People with Parkinson’s travel all the time and there is no reason why you cannot or should not do so. If travelling for the first time, it is advisable to discuss with your doctor or PD nurse specialist as they can help you with any concerns that you may have. If you have movement difficulties, then the advice of your doctor or PD nurse specialist will help you to plan well and alert you to anything you particularly need to be aware of. They can also advise about medications while you are away. It may also be advisable to find out about assistance at the airport. Parkinson's Europe Parkinson's Passport (see Tips on travelling abroad) can help you explain your needs when asking for assistance.

General tips

• Plan your journey to allow plenty of stops to stretch and use the toilet.
• Have a restful day before travelling and after you have arrived.
• Check what facilities are available where you will be staying and book appropriately. If stairs are difficult make sure there is a lift available or book a room on the ground floor.
• Before arrival, identify where the nearest hospital and pharmacy are. You could also ask your doctor if she/he knows of a doctor or neurologist where you are staying in case of an unlikely emergency.
• If you are rather immobile or disabled, take a letter from your doctor stating that you are fit to travel and detailing your medication. The Parkinson's Passport (see Tips on travelling abroad) can help you explain your situation.
• Do not try to do too much each day. Allow time for rest and have a flexible schedule. Remember that everyday tasks, such as dressing and eating, may take longer away from your usual surroundings.
• Drink plenty the previous day so that you can reduce your intake and visits to the toilet on the day of travel. But remember that you must still drink on your travel day, especially if you are flying, so you don’t become dehydrated. This is particularly important if you have low blood pressure.

Medication tips

• Carry water for when you take your medication. Do not take levodopa with food.
• Ensure that you have plenty of medication and include some in your hand luggage. We recommend taking enough for the entire trip and adding on three days. It is also helpful if the person you are travelling with takes a further supply of medication with them. In this way you will not have the difficult situation of finding your medication in a foreign country, and if you lose one set, you won’t have to panic. For security reasons, always keep medication in its original container.
• Take spare prescriptions, health insurance policy numbers and a list of contact numbers for family, your doctor and anyone looking after your home. Useful contacts can be listed within the Parkinson's Passport (see Tips on travelling abroad).
• Take a letter from your doctor stating you have Parkinson’s and the medication you take. Some airport security may question the quantity of medicines you are carrying with you, and such a letter will help you explain why you need them.

Insurance tips

• It is advisable that you arrange your travel insurance as soon as you book your flights, so that you are covered should you be unwell and unable to travel on the actual day.
• Check any insurance policy carefully as some illnesses may not be covered. Good travel insurance can be expensive so check out prices with various companies - but always go for the cover you really need rather than the cheapest deal.
• Check if any disability aids or equipment are covered under your policy.

Accommodation tips

• When booking, make sure each company you use or book with is aware that you have Parkinson’s, so that you can arrange special requirements for you, such as a groundfloor room, a room near to a lift or a specially adapted bathroom.
• Make sure you have written confirmation of any specific facilities or accommodation you have booked.
• Shop around to see which company offers the best deal for your needs.
• Check dining facilities to see if meals are included; for example, if you will be served buffet meals that require you to carry a tray.

If travelling by plane or ship, make sure the company knows that you have Parkinson’s, particularly if you have mobility problems.

Pre-book any assistance you may need – such as a wheelchair at airports – to avoid long walks or waiting in queues. Even if you do not normally need assistance, don’t be afraid to ask for this or ride in an electric ‘cart’, particularly if you have hand luggage to carry.

Special services may only be available when booked in advance so don’t leave it to the last minute to ask for assistance. Unfortunately, some airlines restrict the number of people with disabilities that can be carried on one plane, so it is best to book early.

Check in early – this may be possible to do online up to 24 hours in advance. Request an aisle seat if your mobility is difficult.

Investigate public transport and parking facilities where you are going to avoid problems on arrival.

You may wish to contact the Parkinson's disease association in the country you are visiting as they will be able to offer advice on travel specific to their country.

• Use Parkinson's Europe's online PD Doc that states, “I have Parkinson's Disease. Please allow me time. In case of an emergency, contact [contact details to be inserted]”. The document, available in 25 different languages, can be completed online, personalised and printed before you travel, and kept in your pocket, purse or wallet. This helpful document can then be shown if you have difficulty communicating because of your symptoms or language barriers.
• Parkinson's Europe's Parkinson’s Passport provides more detailed information concerning medication and treatment you may have had, such as deep brain stimulation. In an emergency, the PD Passport provides clear instructions and details of medical requirements so that appropriate assistance can be provided.

Medication

• If travelling within the European Economic Area, take with you a European Health Insurance Card (EHIC). This covers medical treatment you may need whilst in EU countries as well as Iceland, Norway, Lichenstein and Switzerland. Important! An EHIC card is not an alternative to travel insurance so make sure you have both! An EHIC card does not cover private medical healthcare or the cost of being flown home for example.
• If you are considering going abroad for planned treatment, be sure to check the necessary information on cross-border healthcare.
• Check with the embassy of the country you are visiting for regulations concerning medication you need to take with you. In certain circumstances a personal license for the import and export of controlled medications may be required if you plan to take several weeks' supply with you. Your doctor, pharmacist or the foreign embassy will be able to advise you. In most cases a letter from your doctor stating the medications you take will be enough.
• As some medications are known by different names in other countries, it is a good idea to check the local names of the medications you use before travel. This can be helpful if you run out or lose your medications. Remember to carry spare prescriptions with you.
• If you need to travel with and use a syringe, check with the airlines in advance as some have regulations and will require special permission for this. Place syringes in hold luggage.
• If vaccinations are recommended check with your doctor that these are compatible with your Parkinson’s medications.
• If travelling between time zones, plan in advance how you will adapt your medication so you don’t have to work this out when you are tired from travelling. Again, discuss this with your doctor (or PD Nurse Specialist if you have one).
• Exposing some medications to extreme heat can reduce their effectiveness so store them in a cool place and take only a small supply with you when out and about. A small cool bag can be useful.

Relocating abroad can be highly successful but it is important to plan well in advance to avoid problems. Make sure that the health and social care services offered where you plan to live meet your needs – both now and in the future.

There are some key points to consider if you are thinking about such a move.

Gathering information about your new country

• the country’s embassy
• government departments for foreign affairs, health, pensions and social security
• Parkinson’s organisations - particularly those based in your prospective new country. They should be able to advise you on national and local health services, available Parkinson’s treatment and other sources of help
• disability organisations in your country that can provide advice on relocating
• expatriate organisations and websites - the consul in your prospective new country should be able to provide you with details of expatriate associations and clubs.

If you are moving to a European Economic Area (EEA) country you must apply for a resident permit within three months of arrival.

Language and culture

If your mother tongue is not widely spoken where you plan to live it will be important to have someone you can turn to who understands the language and can help you communicate effectively, especially in an emergency. Try to learn some useful words and phrases before relocating.

You will no doubt encounter cultural difference so spend some time familiarising yourself with the customs and traditions of your prospective new country.

Your new country’s health and social care system

Make sure you have looked into the following before you relocate:

• How is healthcare funded and what is covered?

You could be required to pay for some services or need to take out insurance. Reciprocal health cover exists between some countries but compare services in detail to see whether these include the treatments you need.

• Will your medications be readily available?

Are they free or will you have to pay for them, and, if so, how much will they cost?

• How are the health and social care systems organised – generally and in relation to Parkinson’s-specific care?

The type of services you are used to in your own country may not be available or may operate differently. For instance, in some countries, family or friends maybe expected to provide some hospital care, such as washing bed linen and providing meals.

• What services are available specifically for people with Parkinson’s and their families?

Services will vary from country to country and, of course, your needs and your family’s need for services might change as your Parkinson’s progresses or you get older.

• How far will you have to travel for specialist services?

Transport may be complicated and costly. Travelling long distances may become difficult as your condition develops or as you get older.

Money matters

You will probably need to review your financial situation before you decide to relocate abroad. Think about how you would cope if your circumstances change.

• Check that your pension rights are transferable and you are entitled to future increases in your new country. This can be complicated!
• Find out if you will still be eligible to receive social care benefits when you move; for example, some services may only be free of charge when you have reached retirement age.
• When buying property, take additional costs into consideration such as adaptations for accessibility.

Getting around

If you want to drive and run a car in your new country, find out whether there are specific rules that apply to people with Parkinson’s. Check how good public transport or taxi services are locally as you may need to rely on these at times.

Once you have resident status in an EEA country, you can exchange your driving license for an EEA national license. For non-EEA countries, you will need to get an International Driving Permit (IDP) before you arrive.

Returning to your home country

Look into any rules and regulations that would affect you if you decide to move back, permanently or temporarily. If you have been resident abroad for some time, you may have to pay for health services that residents receive free of charge.

There may be tax, pension and social care implications if you decide to return to live in your country of origin permanently – for example, you may not have an automatic entitlement to certain financial benefits if you have lived abroad for several years.

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