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October 5, 2007

BehindTheMedspeak: Have M.D. Will Travel


An August 7, 2007 Wall Street Journal story by Joseph De Avila about the rise of personal travel nurses — sometimes at a cost of over $1,000 a day — got me to thinking: What could I charge per day to accompany an aging mogul in precarious health on his peregrinations around the globe in his private jet?

You say that they already have a personal physician accompanying them everywhere, so what would they want with me?

Well, for starters: I've been called to a hundred times more cardiac arrests and codes in real life than those guys have seen on TV.

And did I mention that my specialty is airway management, with emphasis on crisis situations?

A cardiologist at the scene of a respiratory arrest is about as useful as an IV pole.

Whad'ya think: $10,000 a day seem reasonable?

Sounds about right to me.

Here's the newspaper article.

    Have Nurse, Will Travel

    Rigomar and Joyce Thurmer faced a huge problem when they arrived in San Francisco for their Christmas vacation last year. There was a blackout at their hotel.

    Mr. Thurmer suffers from emphysema and congestive heart failure and breathes with the help of an oxygen tank that runs on electricity. But the Thurmers came prepared: They had hired a nurse to accompany them on their vacation. Andrew Fallon, a licensed practical nurse who often travels with the Thurmers, helped to get the couple new hotel accommodations and had an oxygen tank delivered to their new hotel.

    "He steps in when something goes wrong," Mr. Thurmer, a 77-year-old retired architect from Boulder, Colo., says. "I wish we didn't have to have him, but we wouldn't be able to travel without him."

    The Thurmers are among the growing numbers of elderly or chronically ill travelers who are hiring skilled nurses to come along on vacations to administer medications, monitor care and generally help them get around.

    For years, people with special needs have hired non-medical caregivers to travel with them — or they have simply stayed home. But increasingly, as the population ages and more people are living with chronic illnesses like diabetes and heart disease, patients are seeking specialized care when they travel. Unwilling to give up the active lifestyle that many retirees today enjoy, older trekkers are also taking advantage of advances in medical technology — from portable dialysis equipment to airplane-friendly oxygen tanks — to keep them on the go even after they become frail.

    There are no statistics tracking the number of travelers who vacation with nurses, but health-care experts say the demand is increasing. Nursing agencies, home-care specialists and nursing schools say more travelers are seeking nurses who will pack up and come along. And a number of companies have sprung up to provide skilled caregivers for travel — including Trip Nurse in Boulder, Colo., and Executive Care Service in Orlando, Fla. One firm, Accessible Journey in Ridley Park, Pa., offers organized tours for frail or disabled travelers, with nursing care available.

    At Partners in Care, the private-care unit of the Visiting Nurse Service of New York, President Marki Flannery says more patients are asking for nurses to accompany them during leisure travel. And "we are customizing our services" to match up patients with medical personnel willing to travel, says Ms. Flannery, who oversees a network of 200 nurses and 5,800 home health aides.

    Hiring a travel nurse can be costly, sometimes running more than $1,000 a day, plus travel expenses for the nurse. The costs typically aren't covered by insurance. Employers also must carefully check a nurse's credentials to make sure he or she has the necessary skills. And people traveling abroad should be aware that the services nurses can legally provide will vary from country to country, Ms. Flannery says.

    Private-duty nursing agencies make criminal background checks and conduct drug tests. And many allow customers to interview nurses before hiring them to ensure that they will mesh well with the patient and family. Otherwise, having an extra person around on a family holiday can be uncomfortable.

    In the past, some vacationers with disabilities hired medical transport services to assist them with air travel, such as moving through airport security and getting on and off the plane. But now, "it has absolutely broadened," says Elinor Ginzler, who oversees projects on mobility and housing for AARP in Washington, D.C. Now nurses are not only helping travelers on plane trips; they also are staying in hotels or cruise ships with them — often in the same room.

    The practice often appeals to the so-called "sandwich generation" of people in midlife who have to care for their elderly parents, as well as their own children. Hiring a nurse for a frail parent allows them to continue to vacation as a family.

    In May, Candice Miller, a 59-year-old retiree from Longmont, Colo., traveled with her father to Alaska for 11 days to celebrate his 83rd birthday. Ms. Miller hired a registered nurse from Trip Nurse to care for her father, who has Parkinson's disease. The nurse helped dress him, administered his medications, and assisted him with his feeding tube. "I wouldn't have even considered it doing it myself," Ms. Miller says. "It would not have been a vacation otherwise."

    Trip Nurse — which charges $300 to $1,000 a day, depending on the time and care needed by the patient — was co-founded a year ago by Mr. Fallon, the nurse who travels with the Thurmers. He had met the Thurmers via word-of-mouth, but realized that there was a larger market for such services. The company has served only a handful of patients so far, but Mr. Fallon says demand is rising. The ability to travel and visit family is "very appealing to someone stuck in a sedentary lifestyle," says Mr. Fallon.

    Some patients hire a nurse just for transport. Last fall, Ruby Valme, a registered nurse and field supervisor for Partners in Care with the Visiting Nurse Service of New York, picked up a patient from a New York area hospital and flew with him on his private jet to the patient's home in the Midwest. Ms. Valme coordinated with the hospital, handled the patient's medical equipment on the plane and handed off the patient to his home caregivers.

    On the plane, Ms. Valme monitored the patient's oxygen flow, administered his medication, and helped him get on and off the plane. In addition to Ms. Valme's fees, which range from $60 to $80 an hour for plane transportation, the patient also paid for Ms. Valme's hotel room for one night and a return flight home on a commercial airline.

    Ms. Valme says some nurses are interested in this type of service because they enjoy traveling. "You are taking care of someone and at the same time it is fun and interesting," Ms. Valme says.

    There are also options for those who cannot afford to pay for the plane ticket, hotel room and the fees that come with hiring a nurse. Elizabeth Clemmer, a 67-year-old retiree from Chevy Chase, Md., often seeks to hire a certified nursing assistant in the city she is visiting when she vacations with her husband, Dan Clemmer. Mr. Clemmer, 68, has multiple systems atrophy, a condition similar to Parkinson's disease.

    Last year they took a weeklong trip to Rehoboth Beach, Del., and Ms. Clemmer used Eldercare Locator, a free online service from the U.S. Administration on Aging, to help find a nursing-assistant agency. She punched in the ZIP Code of the area she was visiting and the services she was looking for, and the Web site gave her the phone number of a local social-service agency that helped her find nursing-assistant agencies in the area.

    She found an agency that suited her price range and her husband's needs, costing about $15 an hour for the care. Ms. Clemmer says she prefers to work with an agency because she can always request a different nursing assistant if one doesn't click with her husband.

    Sometimes it can be awkward for the family and the nursing assistants on a vacation, says Ms. Clemmer. For example, dinnertime can make for some uncomfortable moments. "The addition of a new person at a table changes the dynamics," Ms. Clemmer says. She adds that most of their nursing assistants bring their own food. But when dinnertime rolls around, and the nursing assistant is sitting alone, Ms. Clemmer says she can't help but feel for them. "It does feel that you are not inviting someone to the party," she says.


Not to worry: I'll bring my own dinner.

October 5, 2007 at 12:01 PM | Permalink


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Hey Joe -
I've commented you (is that a word) before, but your visual of the Paladin business card moved me to comment this time - I have one of those languishing somewhere in my parents' house,with Richard Boone's signature. Old memories!
Best -

Posted by: Kevin Gentry | Oct 5, 2007 4:41:35 PM

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