What If You Couldn't Drive?

If you couldn’t drive, how would you get around? Depend on family or friends every time you wanted to get out of the house? Call a cab? Take the bus?

“Honestly, a lot of us can’t wrap our minds around the possibility that someday we won’t be able to pop into our cars and drive somewhere,” says Virginia Dize, co-director of the new National Aging and Disability Transportation Center (NADTC), a program funded by the Federal Transportation Administration and launched last October. “It’s really hard to deal with.”

AAA reports that “seniors are outliving their ability to drive safely by an average of seven to 10 years.”

At the same time, most older people choose to stay in their own homes — many of them in suburban and rural areas. “Those are the transportation-poorest areas in the country,” Dize says.

Communities around the country are somewhat belatedly trying to tackle this problem as older Americans make up a growing share of the population. Here's how three are trying new solutions:

In Lynn, Mass., Greater Lynn Senior Services (GLSS) arrived at an innovative mobility program by taking an unusual route. In a joint project with other agencies, GLSS looked at why so many older people in the area were re-hospitalized soon after they were discharged. It became clear that a lack of mobility and transportation were significant reasons why they were ignoring the follow-up instructions they got when they left the hospital.

And even though GLSS has provided medical transportation services and paratransit (for those with disabilities) for years, it wasn’t solving the problem.

“You’re missing something if you only focus on vehicles or people-moving,” says Valerie Parker Callahan, GLSS director of planning and development. “Every individual has a set of capacities and resources and deficits. And the environment can either support you or make it more stressful for you to negotiate.”

So GLSS took a holistic approach to mobility and transportation.

In 2012, it began setting up Kiosks for Living Well one or two times a week in community centers and senior apartment complexes. The staffed kiosks offer exercise and fall prevention classes, blood pressure checks and ways to connect socially. They also include a computer program called It’s Never 2 Late (iN2L), designed to help older adults and those with dementia feel comfortable with technology-based therapies and activities. Users can play therapeutic games or solve transportation at the kiosks. For example, staff might help them learn how to use Google Earth and see bus routes and schedules.

“It’s really talking with folks about mobility options,” Callahan says. “Sometimes it’s a response to ‘I need to get to the doctor with my husband, and he’s going to need a [wheelchair] car, and we have a problem because we can’t leave my sister home alone who is living with us.’ The question is: How do you support these folks, and also give them the decision making support that will help them solve the problem moving forward?”

Transportation problems can be related to other problems in a web of cause and effect. Fear of falling might keep someone at home, which results in social isolation. A GLSS kinesiologist can assess program participants’ homes and give them travel training, accompanying them on an unfamiliar route and pointing out potential tripping hazards. GLSS will also pair someone with a travel buddy if the person is leery about going out alone.

The health-oriented programs at the kiosk have a transportation connection, too. “Because there is a keen connection between mobility and heart healthiness, it makes a lot of sense to do cross referrals” with the nurses and the community health workers who staff the kiosks, Callahan says. “Whether it’s strengthening exercise, tai chi, [health] assessments or iN2L, we really are trying to promote the capacity of consumers to navigate around their community.”

Detroit lags behind other major metros in meeting its transportation needs, says Roberta Habowski, mobility project manager for myride2.com. The nonprofit service, initiated four years ago by the local Area Agency on Aging, does not provide transportation. Instead, it goes the extra mile to help people find the best way to get from Point A to Point B.

“I look at us as a transportation concierge service,” Habowski says. “We’re at the forefront of the true one-call, one-click concept.”

Two full-time mobility specialists take requests and research options for area residents, including private, volunteer and public transportation services. “We try to find at least three options that might work, always trying to find the least expensive,” she says. “We can help them book it, or they can take the information and use it themselves.”

Myride2 can suggest options that most people aren’t familiar with. For example, some cancer support groups provide free rides to chemotherapy sessions. The program’s website is also loaded with helpful information about more standard transportation options, such as step-by-step instructions for riding the public buses, links to routes and schedules and details about using wheelchair lifts.

In 2015, the service answered more than 2,000 requests. “We are generally always able to find something for someone, but the problem we run into is that [the options are] cost prohibitive” for some users, Habowski says. “It does happen more than we’d like it to.”

Fragmented service contributes to a lack of affordable transportation, with buses unable to cross county lines. Habowski is part of an effort to create a regional transportation system that would include paratransit on evenings and weekends over a four-county area. In November, voters will decide on a ballot initiative that would fund it.

In many small towns, public transit is nonexistent. But in Malta, Mont., population 2,200, a dollar will get you anywhere in the community. Make a call to the dispatcher at the Phillips (County) Transit Authority, and she’ll use a two-way radio to contact a bus driver to pick you up. In 2015, the bus service made nearly 54,000 stops around town.

“We pick them up starting at nine in the morning, to get their hair done, go shopping, visit friends, do their banking — whatever they need, we take them around,” says Betty Hasler, who runs the operation. That includes to the local bar, the favorite destination of a couple of riders.

But “there’s no alcohol allowed on the bus. We’ve never had any problems in ten years — never had a rude rider,” Hasler hastens to add. “Everybody kind of looks out for everybody.”

Anyone of any age may ride the bus, but most passengers are older. The $1 is a “suggested contribution.”

“A lot of our elderly are on fixed incomes,” says Hassler, who makes up free passes for those embarrassed by their lack of cash. “When they’re scraping the bottom of the barrel, that dollar actually means a lot. When they’re riding every day, that’s twenty dollars a month.”

Two-thirds of the transit authority’s $250,000 annual budget is covered through a federal grant, and the rest through a local match. Most of the service’s four buses and three minivans are wheelchair accessible. Drivers are authorized to help people to their door and carry groceries if needed.

The transit authority also organizes trips to the theater in nearby towns or to view the annual elk bugling (a fall mating ritual) or bird migration for as little as $5 a ride. Otherwise, for those who need to go out of town, the fee is 65 cents a mile. Some use the bus to go to medical appointments, with the closest specialists some 200 miles away in Great Falls or Billings.

The bus service means more to people than just getting a lift, Hasler says.

“A lot of people we pick up, we are their only source of socialization. We had three or four who were recluses. Finally they started riding the bus, and they started seeing people. One lady would get out and just ride around for a while,” notes Hasler.