Pace. One thing in the morning, one in the afternoon, and a seat every two hours: a café, a bench, the hotel. Three stops with rests is a good day; six ends with someone pretending they are fine. Count the walking minutes between stops. On a day trip, reserve train seats and the coach’s front rows, and tell the tour company about any walking limits when you book.
Stairs. The hard metros are Paris (only line 14 is step-free end to end; the buses are fully accessible), London (94 of 272 Tube stations are step-free; the Elizabeth line, the DLR and every bus are) and Budapest (only the M4 has elevators at every station). The easy ones are Tokyo (most stations have a elevator), Singapore (every MRT station has a step-free route) and Hong Kong (every MTR station has a elevator or ramp from the street). Where the metro is hard, take the taxi app.
Medicines. Bring the whole trip plus a week, in the original packaging, with a copy of each prescription and a doctor’s letter. Japan allows one month of prescription medicine and two months of over-the-counter without paperwork and bans some common ingredients outright, so check the MHLW list. Singapore allows three months but wants an application two weeks ahead for anything on its controlled list, sleeping pills included.
Insurance. Declare every pre-existing condition, including the one that is “under control”; an undeclared condition is the usual reason a claim is refused. Medicare does not cover care outside the US, and a UK GHIC covers state care in the EU but not repatriation.
Hotels. Ask two questions: is there a elevator, and how many steps from the street to it. In Europe the first floor is one flight up, and old-town hotels in Lisbon, Porto, Rome and Prague often have no elevator.
Heat and hydration. Tokyo, Bangkok, Singapore and Hong Kong in summer, and Rome, Madrid and Athens in July and August, are hotter than older travelers expect. Walk before 11 a.m., keep the afternoon indoors, carry water, and treat dizziness as a reason to stop.
Concessions. Over-65 discounts are patchy and often EU-only. The Prado halves its ticket for anyone over 65 with a passport; the Acropolis Museum does it for EU citizens only; the Louvre and Italy’s state museums have no senior rate; London’s national museums are free for everyone; Tokyo National Museum is free over 70. Carry the passport.
Start early. Stop at two hours, and have the taxi app ready when the stairs appear. Keep the medicines and prescription copies in the day bag, and the hotel’s elevator answer in Waystop’s Documents with the booking.