Study Finds Ridesharing Services Improve Older Adults' Lives
A researcher says results show promise for combating social isolation
Connie Torres, 76, has always been gregarious and social, but getting around to visit friends and family after retiring from her job in retail banking a few years ago had become more challenging. Her daughter, Nancy, who works full-time, moved into Torres' Los Angeles suburban home to help care for her mother, who has an autoimmune disease.
Torres considers what her daughter has done a blessing. And because she has had to curtail her driving due to health issues, she doesn’t want to burden Nancy with providing rides to social activities.
“My daughter is a godsend, often taking me to doctor appointments. But asking her to take me to the mall to go shopping or to lunch with friends when she has work was just too much,” Torres says. And while her daughter was willing to help her mom out when she could, trying to coordinate more than the necessary medical and special-event rides around her busy schedule was challenging.
According to AARP, family caregivers provide 83% of the transportation needs to older adults every year, which equates to 1.4 billion trips.
Participants Used Rides for Social Activities
It is one of the reasons Torres was delighted to participate in a study conducted by the University of Southern California (USC) through a grant from the AARP Foundation offering free rides through the ridesharing service, Lyft.
“I’d never used a smartphone app to book a ride, but I thought, why not try this? It could be fun,” she says. (She also talked about her participation in the study in this video.)
"We have myth-busted the perception that older adults are opposed to new technology."
The study provided 90 days of free Lyft rides to 150 patients over age 60 from Keck Medicine of USC in Los Angeles, where 25% of patients live more than 90 minutes away.
One part of the study was to ensure patients made it to their medical appointment follow-up visits, since national statistics show 4.5 million patients miss these crucial doctor visits each year. The second part was to assess the impact of unlimited social transportation access based on a growing health concern for older adults: social isolation and loneliness.
“Aging patients with chronic disease often face medical and economic insecurities, but our study was the first to show offering no-cost access to not just medical appointments, but social activities, can actually improve self-reported health and well-being,” says Dr. Leslie Saxon, who led the USC study.
The results revealed one-third of the rides were used for medical appointments. But the majority of them were for fitness activity, social visits with friends and family and other leisure outings that improved the participants’ perceived quality-of-life by 92%.
By 2025, drivers age 65 and older will represent one in four drivers on the road. However, a Rand Corp. study found 20% of older adults, especially with chronic illnesses, do not drive and one-third face driving restrictions — some self-imposed, due to health conditions like declining eyesight, arthritis, mobility issues and medication side effects.
The absence of transportation is a key factor in the growing problem of social isolation for older adults. The AARP Public Policy Institute reported that a lack of social contacts among older adults is associated with an estimated $6.7 billion in additional federal spending annually, according to an analysis of Medicare spending data.
Older Adults Embraced a Rideshare App With a Little Tutoring
The key to the USC study was the up-front training and education older adults received on the Lyft app. While both the smartphone app and a landline concierge were options, 86% of the participants used the app.
Torres had never used a rideshare app before her involvement in the study, but took to the on-demand service easily after the initial training.
“I still use the app for both my doctor appointments and to stay connected to family and friends,” she says. “I’ve even recruited my friends and my cousin — who lives forty-five minutes away — to try it so we can get together more often. I like the freedom, but it does come with a cost, so I probably don’t use it as much as I was during the study with the free rides.”
Says Lisa Marsh Ryerson, president of the AARP Foundation, which provided USC the $1 million study grant with support from UnitedHealthcare: "From our perspective, the investment in up-front education and training for riders that was built into the study design was crucial. Since the majority of the study participants used the app —and we had some riders who were in their 90s learn the app instead of using the landline phone option — we have myth-busted the perception that older adults are opposed to new technology. In fact, the study showed the opposite is true, if education is built-in.”
She sees the study broadening the dialogue for public and private partnerships to seek solutions that offer affordable, available and convenient options for older adults to stay independent and socially engaged.
Ryerson believes this trend is the key to improving individual and community health. To that end, the AARP Foundation is engaging its members, communities and others in driver safety programs and initiatives that combat older adult isolation, such as Connect2Affect.
When it comes to technology, adoption and usage are two different things. A 2019 Pew Research Center study found 53% of people over 65 own a smartphone — an increase of 11% since 2017, and almost triple the number since 2013.
However, while AARP reports that almost three in 10 Americans over 50 have used a rideshare app, a majority of older adults say privacy and safety mean they aren’t likely to be trying it out in the near future.
“What surprised me the most about the study findings were the participants who started out calling to schedule rides migrated to the app because it was faster and easier,” says Megan Callahan, Lyft’s vice president of healthcare. “This validates what many studies have found: that older adults are motivated to break down barriers to improve their health, and once educated, technology is no longer a barrier.”
Medicare May Help With Cost Challenges in 2020
While 80% of the USC study participants said they would continue using the rideshare service post-study, like Torres, many find the cost can be a barrier.
One solution could be changes the Centers for Medicare and Medicaid Services (CMS) announced that would expand covered benefits for non-medical emergency transportation in 2020 Medicare Advantage plans, which offer benefits not covered by traditional Medicare. According to the Kaiser Family Foundation, Medicare Advantage plan members (more than 20 million people) make up one-third of Medicare beneficiaries.
One reason for the change is that CMS wants to offer more flexibility to health plans that support beneficiaries who are managing chronic illness, acknowledging that non-skilled medical care is part of this equation.
While Lyft rides were free to participants in the USC study, the average cost per participant was $21, and monthly ride costs totaled $500 per rider.
Paratransit options, such as Access in Los Angeles, are less expensive, but patients pay in the time they take and the inconvenience.
“If I want to use Access, I have to call at least twenty-four hours in advance. Whereas with Lyft, I can call ten minutes before I need the ride,” explains Torres. “And (with Access), I also have to plan on being gone all day for a doctor appointment that might last twenty minutes.”
Access requires that passengers be ready for pickup one hour before their scheduled time. Then, allowing for traffic and shuttle pickups for other passengers and return trips, the entire effort can take up to seven hours.
“Using the paratransit service just doesn’t work for me,” says Torres. “Not only does it take hours to get to and from the doctor visit, but I can’t afford to sit next to someone who might be coughing or have other germs that can worsen my already weakened immune system.”