Advice on the "what if?"

It does not make sense that you don't consult his doctor first.

Yes, you need good travel insurance that will also cover medical evacuation.

My experience in a rather large Spanish hospital in Palencia and a clinic in a smaller town, was that very little English was spoken, but they went all out to find a Dr. and a nurse that did. Even then, they used their Google translate to make sure I understood what they had said. Needless to say I was rather surprised that medical professionals spoke so little English, not even basic stuff. Everyone was very kind and considerate and the care was top notch, though very different from an American or a German hospital.

I am sure someone will contribute info about the other countries.

The nice thing is that you will be on a cruise. If he's tired, he can opt to stay on the ship and still enjoy the energy. Also, the ship has a doctor for smaller crises. So many people speak English these days, that I can't imagine you wouldn't be able to find someone who speaks English in a medical emergency. Even in the US, there is always a translator for those who don't speak English. Why not make sure you have that application on your phone in which you speak English and it will speak in the language of the medical profession, if need be. I'm so glad you are taking him on this trip!

Now I might sound a bit callous here, but this has always been the way my family approached life. We summered next door to my grandparents. When the neighbors would come over and tell my mother she had to get my 89 year old grandfather off of the roof, she'd shrug her shoulders and say, "If he falls off the roof at age 89, isn't it a grand way to go", and knowing full well he'd never get off the roof for her anyway. So I say, don't worry about it and let him live his life to the fullest. We never know what the future holds. Enjoy your travels with your dad as you are very fortunate. Don't worry!

Susan and Monte,

As suggested, I recommend you consult his physician first. I am 69 and active, buy know that my equilibrium is not what it was even ten years ago. Consider having your Dad use a walking cane.

If you go, make sure your Dad gets plenty of water.

If planning tours from the ports, choose those that are not strenuous.

Choose a cabin on the ship that is near the elevators, to reduce walking.

As for foreign medical care, all the countries you listed, generally have good medical care.

Medicare does not cover anyone overseas, but you can purchase trip insurance with a medical insurance component as well as medical evacuation. It is not terribly expensive.

Regarding communication with foreign medical persons, I don't think that is a huge problem. There will be people that speak English.

Yes, his doctors are fine with him going. He really is healthy as a horse, just lately showing his age.

Thanks for the input and I agree Wray! He is ready to go, has told me many times since losing my mom 5 years ago. But, since he is living he tries to stay healthy. This will be a wonderful trip, certainly his last, although he is still taking about going to Russia!

It is also kind of weird because his dad died on a cruise to Greece- maybe I'm just getting spooked!

Good ideas so far. On my last tour, a person fell and spent 5-6 days in the hospital then had to be medivaced home from Asia. The problems you mentioned already came up: little English in the hospital and very different customs (family members were expected to bring sheets and pillow cases for the patient.) Really pressed home the value of both foreign medical insurance and evacuation insurance. So the steps I heard that made sense to me: check with your father's doctor, understand his insurance coverage and buy more if needed, discuss the issues with your father, consider devices such as canes, walking poles etc.

First, kudos to your Dad for being such a determined individual. I have a mother that age,and while she is no longer able to travel she is just as determined to stay as independent as possible for as long as possible. Kudos to you for supporting your Dad and seeking ways to help him enhance his life.
Having said that, I think you have some tough decisions to make. Your Dad's doctor is probably the first place to start. If a thorough physical exam, blood panels, etc clear your Dad to travel make sure you have that clearance in writing from the doctor. I know from my own experience of being hospitalized overseas that is a sticking point for all types of medical insurance/coverage. "Was the patient healthy enough to travel at the time of the trip?"
As you said, you will need to research all the types of coverages that might be needed and read ALL the fine print. We have Kaiser, and they covered all of my overseas medical costs with a reimbursement check. (took about three months) The supposed "travel insurance" that came with our credit card turned out to be disappointing. Getting specific information about your Dad's plans is critical, and do as much as you can with email so you have it "in writing".
If your Dad doesn't have an Advanced Directive that MUST be done before your travel. Make sure you have a copy (or two) along with you.
The good news is that it is a cruise which allows for more rest if necessary. (I assume your Dad could stay on the boat if he wasn't feeling up to walking around.) It might be a good idea to talk to a representative of the cruise line and ask them your specific "what if" questions. I am sure they have well-established procedures in place.
After you collect all the information you can have a Sit Down and talk through all these issues openly and specifically with your Dad. You can then make a mutual decision that allows all of you to feel positive with "no regrets". If this trip seems too rigorous you might be able to substitute a travel experience that would still allow you to make memories but be less worrisome.

S&M one suggestion is that the two of you have a plan on what you would do, if he has to leave the ship for med reasons. That is, one or more likely, both of you, will have to get off and stay with him, and there's a certain amount of logistics you might end up dealing with, that are not necessarily covered by any insurance your father may get. The cruise lines likely deal with this all the time, but once you're off the boat, you're not their concern.

"This will be a wonderful trip, certainly his last, although he is still taking about going to Russia!" We can tell you from experience that, as long as he is even in semi-good health, this will probably not be his last trip. My father is 97 and needs a walker. When he and my mother were in their 80s they traveled to Madeira, their place of birth, three times but always with family as they couldn't manage alone. Since my mother died four years ago my father had returned to Madeira three more times, most recently in April. He still uses a walker, slowly, but when traveling uses a wheelchair. He needs to take the younger family members to handle this as we, who are in our 70s, can't manage alone with him. When he returned he said it was too hard to travel and that would be his last time. He has never had a health issue except for this most recent trip where he and my S-I-L caught a stomach virus. Last week he said he would like to return to Madeira again. Let us know how your father feels about travel a month after you return.

Good ideas and suggestions. I think you are correct Stan, if we are off the boat then the cruise won't be concerned with us!

He has agreed to stay on the ship if he is tired, and I think all of our excursions are off the bus a maximum of 2 hours or less at a time. So, he could also stay on the bus or we could get him sitting somewhere. I think my biggest concern is falling, not so much a serious illness or medical emergency, but you never know!

That's funny Carol! Yep, that's my dad. A few months ago he was "looking" at another trip about two weeks after we return from this cruise. I advised him that it is too close to be planning another one. I'm saying it is his last, but he isn't!

He might soon want to look into a folding walker. We went to Madeira in 2015 with my father (he was almost 96) and our two sons, who left family behind to help with Grandpa. We found a walker that converts from a walker to a wheelchair. It's great for walking but not as easy to push as a normal wheelchair, but still perfect for traveling. He was able to use the walker to get to breakfast in our hotel and to walk a bit at certain sights but to really get around our sons pushed him in the wheelchair. There's a message here for all of us: having something to look forward to is an important part of enjoying life at any age! May we never lose that.

Susan, more specifically, something we witnessed on a Carribbean cruise: we saw someone taken off the ship at a port by ambulance. Shortly thereafter, his spouse had to come back to the ship get all their luggage and valuables (passports especially) off the ship so that she could follow him to the local hospital by taxi before the ship left the dock. The ship crew helped get her off, but then they were on their own, in a foreign country. Not trying to be alarmist, just pointing out something no one thinks about. A bit of planning who does what, helps.

My mother was hospitalized in two Greek facilities in 1995, one if them on the island of Chios. There was no problem at all finding English-speaking doctors. Nurses were a different matter, and the ward nurses did not appear to have RN-level skills.

While you're Googling for the already-suggested lists of English-speaking doctors (just in case), try to locate the telephone numbers for the consular affairs sections of the US embassies in the countries you'll be visiting, or a nearby consulate. If something complex happens, the consular folks should be able to provide guidance, because you know they've dealt with a lot of similar situations.

As another poster said, balance tends to become more problematic as we age. At 65 I have a problem negotiating unpaved/non-graveled paths. It's extra-tiring to balance on loose rocks, and with tiredness I tend to get trippy. It gets worse if I'm hungry. I'm currently walking around France with an unsightly bruise on my cheek and a bum knee acquired on Porquerolles. We'll see whether that is enough to keep me from starting out on future unpaved, multi-mile walks without having had a solid meal. On a cruise you probably won't be skipping meals, but try to be sure your father has something hearty to eat before setting out. You might consider carrying something like packets of nuts with you on your excursions, as well as water

Pack a couple of folding walking poles for both of you, not a cane for him. My mother can't get the hang of a cane, but a rubber tipped hiking pole works. A Parisian friend in his late 80s uses a crutch under one arm for stability and still takes all the stairs and the metro. Doubt your dad would agree to either a cane or crutch, so try hiking poles.

Get copies of his medical and "emergency assist" insurance policies and call the companies to confirm what is covered outside the U.S., who you need to contact and when. And write down the name of every person you talk to, date, time and what they said -- then email back to that person/company your understanding of what was said.

If he has a Medicare supplement insurance policy, it MAY cover foreign emergency treatment depending on which letter coverage he has (we have F, which covers up to $50,000 after a $250 deductible.)

Get copies of any travel insurance policies taken out for this trip, too.
And if you carry the numbers for the American Consulate or Embassy in each of the cities you will visit, they could send an interpreter if the hospital doesn't have one (which it probably would.)
Sounds like you will need a "vacation after your vacation."

Hi Susan:

One or two additional things. Make sure any additional insurance you buy will cover the costs of a companion to stay with your dad. If he is injured and needs to stay behind , you would be responsible for all costs while you stay. It will also help offset the costs you will incur.
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As posters have said before make sure any Medicare supplement plan covers what Medicare will not or buy additional insurance.

If you do buy additional insurance make sure someone at home knows all the particulars. That way they can help with communication. Just make sure the insurance company has them as an approved contact.

Lastly, make sure you have plans in place for you as well. If you or your husband became ill, how would you take care of your dad etc.

Some brand travel insurance policies are not sold after 85 or 90.

I was going to suggest hiking poles but Bets beat me to it. Leave the rubber tips on.

And if you carry the numbers for the American Consulate or Embassy in each of the cities you will visit, they could send an interpreter if the hospital doesn't have one (which it probably would.)

Do not count on this! The Embassy might very well have a list of medical professionals that speak English, though. The U.S. Embassy in Rome has such a list on this page along with info on how they might be of help.

Tons of great and important information! Thank you all so much for the help!

It is also kind of weird because his dad died on a cruise to Greece- maybe I'm just getting spooked!

I kind of get it. At 92 and your wife gone it's sort of romantic. It makes me remember that I want to go like my grandfather, in my sleep, not screaming like the people in his car.

My husband and his travel buddy (both retired military - in case that might sway your dad), take canes that fold into seats. It helps if they are standing for any length of time or just need to sit down. Other men always ask about them when we're traveling.

First of all, congrats to your dad for staying active! What a wonderful example for all of us! :-)

It sounds like you've received some great advice in this thread. The only thing I'd reiterate is making sure that you have evacuation insurance that will cover medical transportation back to the States. On our last out of the country tour (NOT a RS tour), we were required to show that we had a required minimum amount of medical evac insurance so that we could afford to get home. Medical transport is insanely expensive, and it would be worth the cost in terms of peace of mind if you have the insurance to get you (all of you - accidents happen to all of us!) if something unexpected happened.

It does not sound like fun for anyone to do this trip or is that not the purpose?

Susan and Monte, your dad sounds like a fun travel companion, with a great attitude. It's good that you are considering all possibilities.

I would pay no attention to negative feedback; clearly almost everyone is offering you support, encouragement, and helpful advice.

Thanks Zoe!

Yes, this trip is about fun! Not sure why it wouldn't be. We had fun with our cruise in 2013 to the British Isles, and fun with him walking all over London in 2015. This will be dad and two remaining daughters. We'll have great fun laughing, being together, having wonderful cruise dinners together and my sister will see Italy which my dad has always wanted her to see because she use work in archeology. Dad loves seeing us laugh together so it will be a dream for him, and us too.

True- we won't have a good time if he ends up in the hospital or taking a fall. But, you can just take precautions and then live your life. He wants to go, so we will.

Thanks for all the encouragement and great information!!

Susan and Monte,

A few thoughts and questions.....

Are you going to be on the cruise for the entire trip, or spending some time in cities? If you'll also be in cities, one thing you could consider is a membership in IAMAT.org which provides a list of Englsh speaking Doctors who will treat minor ailments for a set fee. That should take care of minor problems.

"What if we end up in a foreign hospital? Are there interpreters available to help us? Any advice to be better prepared?"

In my experience, don't count on there being interpreters available. Physicians / Specialists and Nurses may have some ability to function in English but the majority probably won't be fully fluent. If you're in a normal ward as used by the locals, some of the staff may not be able to speak ANY English! Google Translate may be be able to help a bit, but it's not a panacea for instant and accurate translation, especially where specific medical terminology is involved. Also, the staff are often run off their feet, and they may not have the time or patience to sit there while someone types out phrases into a translator app.

A few suggestions that may help....

• If your Dad takes any medication, be sure to bring an adequate supply, and also determine the generic name in case you have to replace it during the trip.
• It's been years since I've taken a cruise, but from what I recall the shipboard medical facilities are often on a "pay-per-use" basis. It would be a good idea to verify that prior to the trip so that you're financially prepared if necessary.
• Be sure to review your Dad's medical insurance policy so that you're aware of all the terms and exclusions.
• In the same situation, I'd probably prepare a small card in Spanish, Italian, French and Greek with information on your Dad's name & address, pre-existing medical conditions, current medications, allergies to med's, blood type and name and phone number of his family Physician.
• If the cost wouldn't "break the bank", you could consider signing up for a short term policy with someone like Med-Jet Assist, in case repatriation with medical attention is necessary.
• If you're travelling with a smartphone, bookmark the locations of the U.S. Embassies or Consulates in each of the countries you'll be visiting.
• Some travel experts recommend registering trips on the government website. I've never done that in the past, but may consider it in future - https://step.state.gov/

Hopefully all will go well and you'll come back with some wonderful memories of this trip with your Dad.

Thank you Ken. Lots of great info I will be using! Hopefully all for not, but better to be prepared in advance.

Just a FYI- med jet assist only covers people below age 84.

Thanks for the FYI on Med-Jet Assist. I've never used them so haven't looked into the details.

Medjet Assist does have an age limit, but it's great for those who can take advantage of it. In fact, AARP offers a discount on membership if you're above X years and below Y years old.

You will need comprehensive medical insurance that covers helicopter transportation to a hospital from the ship and/or ports of call as well as transportation back to a US hospital if need be. You don't want to be caught off guard. You are right that medicare does not cover int'l travel. Speak to the cruise line about your concerns as I suspect you aren't the first person wondering about foreign hospitals/language barriers. It may be so hot that he'll need the air conditioning of the ship. At least there is that.

Build some wonderful memories on this trip. You sound more nervous than he is and he sounds (from your description) as sharp as a tack.

Yes, he is sharp as a tack and strong too, up until the last few months which is why it makes me more nervous. And you are correct continental, he is not the least bit nervous about it. It's me and my sis that worry about him, and he doesn't worry about himself, just us!

He walks his 1 1/2 miles everyday still, even the day after his fall!

Thank again for all the great advice! I've got homework to do!

Insurance policies that you're looking at might cover some level of assistance with necessary communications and arrangements, not just paying for them afterward. For instance, when we've used Travel Guard for our tour members, I believe that finding a translator was a task they handled.

Just a quick update:

My dad has an "Emergency Assistant" card he has had for 30 years and pays just a few dollars a year. They will evacuate him from anywhere to a hospital and to home with no maximum dollar amount and no problem of preexisting condition. They will also provide a nurse to travel with him if needed. They don't cover anything else.

He also called his medical insurance (not medicare) and they will cover him abroad but he pays the bill and they reimburse him. That is how my insurance works too. Not really sure what happens if the bill is hundreds of thousands- but we can't worry about everything!

So, I think we are ok since we have the Princess coverage that we might use if we need to cancel, and some small medical with that but we do have back up.

Now, I'll get the translation apps, phone number of embassy and all the other information you all have supplied to me. I'll talk to him about walking poles, and everything else to keep him cool. I'll make sure to get a list of his meds and a copies of his insurance cards.

He tells me "lets not worry about it" but I know better than that! I'm sure it will all be fine. But, I'll be prepared the best I can in case of "what if?"

Thanks everyone!

No payment- insurance covers all evacuation. But, he can not be told by a MD that he can not travel. So, as long as MD ok's travel then he should be covered. But, with anything, I suppose you really don't know until you use it!

All of the doctors and most of the nurses will speak English, so no worries there.
You should have a list of all his medications, recent illnesses, operations, etc available in case anyone asks.
It's a good idea to bring more medication than he will need, just in case.
You might also familiarize yourself with these common terms, which will be useful:
fainting
taking blood or urine samples
dehydration
shots
sprain, broken bone
and understanding how to take medication, if necessary

Most common guide books have some information, or you can GoogleTranslate for the appropriate medical terms, in case you run across anyone who doesn't speak English.
You should definitely investigate medical insurance. The good news is that medical treatment is much cheaper in Europe.

Something I learned when we cruised with Holland America....when we purchased our air through the cruise line, the med/evac insurance we purchased with them covered us from flight to flight. I contacted them to extend the coverage for the 3 weeks we traveled independently after disembarking the ship. I was told it wasn't necessary; that my contract with the cruise line including insurance was valid until I completed my final flight home. Fortunately we didn't require anything. We cruised around with Dad until he was 95 and had wonderful times. Yes, it was fun. Safe travels!