Italy with an elderly parent

Since he has his heart set on Italy, he'll be motivated to go around seeing the sights and generally enjoying the place, so that's a good thing. Cobblestones are everywhere, and they're slippery when wet, so that's a point of caution.

Just one piece of advice I have is the importance of using railings when going up and down stairs. Other tourists don't realize that an elderly person needs the railing, and they may congregate at the sides of stairs and block the railings. (This happens in New York's Grand Central Station all the time!) In Scotland, we asked people "Would you please let us use the railing?" and they immediately and cheerfully complied. In Italy, you'll need to ask in Italian--and possibly in other languages, because the people you're asking may be tourists from any number of other countries--though lots of people speak enough English and understand hand motions well enough to figure out what you're asking.

I'm not fluent in Italian, but I believe the following is what to say: Per favore, lasciaci usare la ringhiera (let us use) or Per favore, lascia che usi la ringhiera (let him use).

I'm pretty sure someone asked in the past about relatively flat towns/cities in Italy, but I'd never find that thread. I do think it's something to consider, having traveled several times with my mother, who had significant pulmonary issues. She would look at a street running downhill and decide not to walk that way, knowing that she would later have to walk back up. Some places are just a lot harder than others, and there are so many wonderful options in Italy that you should be able to fill your itinerary with places that are mostly flat--Rome being an exception.

Padua, Vicenza and Ravenna are all interesting, attractive towns without challenging terrain. Although there's a significant uphill walk as you leave the funicular in Orvieto, there's a bus that goes over near the Duomo, and I think it would make Orvieto quite manageable.

The hump-backed bridges in Venice could be a very big concern, but one could stay in a hotel near the train station and spend some time taking vaporetto trips without constantly crossing canals on foot. I believe going out to Burano and Murano would work OK. I haven't been to Venice in ages, so I can't guarantee the accuracy of my memory.

Assisi is quite hilly. It's possible that the basilica would be manageable, possibly by bus or taxi from the train station, but I don't think the charming, non-touristy area uphill from the church would work out.

My general suggestion would be to Google for photos of each place you are considering. And of course it is a good idea to select hotels near your top sights, to facilitate rest breaks. Avoiding the hottest part of the year would be helpful, and the point about wet cobblestones is a good one. I don't know how easy it is to find a temperate, relatively dry period.

There is a company in Canada called Senior Discovery Tours. You might look into what they offer. Some of their tours are not physically demanding, others a a little more so. Their prices usually include airfare and medical insurance.

You have to go to Rome, but you do not have to strain your dad too much. Taxis are your friend and they are not horribly expensive. Make sure your lodging has an elevator and A/C even in September. We No longer fill our days for sun up to sun down. We do one big “thing” each day, early, then after lunch we take the pausa, re-emerging about 1700 for a walk, an aperitivo, then dinner about 2000.

While I understand a car might be a good way to move about, for Rome and Firenze (Florence), you should take the very comfortable train, the highspeed Frecciarossa. The station in Rome is a stub station, as is the one in Firenze, so not schlepping bags on stairs and you can get assistance in the station.

Venice could be tough due to the bridges although many now have ramps to make them more accessible. But he does not have to trek over them endlessly. You can build an itinerary around using the vaporetto and it certainly would be fun for him —and you — to see.

If you do the big three, Rome, Florence, and Venice, you can still do some nice rural stuff with the time you have. Maybe rent a car in Florence and spend a week driving around Tuscany. Venice has an easy stub statio, too, but you could drive there and leave the car. Or start in Venice, drive through the Dolomites to Tuscany, the drop the car for some time in Florence, take the train to Rome.

By all means have him take along a cane or a trekking stick as is used for hiking. Provides excellent stability even in cities.

As a person with parents who are not as active as before here are my suggestions. Get a hotel in the center or nearby with lift and a/c. You may have to spend more but I noticed my parents would go back to the room in the afternoon for a nap. Do one thing in the mornings and then one thing in the afternoons. Taxis and public transit are your friends. Also I’ve noticed Southern Europeans to be much more helpful with the elderly.

Don’t move too often. Packing and unpacking are some of the most stressful times for senior-I’d forgetting and losing items. A couple nights stay at least. Just know that you will be going at a slower pace then normal.

Just a few things my bum knee and I have noticed:

1. In cities, traveling by bus sometimes is easier than contending with stairs in some metro stations.
2. Many metro stations have escalators or elevators. Search them out.
3. If traveling by train, many of the multi-track stations also have elevators on all platforms so you won’t have to contend with stairs. Especially great with your luggage.
4. If you have a car, you’ll usually have no problems finding convenient parking in smaller towns. In larger cities, research where the parking garages are (either Google Maps or Michelin Navigation will show them) and the ZTL’s. Sometimes you’ll be able to park close to the centro storico within a short walk. For example, in Torino, there’s an entrance to a massive underground car park at the edge of the ZTL across from the RR station. When you take the elevator to ground level, you’re in the center.
5. In cities, taxis can be an affordable luxury.

In Rome the Borghese Gallery might be a good fit for you and your Dad. You must have reservations and book them as far out as possible. Every 2 hours they let in a limited number of people. When the 2 hours is up, everyone is cleared out for the next group of reservations. It's 2 story, but there is an elevator. The inside of the building itself is beautiful, and with the sculptures and art, it is well worth the time. Then go out into the Gardens and rent a golf cart to take him around. This is very popular, get to see the property and it's relaxing. buses and taxis may be your best bet for getting your Dad from place to place in Rome.

Venice can also be relaxing, if it's planned right. Book a hotel with elevator and if in the summer or through September, make sure it has AC. Close to a vaporetto stop. The Hotel Al Ponte Mocenigo is not far from a vaporetto stop. It is multi story, with an elevator.
They also have one large room on the ground floor. The hotel has a main entrance that you have to cross a small bridge with steps.
The entrance on the back side is flat, so that would be easier for your Dad. If you reserve that hotel, explain and ask for directions to the rear entrance. Also you might want to request that ground floor room. they were very helpful and friendly when we stayed there.
We did stay in the ground floor room, just the luck of the draw. It has a glass door that opens onto a small courtyard at the front of the hotel. it was a large room with a large bathroom. But you may want to request a room with a walk in shower. The ground floor room had a large step in tub.

The last suggestion I have is to pack Light!! Both of you because you may be doing the lugging of the suitcases yourself.
You can always have laundry done in Europe.

Whatever you decide, please let us know, and a trip report would probably be helpful to a lot of other people!
Have a great trip,
Mimi

Thanks for the great advice so far.
Just a few things to note.

If I get a car I would only do so for outside of major cities, Two years ago I rented three different cars in three different locations because of stops in large cities such as London sand Paris. And I only drove through Monaco because we wanted to drive on as much of the F1 track as we could and the Drive around the Hairpin was amazing! Gave a new appreciation when watching the race this year.
Dad normally does not use a walking stick as he still has good balance (was up a 10ft ladder the other day.. but he does use one on out trips the last few years.

As for leaving things and packing you are SO right. Lost about $50 in stuff last year and this year. It happens and I am pretty much resigned to it. I figure it is much like any other part of the budget. You just spend the money and move on. Last year he left his custom made walking stick in the back of a taxis in Paris. Fortunately it was the last night. And we caught a flight home the next morning. But frankly sh1@# happens. I figure as long as we get home in one piece with out major items and out photos intact anything else is beside the point, This year it was the card reader for our iPods that got lost. Oddly I remember putting it in the case but somehow it got lost. That was a pain not so much for cost as because it was surprisingly hard that find a replacement.
Regarding the agenda. In general we have move to an ABC agenda. We grade each thing we want to do as A B or C. A is must see. B is would like to see and C is while in the area if we have nothing else to do. Usually we plan one A and one B per day and list possible Cs for that day. So useing London for example we had Westminster’s new Jubilee Exhibition as the days A. With Tower Bridge crosswalk as the days B (we stayed near Tower Bridge so that was more logical then it sounds) and we had Thames cruise and the Eye as two Cs. We went to Westminster (and that was great) and then took a cruise back to our hotel near Tower Bridge after Lunch. Took a short nap and then did the Tower Bridge in the afternoon. Never did do the Eye.
This was an example of how we work. We can count on one major thing each day beyond that nothing is promised, I also have learnt that we need to alternate between intense days and slow days. For instance the day we did Windsor was followed but a much less intense day in London.

We try to avoid tours as much as possible because it is hard to predict what Dad will feel like. And we don’t want to feel pressured into anything. This year nothing would do but Dad wanted to take a yoeman Warner Tour (great fun) and as a former Sergeant in the US Army he enjoined the banter with them. But it was a bit faced pace going up the hill in the Tower. But he was going to make it or die trying. Thus I find it better to go at our pass if at all possible.
I wonder how expensive a private tour guide in some of the big cities would be for a day or two?
I figure this trip is not going to be inexpensive to begin with so... who knows.

Anyway once again thanks for the advice.

Although folks fairly often recommend private guides on this forum, it is extremely rare for them to reveal what they paid for those services. I don't know why; it's critical information, and all you need to do is include the year of the trip so readers are not seriously mislead by old information. Rick at least occasionally does provide half-day and/or full-day fees for guides he recommends. Private guides are not in my budget (I'm usually a solo traveler), so I haven't really paid attention to those numbers, but you can look at his most recent guide to Italy. My going-in assumption would be at least 400 euros for a full day if you are not using the guide's vehicle, but that's barely more than a guess.

That figure is specific to the affluent western European countries. I had a guide in Krakow for two hours a few months ago, and I think I paid the equivalent of about 20 euros or 25 euros per hour.

I second the use of taxis in major cities like Rome. Florence is easily walkable from a well-located hotel.

For Italy we generally think first of the Top 3 - Venice, Florence, Rome. But there are so many wonderful places in Italy that would be less crowded that still have wonderful architecture.

Locations that would be level that come to mind:

Ravenna- breathtaking mosaics and a charming town (was there two days and would like to return), The TAMO Museum is also worthwhile and just skip the upper floor section.

Verona- Roman Arena and wonderful town to explore at a relaxed pace.

Stresa - if you would like a lake town, this one is my favorite. There’s the cute islands to either explore or just gaze from the relaxing promenade. Isola Bella has the beautiful Borromeo villa and gardens to tour. Even a nice ride on the small lake ferry could be something he would enjoy.

Lucca- another level town. This one has the wide wall to walk around, and I saw some elderly men gathered for some social time on it.

Some you might want to avoid:

The Tuscany area tends to be hillier, but Siena has a beautiful cathedral and wonderful Campo. Check out photos or YouTube to see if it’s too hilly.

Venice- LOTS of constant up & down from the walkway bridges.

Also I should comment that you can always find small outdoor tables at restaurants that are worth the price of a beverage or snack to relax and enjoy the views for as long as you wish!

We use private tours guides through toursbylocals.com. They have a variety of guides listed, languages the speak, days available and PRICE. You can read thier profile, then email them what you want to see. They can help you plan for your circumstances.
For example, last august we were 6 people, we took a private tour of Split for 3 hours and it was $110. Granted, we were in Croatia which is less expensive then London, but this an example.

Lots of good advice here, but you must do this: consult with his internist or PCP and have a thorough exam performed. The last thing you want to find out is that he has some underlying cardiac condition just ready to become a problem. If he gets clearance from his doctor start a program of increasing aerobic activity-walking is probably the safest. Ask for an occupational therapy and physical therapy referral. They will test him for ambulatory skills, balance, endurance, and can prescribe any assistive devices he may need. A walking stick might just be it, but they can teach him how to use it effectively. The only destination advice I strongly disagree with is Venice. It’s mostly all walking, and lots of up and down steps over bridges. Getting on and off vaporetto is a challenge for the elderly (except the Venetians) and I’ve witnessed a few near falls. Other cities if things go sideways you can get a cab. Not so easy getting a water taxi in Venice.

I think much of Italy will be as difficult or more so than your experience in France. As you can read on another recent thread, most hill towns seem to be uphill in both directions.

Train tracks are not normally announced more than 15-20 minutes in advance in Italy. (Boarding assistance is available to pre-book, but with you along, he probably doesn't need that.)

• Some museums in older buildings have a service elevator (ascensore) somewhere that they will be happy to let disabled and elderly visitors use, but staff may need to accompany you, and it may mean walking the length of the museum to reach said elevator (more than once during your visit). For instance, I experienced this a lot in Bologna, when my dad was older. Newer, purpose-built museums are usually better laid out for that.

• In many hotels that have elevators, you still have at least a half-flight of steps at the front entrance. At some of Rick's recommended hotels near Termini station in Rome, the elevators are old-fashioned types that require each passenger to close all the doors properly or they won't operate. For this and other reasons, they may not be in service when you want them, so I'd avoid staying on the higher floors.

• The Vatican Museum gets extremely crowded, with few opportunities to sit down, and it's a long walk from the entrance through the majority of the museum to the Sistine Chapel. St. Peter's Basilica has also been very crowded, unless you plan to attend mass and get through the security line in time for that. Standing in said line can also be a problem (on stones, probably in hot sun). You might decide to skip both.

• Other museums (like the Villa Borghese) have reservations systems and strictly limit the number of visitors at any one time, making your two-hour visit time much more pleasant. Almost any other church doesn't get that crowded. The Capitoline Museums, for instance are perched on a hill and spacious inside; preview their accessibility notes at http://www.museicapitolini.org/en/informazioni_pratiche/accessibilita_disabili.

• Read advice in Rick's guidebook for reservations and crowd avoidance at each location. He won't provide specific elderly/handicapped advice, but will often mention a hill or stairs or average walk time.

• In Venice, another nice (popular) hotel with a few ground floor rooms (after the entrance stairs) is https://www.casarezzonico.it/en. But bridges can still be a problem.

Douglas,

I traveled to Italy a few times with my elderly mom, she was 88 on our last trip together.
I wrote out this list when replying to a thread a few years ago.

Helpful tips I've learned from traveling with my elderly mom:

1. Request wheelchair assistance at all airports-- even though my mom
   gets around fairly well, sometimes there's much walking at airports
   & it's great to have someone (who knows the airport very well) to
   help you maneuver you through the airport(s) through customs,
   immigration/passport check-point, baggage claims, etc..

2. Always book hotels with elevators & make sure there are no steps
   going up to your room, once you get off the elevator.

3. Many tourist attractions ( museums, etc..) have "hidden" elevators--
   just ask, or sometimes you can find this info on their websites.

4. Expect to take many breaks throughout the day & make sure to keep
   her well hydrated.

5. I've learned to be extra vigilant of my mom, because sometimes she
   will not tell me that she's tired, but I know when it's time to go
   back to the hotel, take a taxi or just sit for a while.

6. Sometimes less is more... the fewer destinations & longer stays work
   better than moving from one place to the next (avoid 1-2 night
   stays)

7. Make sure she takes all her medications plus written prescriptions
   from her doctor (just in case...)

8. Make sure to pack light. We each take a 20"carry-on roller suitcase
   & plan to do laundry every 6-7 days. On our last 2 trips, I ended up
   rolling both carry-on suitcases and had wished we only had one
   suitcase instead of 2!

9. Take lots of photos and enjoy your trip!

BTW, I did quite a bit of research before each trip with my mom. Here's a very helpful website full of travel tips: Sagetraveling.com

Have a wonderful trip!