Traveling abroad with Mom but I'm not her POA. What do we need to protect both of us?

Just reading this now in connection with my search for help on a domestic trip with my Mom ...I hope my answer is not too late. JAsDaughter, I really wish you and your Mom could take this trip and I think it's lovely that you want to. But, in my view, you've not addressed a potentially huge issue. I think you misunderstood the first reply to your question, specifically with respect to MediCARE — not MediCAID, the term you used in your reply to that responder. ((If for some reason she is not covered by MediCare (I think retired military/government employees have some other coverage) you must determine if her primary provider covers medical expenses outside the US, but the rest of my answer assumes she IS covered by MediCARE)). MediCAID is for the indigent. MediCARE is the primary insurance carrier for most Americans over the age of 65. With the tinest of exceptions, not likely to be applicable in your case, MediCARE WILL NOT PAY FOR MEDICAL EXPENSES INCURRED OVERSEAS! See www.medicare.gov/coverage/travel-need-health-care-outside-us.html Given their government provided healthcare system, the only kind of medical care she'd be likely to get in London would be as a genuine emergency. And then, English caregivers would demand payment from HER/YOU. Whether this is a deal breaker for your trip to London would, in my view, depend on whether or not your mother's MediGAP policy (her privately purchased supplemental to MediCARE) covers such costs — you'll need to superduper double check that with that provider — OR whether she can qualify — given her cancer — and purchase at an affordable cost — a short term traveler's policy to cover any such expenses. I would expect very few, if any, travel insurance providers will cover her, or at least cover any expenses related to her cancer — which expenses I fear all would later insist ARE related even if she "just" gets the flu or breaks her little finger. These are all questions for you to raise and resolve when you are checking with her existing Medicare Supplement provider and/or shopping for such insurance protection. Check with your own medical insurance provider too! PLEASE DON'T LEAVE THE USA WITHOUT IT!

You need a detailed plan.

Start by reading these websites which explain what is needed prior to and during travel with a cancer patient:

myvmc/lifestyles/travelling-with-cancer/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600098/

http://www.cancer.net/navigating-cancer-care/cancernet-feature-articles/traveling-cancer

It is also important to have a plan if your mother should die on the trip. Will you have her cremated and leave her remains in London? Will you have her buried there or will you repatriate her remains? It is important to plan what to do if the worst occurs so that, no matter what, you will know what to do without question and can follow the plan at a time where you may be in great emotional distress.

Yes Veronica, We do try and help others....by sharing our experinces. I honestly hope you, JA's daughter, will be able to come to a decision regarding this. Talking on the phone is never the same as being right there with a person. Trying to just eyeball the situation to see if she can do the trip vs actually doing it is not the same. The doctor sees her briefly in his office. Probably does not know what her energy level and tolerance to activity would be. If she travels from Texas to England, and ends up ill in a room most of the time...... her last memory of the place she wants to go could be a huge letdown. It seems best to see if she can be done with chemo, in remission and at her optimum health (whatever that may be) before even contemplating such a trip. Let us know what happens.

Norest there was a similar situation where a retired veterinarian was going to fly solo to the Far East then go on a cruise. We never did hear what happened. I really wish people would come back and give updates because we freely give of our time and experience and hear nothing.

Yes, it's a Last Wish, but oh my the odds of her dying are high. The odds of her getting ill on the first leg of the trip would mean you are off the plane and grounded at a distant hub. A good friend of mine had to drive from Tulsa to Detroit because his 3yr old granddaughter got deplaned there with her mother. Then they had to drive back to Tulsa with a screaming toddler. Not a pretty picture, but infinitely better than what JA could find herself in.

i seem to remember a similar post about this. I feel I have to take a patient advocate position in this. Sorry! This doesnot seem like a well thought out plan. It seems unrealistic. I don't know why anyone would take someone in ill health on a long trip, especially a flight overseas. She will be exposed to many germs which her body can't fight off. Travelling a long flight is taxing on a healthy person. If she goes into remission and feels better maybe then. What is magical in your eyes about this trip that you would put her through this? I hope the POA nixes this trip.

I have known several hospice patients who have taken last trips sucessfully and some we never heard from again. They had to sign out of our hospice if leaving the area but if staying in the USA they could be connected with another at their location. these final trips are very important especially if it is a last chance to visit the "homeland" and see long not seen relatives who may not be fit or more likely can not afford to make the trip.

Thank you both. I know this will be an effort for both of us. I'm going to visit her (I'm out of state) for the next week, will be with her during this next Chemo treatment, will meet with the doctor - get his take on the situation, and see how that goes. I'll evaluate her at home and see realistically what I would be dealing with.

She isn't on Medicaid, so that wouldn't be an issue. I'm also going to empty every airline mile we've both accumulated over the many years and get us there in Business Class. I don't know how it could be done otherwise.

Also to your question - domestic location? I wish. No, London is in her blood. She's a complete Anglophile…..

It's getting a plan in place, as you mentioned, and the legal aspects I suspect I'll bring up AND complete while I'm there - else I won't do it. You're both right. And sure, there are others who could go with us, but it would be at my cost, and I'm not willing to do that. If I can't take care of her, I won't take her.

Will update after evaluations! Doctor/atty/POA, etc. I hope it goes well…..

JAsDaughter, your profile mentions that Mom has cancer. If there are no cognitive issues, then some of the potential problems probably won't apply. For example, she may very well understand the airport security procedures and not be bother by them. If she is still able to sign for herself, the POA issues are reduced.

I suppose it is possible for her to appoint you as POA before the trip, and return the responsibility to the current POA upon your return.

I once went on a cruise on a very small ship, with an alumni group. Two sisters were on the trip with their mother. We needed to return to our first port on the second day. The mother was very ill and needed to disembark. One daughter went with her. She died ashore. The daughter took care of details, mainly by calling a brother who was standing by, and then re-joined the cruise a few days later. The story was that at the time they bought the tickets Mother was in remission with cancer and wanted to take one last trip. They didn't realize how sick she had become again until they were on board.

I remember thinking at the time, "Boy, I sure hope that is how I get to go ... doing something I like doing, right up until the end." I heard that attitude expressed many times on the rest of the trip. I am not sure that the cruiseline felt the same way, but the passengers thought it was OK for the sisters to make this attempt for their mother.

I admired the fact that there was a contingency plan in place. Everyone (including a brother at home) knew what they would do if mother became very ill, and they had looked up what would have to happen with the body if she died.

When my husband developed dementia we continued to take cruises and to travel (with the encouragement of his neurologist). We traveled by plane, by Amtrak, and by car. But as the disease progressed we scaled back. Our last cruise was on Lake Michigan. (He did not want to be outside the US, for fear of not being able to donate his brain if he died abroad.) His daughter traveled with us -- I could have not done that last trip alone. That was in June; he died in November.

So I am enthusiastically in favor of travel for those very sick, AS LONG AS they can handle it and will genuinely get pleasure from it -- or at least have the potential for it. And AS LONG AS their companion is fully prepared for all the possibilities of things that could happen.

In your case, JAsDaughter, your mother wants to go to London. Awesome. But are there domestic locations she has also wanted to visit or revisit? Staying within the US simplifies some of the contingency plans. Niagara Falls? California wine country? Any of the national parks? New Orleans and bayou country? Mount Rushmore? I would want to take her somewhere, if I were you, but I think I'd try to scale back a bit if that would also give her pleasure.

A new member of my local support group just returned from a couple of weeks in Europe with her husband who has dementia. Four other adult relatives went with them. They had an awesome time, and it probably was their last chance to go abroad. But the wife was very, very glad for the support and help of the other adults. Is there anyone else who might travel with you and Mom?

Whatever you decide, I wish you and your mother the best.

You need to stay home. Medicare will not cover her health care abroad. You pay out of pocket. You cannot sign for her for anything unless you have at least a Health Care Proxy. You need to carry her medical records, especially the Rx. The airplane cabin pressure will be very very bad for her brain. The airlines does not want the risk. If TSA decides to pat her down, you'll have a small riot on your hands. You can expect them to search a diaper. If she has limited mobility, she cannot be seated near emergency exits. The crew onboard can and will use full restraint if she loses control and refuses to cooperate with them. They can even order her off prior to departure, if in their opinion, she cannot be transported without disturbance. If she has a court appointed Guardian, he would need to give you written permission to travel.