"Penny" wrote an online caregiving expert with a personal dilemma. She has been the primary caregiver of her father for years, and though he's doing well in assisted living, he still depends on her a great deal and is accustomed to her daily visits. Penny has been invited on a week-long vacation with a friend, and she is having second thoughts about going. "Dad gets sulky when I talk about going, so then I feel guilty even considering it," she stated. "Is it bad for him if I go?"

Penny's situation is one faced by millions of caregivers each year. People who provide care for an elder loved one often think they cannot take time for themselves. They fear that their charge will not get the care he or she needs, or worse, that he or she will resent them for doing something "selfish." Taking time away from caregiving duties is not a selfish act. Studies have shown that caregivers who regularly take a personal time-out or go on vacation provide better care and report lower levels of stress. But, taking a vacation is harder for caregivers. Beyond the emotional struggle, like the one Penny faces, caregivers have to do quite a bit more planning for a vacation than people without caregiving duties do.

The first step is to decide whether or not to include the person you care for in your vacation plans. If the loved one is in a retirement community, assisted living or skilled nursing facility, the decision to leave him behind is a little easier, because you can be fairly certain that he will receive the care he needs while you are gone. It becomes a little more complicated, but not impossible, if you care for him in his home. Respite care, offered by many retirement homes and home care providers, could be an option.

No matter where you provide care, you may be concerned whether that care will be of the quality he expects, or worry that he may reject it. You can minimize this with some advanced planning:

• Find a replacement caregiver. It can be someone you and he know, or you can hire a professional, but it's best if the same person fills in for you the entire time you are gone. This will help him be more accepting than if there were a different person every day.
• Introduce the temporary caregiver well in advance of your vacation. If possible, have her shadow you for a few days so that he gets used to having her around and sees that you are showing her the "right" ways to do things.
• Make a list of responsibilities with detailed instructions for the caregiver. You may also want to make a daily checklist of duties.
• If he will be receiving respite care in a different setting, see if you can arrange several visits in advance so that he can become more comfortable with it.

Many caregivers decide to bring the loved one along on their vacation. This can provide some good stimulation and quality interaction if other family members are involved, but it also can cause a lot of stress and reduce the overall benefit of the vacation. It's a great idea to check with your loved one's physician before you go. Explain the nature of your trip and your planned activities and ask if she has any concerns. At this time, you can also ask for a list of medications, extra prescriptions in case of an emergency, access to medical records and contact information. Also, don't forget to pack the individual's insurance and Medicare cards. Next, consider your loved one's travel limitations. Check with the airline or railroad about amenities like priority boarding, courtesy wheelchairs and other things like portable oxygen. If you are driving, consider renting a vehicle that may provide more space for him or any needed equipment. Plan your trip with designated times to rest and choose activities that are convenient and low-stress. Remember, you don't have to do everything together.

Here are a few more tips for making vacation travel with an elderly loved one easier:

• Plan ahead and involve him in decisions about where to go, how to get there and what to do when there. Stick to the plan, but be flexible and willing to improvise should things not go as planned.
• Stock up on supplies, such as his favorite foods, medications, hygiene supplies and mobility aids. Make lists of things that can be brought from home and things that can be purchased or rented at your destination.
• If you are driving, plan regular breaks to get out and stretch. Take bottled water and light, non-salty snacks. Carry extra pillows for comfort during the trip.
• If flying, change position frequently and let him move around the cabin when possible. Carry prescriptions with you instead of checking them with your luggage. Fly at off-peak times when the plane should be less crowded.

Vacations aren't impossible for caregivers. They may require more planning and preparation, but the benefit of taking time off, with or without the one you care for, makes them worth it.

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