After an Elderly Parent Gives Up the Keys, What's Next?
There are more alternatives than ever, but chaffeuring parents often falls to adult children
Sherri Snelling, executive director at Keck Medicine of USC and author of A Cast of Caregivers – Celebrity Stories to Help You Prepare to Care, is a nationally recognized expert on America’s 65 million family caregivers with special emphasis on how to help caregivers balance “self-care” while caring for a loved one.
According to Automobile Club of America research, men over age 70 will outlive their safe driving ability by six years; women, 11 years. Next Avenue has explored the often complicated path to convincing a parent to give up driving for their safety and that of others. But after giving up driving, what comes next? For many older adults, surrendering the car keys is tantamount to losing their independence. But when giving up the car means being virtually trapped at home, that isolation makes the situation even worse. A parent still has transportation needs – shopping, medical appointments, religious services, visits with friends and family – and if they cannot all be met by a family caregiver, it's critical to explore alternatives.
(MORE: Why My 90-Year-Old Mom Is Taking Driving Lessons)
When adult children present parents with viable transportation options, they can discuss giving up driving as simply a shift from behind the wheel to the passenger seat. Fortunately, there are more possibilities than ever, thanks to a growing network of services dedicated to keeping older adults mobile, safe and engaged.
Finding Transportation Services
Caregivers in search of driving alternatives will need to familiarize themselves with services that might be available in their area:
- Curb-to-curb rides are essentially taxi services. Drivers likely will not help passengers come out of their homes, enter the car or help stow wheelchairs or walkers.
- Door-to-door drivers will help a passenger navigate the street and enter and exit the vehicle, but should not be expected to help with wheelchairs because of liability concerns.
- Door-through-door providers hire drivers who ensure that passengers get into their homes or destinations safely. They'll also help carry groceries or packages.
Before hiring any service, caregivers should ask if its drivers are bonded, insured and trained in certain emergency medical technician services, and whether vehicles are equipped with defibrillators.
(MORE: Building a Network to Look Out for Your Parents)
One growing door-through-door service, SilverRide, operates fleets in San Francisco, Los Angeles, Chicago, Washington, D.C., and Hawaii and is adding affiliates across the country. Its drivers are trained to offer not only rides, but companionship.
"It's not really about transportation," chief executive Jeff Maltz says. "It's about getting to a destination, having a conversation on your way there and being able to enjoy an outing. It's why many of our passengers ride in the front seat with our drivers."
In one typical client scenario, Maltz says, a SilverRide driver picks up a man once a week and takes him to the florist. Then he picks up the client's friend and drives the pair to pick up lunch at a deli. The car then heads to the cemetery where the client's wife is buried. The two older men sit and enjoy their lunch while paying their respects near the grave. On weeks when the friend is unavailable, the driver sometimes joins his passenger for lunch at the cemetery.
Another SilverRide client lived across the country from her mother, who was unable to attend the opera regularly as she once did. SilverRide found a driver and opera buff who could not only take the client's mother to a performance, but accompany her for the evening.
As you'd imagine, such a level of service comes at a price. SilverRide trips with full-day itineraries and companionship needs could run well over $100, but Maltz estimates that the average round-trip call in the San Francisco area costs about $85. The company also works with county agencies and community groups, including the San Francisco branch of the Village-to-Village network, to offer lower-cost services to clients with financial needs.
ITN America, which recently completed its 500,000th trip, is a more affordable door-through-door option that's available 24/7. The nonprofit group employs paid staffers and volunteer drivers, operates in 21 states and, like SilverRide, is rapidly expanding. ITN America's rides average about $11 one way and the group claims that 46 percent of its clients have incomes below $25,000. It uses innovative strategies to keep costs and fees low. For example, families can donate a parent's car to the group in exchange for a number of ride credits. Volunteer drivers can also earn credits they can share with loved ones who need rides, even in other parts of the country.
"Public transportation is not built for frail 85-year-olds and yet caregivers cannot become the only resource for a senior to get around," says Katherine Freund, who created ITN America in 1995. "It takes a community to come together to help seniors who no longer drive still enjoy life."
Other driving resources can be located through local faith-based groups. The Beverly Foundation is a national nonprofit organization that supports transportation programs and provides tips and resources for families seeking ride services. And municipal agencies with similar services can be found via the National Area Agencies on Aging's Elder Care Locator.
(MORE: Taking Away an Older Driver's Keys)
Hospitals may be another option for rides to and from medical appointments and procedures. "The Affordable Care Act has hospitals looking closely at transportation as a way to help keep readmissions low to avoid costly penalties," says Gail Hunt, president of the National Alliance for Caregiving and a member of the National Center for Senior Transportation's steering committee. "Some hospital networks are investing in vans to provide rides to ensure older patients comply with doctor visits after hospital discharge."
Equipping the Family Taxi
Even as ride options grow to meet the rapidly increasing demand, at least 83 percent of caregivers also provide transportation for the relatives they look after, according to the National Alliance for Caregiving. AARP estimates family caregivers take seniors on 1.4 billion trips a year. This can be a time-consuming burden for overwhelmed caregivers, especially considering that 7 of 10 also hold down jobs.
But even if caregivers have the time and inclination, there may be complications. It may be difficult, for example, for a parent to get in and out of an SUV, minivan or sports car. If passenger seats are not at hip level, it can be hard to transfer a parent from a car to a wheelchair and back. Some vehicles serve the chauffeur role better than others or can be modified more easily. The National Mobility Equipment Dealers Association has information on options available for specific models.
Toyota is the only major manufacturer that offers a factory-installed power-lift Auto Access Seat, on its Sienna minivan. The seat swivels 90 degrees, then lowers outside the vehicle to allow a passenger to be lifted into and lowered out of the minivan. The seat also makes it easier for caregivers to transfer a loved one from car to wheelchair.
(MORE: Can You Be Trusted With a Driverless Car?)
The company believes introducing the seat is good business. "Mobility needs worldwide are changing," says Mark Oldenburg, Toyota's national fleet marketing, mobility and strategic planning manager.
What caregiving experts call "driving retirement" is a "three gear" process: the first is a driving assessment, the second is a family conversation and the third is finding alternative transportation. Happily, third-gear options are better than ever, enabling more families to get ex-drivers where they need to go more smoothly, relieving both their parents' isolation and their own caregiving burdens.
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