Big trips require a lot of planning, and your health should be one of your considerations. Claire Larson, MD, a geriatrician with the UNC Center for Aging and Health, says there are 11 key things older travelers should keep in mind before and during a big trip to stay healthy.

Make sure your immunizations are up to date and check to see if any additional shots are suggested for your destination. “Vaccinations are really important when traveling,” Dr. Larson says. “Make sure you have all the routine vaccines that are recommended based on your age and any health issues you may have.” It’s best to check this six months before your trip, Dr. Larson says, because you might need a series of shots over time for full protection. At a minimum, you should give yourself four weeks for the vaccines to take effect.

Arrange wheelchair transport with your airline before your flight, if needed. “There is lots of walking at airports, and it is often more than my patients are able to do on a daily basis,” Dr. Larson says. Airline wheelchair transport is free and available to anyone with a disability or difficulty walking. Besides the physical assistance provided, airline staff can help you find your gate or connect on time when you have a short layover.

If you require a CPAP (continuous positive airway pressure) machine or supplemental oxygen, make arrangements ahead of time. People with sleep apnea need a CPAP machine to get an adequate oxygen supply while they sleep at night. Going without one can affect quality of sleep and put stress on the heart and lungs. The same issues arise for people with breathing disorders that require supplemental oxygen. The Federal Aviation Administration has a list of approved devices, but check with your airline ahead of time, as some have different rules and may require a doctor’s note for your device. Dr. Larson says there are travel-sized CPAP and supplemental oxygen machines that may be easier to transport. This advice goes for bus and car trips as well. Plan ahead to make sure that your transportation allows your device on board and that, if you need oxygen, you have enough for the trip.

Carry on your medications and simple first-aid supplies. If you pack all your medications in checked luggage before boarding your plane, you won’t have access to it during your flight and you run the risk of your bag being lost – and your medications too. Having your medication on board allows you to stick with your schedule throughout the trip. Depending on the length of the vacation and time difference, it may make sense to adjust the timing of some of your medications. Talk with your doctor before making any adjustments. “Keep a list of all your medications on you in case something gets lost or you need to see a doctor during travel,” Dr. Larson says. “Also, keep all of your medicines in their original bottles to avoid being flagged by TSA or customs agents for unidentifiable substances.” Dr. Larson also says simple first-aid supplies such as antibiotic ointment, bandages, over-the-counter painkillers, and antidiarrheal medication can go a long way to keep you comfortable.

Pack a change of clothes in your carry-on. This one is mostly for comfort, but it can be especially helpful for people concerned about bathroom problems. “In case you have travel delays or lost luggage, it’s nice to have a fresh change of clothes available,” Dr. Larson says. “It’s also a great idea for those who have issues with incontinence. Knowing that you have a spare outfit can help relieve some worries.”

Wear comfortable and supportive footwear. “People tend to be more active than usual on trips, and even just walking through the airport can add up to a lot of steps,” Dr. Larson says. “It is important to have comfortable, supportive footwear because you don’t want pain, blisters, or a stress fracture while traveling.” And don’t wear that new pair of shoes for the first time when you expect to be doing a lot of walking.

During long flights or road trips, walk or stretch every one to two hours. Sitting still for too long can be deadly because of the risk of deep vein thrombosis – blood clots in the legs. “The risk for this is highest when sitting still for over four hours, but you should move around every one to two hours to keep your blood flowing properly,” Dr. Larson says. People with varicose veins, leg swelling, or a history of blood clots may find compression socks helpful during long periods of sitting. Long stretches of sitting are bad for arthritis, too, because joints need movement to keep them limber and mobile, which reduces pain. Whether in a car or on a plane, be sure to take pit stops or get up to stretch and walk.

Hydrate. It’s especially important for older adults to stay hydrated because they naturally have less water in their bodies. They also may have conditions or take medications that increase the risk of dehydration, which can cause fatigue, dizziness, confusion, or low blood pressure. “Stay away from caffeine or alcohol, because they’re dehydrating,” Dr. Larson says. “Drink something, preferably water, every few hours, even if you don’t feel thirsty.”

Try to maintain your sleep schedule. “Jet lag is a real thing,” Dr. Larson says. “Even if you don’t change time zones, just changing your routine can affect your sleep.” Quality sleep is important to feel your best and stay healthy during travel. Lack of sleep can lead to confusion and depression and can even affect your metabolism and endurance. Sleep aids such as melatonin can help you readjust your sleep schedule, but be sure to consult your doctor first.

Have an emergency plan for medical issues. Enjoy your trip, but take the time to think about worst-case scenarios. “You should know beforehand where the nearest hospital or medical clinic is and what your health insurance will cover abroad,” Dr. Larson says. “You should have the list of your medications and contact information for your primary physician readily available, along with a plan of how to get in touch with your family if needed.” Contact your insurance company to learn about what it will cover, and consider travel insurance. Notify your physician before you travel so he or she can help create a plan for your medical conditions and travel destination. Share your emergency plan with loved ones before your trip.

Don’t overdo it. “Don’t do things really out of the norm for yourself when you travel,” Dr. Larson says. “This applies to sleep, physical activity, and food and alcohol consumption.” Don’t feel compelled to hike up that mountain, try every food truck, taste all the wines, or catch that late-night show just because you are on vacation. If you deviate greatly from what you’re used to, you may end up with a stomachache or an injury from simply trying to do too much.

Use these guidelines as a starting point for planning your trip, but always be sure to check with your physician and airline for an individualized care plan and alternative travel options.