medical or cosmetic reasons, such as mastectomy products, prosthetic breasts, bras, or shells containing gels, saline solution, or other liquids
- Frozen items (however, if frozen items are partially melted or have any liquid at the bottom of the container, they must meet the "3-1-1" requirements)
Liquid medication in volumes greater than 3.4 ounces (100 mL) should not be placed in the requisite quart-size bag but instead must be declared to the TSA officer. Declared liquid medications and other liquids needed by persons with disabilities and medical conditions must be kept separate from all other property submitted for x-ray screening.
Wheelchair use: Determine in advance whether the airport and airplane are wheelchair accessible and whether jetways or entry bridges without steps for boarding and deplaning are available. If not, ask what procedure will be used for boarding and exiting the plane. Airline policies vary regarding motorized wheelchairs, and it is important to inquire whether the specific model and batteries will be acceptable on the flight.
When a disabled traveler requests assistance, airlines must provide access to the aircraft door (preferably by a level-entry bridge), an aisle wheelchair, and a seat with removable armrests. Aircraft with fewer than 30 seats are exempt from these regulations. Airplanes with more than 60 seats must have an onboard wheelchair. Airline personal are not required to assist when passengers move from wheelchair to wheelchair, wheelchair to aircraft seat, or wheelchair to restroom seat. Those who cannot transfer themselves should have a traveling companion or attendant. In the U.S., only wide-body airplanes with 2 aisles are required to have fully accessible restrooms.
General accessibility issues for wheelchair-bound travelers (including use of onboard aisle wheelchairs) include:
- Is the restroom door wide enough?
- Are the assistance devices, door handles, and toilet handles at lower levels?
- Is floor space adequate for easy maneuvering?
- Are the armrests movable for easier transfer between the aisle chair and passenger seat?
- Are batteries for motorized wheelchairs permitted on board? Do specifications for compliance exist?
- Do special arrangements exist for storing and transporting a wheelchair on the plane if it cannot be brought directly onboard? (Consider purchasing extra insurance on the wheelchair if it is being transported in the baggage area because airlines generally provide a maximum liability per passenger. Always be sure to inspect the chair for any damage upon arrival.)
- Is assistance available at the baggage area?
Hearing impairment: Travelers with hearing impairment(s) should explain to gate attendants that it may not be possible to hear the boarding announcement and that it is necessary that they provide notification when it is time to board. Confirm the flight number and destination before boarding; often, gate changes are announced only audibly. Once on board, explain the hearing impairment to the flight attendant and request that any en route announcements be communicated in person. Individuals who need ground transportation at the destination should have the name and address of the hotel written down so that no miscommunication occurs with the driver.
Service dogs: Airlines accept travel with a guide dog or service dog, if the animal has all the appropriate identification and has obtained the correct veterinary certification prior to flying. Always check with the airline to see what documentation is required and whether any quarantine regulations exist for international travel. (Service dogs are not exempt from quarantine regulations and thus may not be allowed to travel to all international destinations.) Guide dogs must observe a number of safety regulations during flight (e.g., they must not obstruct aisles or an emergency exit). Once a service dog has been cleared for travel, flying with it should be at no additional expense; flying with a service dog is not considered to be in the same category as flying with a pet.
Oxygen use: No regulations exist requiring that airlines provide medical oxygen during flights. Some airlines may require that passengers use the airline's onboard oxygen; others may allow passengers to use their own oxygen on the runway and switch to the plane's oxygen once on board. Verify the airline's specific rules well in advance of travel and make necessary arrangements. Individuals carrying a portable oxygen converter must plan accordingly due to the Federal Aviation Administration requirement that any person traveling with oxygen submit a letter from his or her physician stating the need. Most air carriers require the statement to be written on a doctor's letterhead; however, some carriers may require an airline-specific form.
See also the article Pulmonary Disease and Air Travel for detailed information on air travel and oxygen.
Regulations for compliance: U.S. air carriers must comply with detailed regulations affecting persons with disabilities. (These regulations do not cover foreign carriers that fly to or from the U.S.) The Department of Transportation (DOT) maintains a toll-free hotline to provide real-time assistance in facilitating compliance with DOT rules. The hotline (800-778-4838) is available 7:00 a.m.-11:00 p.m. Eastern Time.
Traveling by Train
Train passengers should prepare in much the same way an airline passenger would. Contact a travel agent or read the carrier's website while making travel plans.
Confirm that all stations on the trip have adequate provisions for wheelchair use. Check to see if the boarding area is level, if a hydraulic lift will be used for boarding, and confirm how to access the boarding area. Ask the following questions:or if a ramp is available. Determine
- Do the seats on the train and in the club car have movable armrests for easy transfer?
- Can travelers remain in their wheelchairs if they prefer?
- Is it possible to be located near an accessible restroom?
- Does the restroom have a wide entrance, a large turn-around space, and grab bars?
- Can the attendant serve meals to seats rather than having disabled passengers travel to the dining car?
- Does adequate room exist for wheelchair mobility in the sleeper cars?
- Are service dogs allowed to travel on the train?
- Do special quarantine requirements exist for service dogs?
- Are accommodations made to relay important destination and emergency information to persons who have a hearing or vision impairment?
- Do any discounts exist for the disabled or for those who require the assistance of an attendant?
- Must special arrangements be made to store wheelchairs if travelers are not allowed to remain in them during transit?
- Is a fee charged for wheelchair storage?
Cruise Ship Travel
Most cruise lines are accommodating to persons with disabilities, and cruise ships that dock in a U.S. port must comply with the rules of the American with Disabilities Act (ADA). A special needs request must be submitted to the cruise line at least 30 days (varies depending on cruise line) prior to travel. Some cruise lines require those with disabilities to travel with a companion.
Wheelchair use: Many ships have a limited number of accessible cabins with accessible bathrooms and adequate space for maneuvering wheelchairs or motorized scooters throughout the cabin. Most common areas (e.g., decks, dining and bar venues, recreational facilities, and restrooms) on a ship are also accessible. The major cruise lines provide a wheelchair for boarding and deboarding, but travelers must bring their own or rent one for use while onboard. Certain vessel transfers requiring the use of gangways or tenders (small boats) may not be accessible to wheelchairs or scooters. Facilities across ports of call vary significantly, and wheelchair accessibility may not be available for all shore excursions; ADA rules do not apply outside the U.S.
Ask questions, such as:
- Does adequate room exist to maneuver a wheelchair on deck and in the cabin?
- Are the doorways to the cabin, bathroom, dining area, recreation area, and night club wide enough for a wheelchair?
- Do partitions (that prevent water from entering) exist between the bathroom and the living area in the cabin?
- Are grab bars installed near the toilet and tub?
- Does the cruise line require medical verification of fitness to travel?
- Are disabled travelers required to have a companion?
- Do any special arrangements have to be made for land tours if the mode of transportation (bus/car) is not accessible?
- Is someone available if assistance is needed getting on or off the ship?
- Is it possible to move to all passenger decks in a wheelchair?
Hearing/vision impairment: For travelers with a hearing or visual impairment, most cruise lines offer features such as visual/tactile alerts for phones, alarm clocks, and door knocking; amplified telephones; assistive listening systems; and braille signage throughout the ship. Sign language interpreting services may be provided for those who use it as their primary means of communication; a request should be submitted as far in advance as possible (more than 90 days for some cruise lines).
Service dogs: Cruise lines accept travel with a guide dog or service dog (some cruise lines do not accept "emotional support" dogs), if the animal has all the appropriate identification and has obtained the correct veterinary certification prior to travel. Check with the cruise line to determine what documentation is required to depart the ship in ports of call and final destination. (Service dogs are not exempt from quarantine regulations and thus may not be allowed to travel to all international destinations.)
Oxygen use: Travelers requiring oxygen must hand carry their own oxygen and/or oxygen equipment or make rental arrangements for use during the cruise. The ship's oxygen supply is for emergency use only.
Dialysis: Travelers requiring continuous ambulatory peritoneal or hemodialysis travel at their own risk because of the limitations of specialty medical care at sea and port calls. A clearance letter from their nephrologist may be required. Travelers are responsible for arranging for the solutions and equipment necessary to perform dialysis. Cruise staff are unable to assist or administer treatments.
Children with disabilities: Onboard youth programs are open to children with disabilities, either based on age or ability level (if a child has special needs). The staff usually cannot provide specialized attention (e.g., one-on-one supervision, feeding assistance, medication administration), therefore a parent or helper can stay with the child.
Staying at a Hotel or Motel
If the hotel or motel claims to be accessible, find out what that means. Because only a few "accessible" rooms are usually available in each hotel or motel, make reservations as far in advance as possible. Additional questions include:
- Entering the hotel:
- Is handicapped parking available?
- Does the entrance to the building have steps or is it at street level? Is a ramp or street level elevator available?
- Access to public areas:
- What is the accessibility to other public rooms (restaurant, lounge, bar, meeting rooms)?
- Are public restroom doors wide enough to accommodate a wheelchair?
- Is the swimming pool accessible without steps?
- The elevator:
- Is it large enough to maneuver a wheelchair in and out of by oneself?
- Are elevator buttons low enough for a person in a wheelchair to reach?
- Are the floor stops indicated in Braille?
- Does a voice system announce the floor?
- The room:
- How far is the handicapped-accessible room from the elevator? Is it on the first floor? The first floor is preferable for disabled persons in the event of an emergency.
- Does a step or partition exist at the door to the room or to the bathroom?
- Are the floors heavily carpeted? This can make mobility very difficult.
- Does adequate space exist for a wheelchair to be maneuvered easily around the room?
- If the closets are walk-in, are they at least 32 inches wide?
- Does the bathroom have grab bars installed near the toilet and tub?
- Can a wheelchair fit under the bathroom sink?
- Do assistance devices exist in the room? Amplified telephones? Braille menus? Other telecommunication devices for the hearing impaired?
- Are service dogs permitted?
- Hearing-impaired travelers should inform the desk clerk of their disability, in case an emergency arises. Travelers should compare their written confirmation with their reservation to ensure they are getting what was agreed upon.
A multitude of resources are available on the internet. Some useful links are noted below.
- Disabled travelers website: www.disabledtravelers.com
- Access guide by country: www.disabledtravelers.com/access_guides.htm
- Airline information for disabled travelers: www.disabledtravelers.com/airlines.htm
- Transportation Security Administration: www.tsa.gov/travel/special-procedures
- Flying with a disability: www.flying-with-disability.org
- Society for Accessible Travel and Hospitality: www.sath.org
- Travel arrangements for persons in wheelchairs: www.worldonwheelz.com
- Travel information for persons with disabilities: www.travelguides.org
- European Network for Accessible Tourism: www.accessibletourism.org
- Wheelchair Traveling: www.wheelchairtraveling.com
- Mobility International USA: www.miusa.org
- MossRehab ResourceNet: https://www.mossrehab.com/patients-and-visitors/information-for-out-of-town-visitors/travel-resources
- DOT information for air travelers with a disability: https://www.transportation.gov/airconsumer/new-horizons-information-air-traveler-disability
- DOT hotline for travelers with disabilities: 800-778-4838 (voice); 800-455-9880 (TTY).