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Senior Transportation: Importance to Healthy Aging

Community health and social service providers generally identify older adult transportation as one of the top three issues (if not the #1 issue) as a want, a need, and a challenge. The reason is that transportation cuts across a host of critical issues related to healthy aging, and driving cessation or the possibility of driving cessation often triggers negative outcomes including depression and social isolation [1,2].


Commentary
Community health and social service providers generally identify older adult transportation as one of the top three issues (if not the #1 issue) as a want, a need, and a challenge. The reason is that transportation cuts across a host of critical issues related to healthy aging, and driving cessation or the possibility of driving cessation often triggers negative outcomes including depression and social isolation [1,2].
For many people, particularly in the United States, transportation is about driving the car where they need to go and when they want to go there; it is about autonomy. However, we know from research that people outlive their driving expectancy, about 10 years for men and 6 years for women [3]. When people are no longer able to drive, they often view it as a loss…of freedom, independence, and control; their family, neighbors, and friends may or may not be available to take them; and they may face a long transition from driver to passenger. The health care professional has a role in assisting patients and their families with the transition to driving retirement [4,5]. Do not assume that an individual will be able to return for a follow-up visit. Ask the question, "How did you get here today?" Hospitals and outpatient services would be wise to work with community transportation and volunteer driver programs to address the challenges patients may face who do not need ambulance services but could manage well with an escort or other non-emergent medical transportation. Not only is a missed appointment serious for the patient who needs treatment but it is also important for the missed revenues to the provider.
When faced with finding transportation options, communities may or may not have transportation services available, and if they do, older adults may not be able to afford them. In addition, some older adults may face transportation access challenges as the same physical and cognitive limitations that impacted their critical driving skills can make it difficult or impossible for them to navigate transportation options, even when they are available [6]. Persons with dementia are a good example where supportive transportation is critical to enabling such individuals to age in place in their communities [4]. An absence of transportation assistance and support can be a barrier to utilization just as it can be the factor that makes utilization possible.
If transportation for older adults is about getting where you need to go, where do older adults need to go?
In a recent STAR Awards application review, the number one destination reported by volunteer driver program providers was bringing senior passengers to health care service. Of these the top five destinations were to doctors' offices, physical therapy services, dialysis centers, pharmacies, and cancer services [7]. In recent years, some hospitals and health care centers have begun to organize or link with transportation services to enable older adults to access their services. However, older adults often say there is more to life than getting to the doctor. And, indeed many transportation services, especially senior transportation and volunteer driver programs take passengers to health care destinations and quality of life destinations such as grocery shopping, employment, personal errands, social activities, beauty shops, volunteer activities, and church services. Many of them, especially volunteer driver programs also provide their passengers with socialization.
In sum, transportation for older adults is not just an issue and challenge for older adults, but for providers of health, recreation, and social services in communities worldwide. Population projections predict an ever-increasing number of older adults, and ever increasing needs for transportation. Supportive transportation services that promote quality of life activities of the older adult population will enable older adults to achieve Three Cs with respect to their community: choice, connectivity, and contribution.