Transportation Vital to Senior Health

By Deborah Jeanne Sergeant

Geriatrician: Region lacks transportation options that are both affordable and accessible to older adults

Obtaining a driver’s license as a teenager represents a step towards autonomy and independence. The inverse is also true: giving up driving as an older adult can mean more reliance on others. Older drivers may have higher risks of getting in accidents due to their deteriorating eyesight and reflexes.

In addition, it can affect health, as adults often need more medical care from their primary care providers and specialists as they age. Delaying medical and dental appointments can worsen health problems. Lack of transportation can prove a barrier for timely appointments.

“It is a key indicator of independence to come and go when you want to or need to,” said Sharon Brangman, chairwoman of geriatric medicine, director of the Geriatric Medicine Fellowship Program and director of the Upstate Center of Excellence for Alzheimer’s Disease at SUNY Upstate Medical University. “We all will reach a point where driving is not a feasible activity. Public transportation isn’t often well established in Upstate New York as compared with bigger cities. It’s not as accessible.”

She wants more options that are both affordable and accessible to older adults. Of course, public transportation can help provide rides. However, the costs of these services can add up for people visiting a different specialist each week or completing rounds of pre-op, post-op and rehabilitative visits. Plus, there’re also trips to the grocery store, hairdresser, house of worship and social gatherings. Unfortunately, some older adults pare their trips down to the medical necessities to save money.

There are some local transportation options for the general public, such as Centro. Its Call-a-Bus service includes special considerations for disability, such as wheelchair accessible vehicles and assistance to the door and with packages (if requested), but age and lack of a vehicle are not qualifying factors. Those who are ambulatory should take Centro and not Call-a-Bus.

Typically, public transportation options do not cross county lines, which can make it difficult for people living in one county who must see a specialist in another. Centro offers services among CNY counties.

“We need options for people who might need a little assistance getting in and out of a car or a building,” Brangman said. “I had a patient whose granddaughter would order her an Uber. But she had to be able to get in and out of the car. If you use a walker or need assistance you need different transportation than a ride share.”

Many senior transportation programs rely upon volunteers, typically newer retirees who still drive. The pandemic has decimated the number of volunteers, which has caused many of the programs to reduce their trips to medical appointments only. Most transportation programs for older adults require two weeks’ advance notice, as the slots fill quickly. This can prove problematic for a patient whose medical appointment must be rescheduled because of an issue in the office.

Sometimes, it’s not just about the ride, but getting the errands done.

“I have patients who say they already have to plan what they want to buy because they can’t carry it all,” Brangman said. “One lives in an apartment who has a bus one time a week to the grocery store but has a cane and purse and doesn’t have the best balance. She’s OK in the store because she can lean on her cart; but can’t carry it all once she arrives home. We need solutions to help the most vulnerable among us stay connected and have their needs met. There are people who live by themselves and don’t have family. We need to meet their needs, too.”

Brangman said that starting in the pandemic, many people have turned to Instacart for grocery delivery for their older parents, as the app provides a convenient way to eliminate trips to the store.

It may help to request that shoppers package items in separate bags so that seniors are not burdened with a huge box or bag full of cans. Also note to place the parcels on a bench on the porch, for example, if lifting from the floor is too challenging.

For older adults who want to select their own groceries such as produce, scheduling regular delivery of all of their bulk or heavy items through a standard website can reduce the amount of items seniors need to pick up. Most of these sites offer free shipping at a certain minimum total. By paring down the shopping list, they need to carry only a bag or two each week. Most public transportation options do not provide assistance with carrying packages.

Using an online pharmacy or a brick-and-mortar pharmacy that delivers can eliminate another trip. Many health insurers cover prescriptions filled through online pharmacies. Some traditional pharmacies that deliver will also add a few small items to the order if requested.

The site allows older adults an easier means of obtaining groceries, takeout delivery and rides without relying on their adult children. Ideal for people who do not use smartphones, gogograndparent employs phone operators to act as a concierge to connect older adults with services such as Grubhub, Lyft, Uber and Instacart. After signing up, all users need to do is call and ask for what they want from a live operator. Updates on the request are texted to the user’s emergency contact such as “Delores has been picked up by Lyft” and “Delores has arrived at her destination.”

Many senior center programs provide discounted transportation for older adults to go to the senior center for socializing. That often includes a hot meal.

It may also help to contact a house of worship. Some of these provide a ministry of free or low-cost transportation to appointments and other places. Neighbors and friends may be willing to help as well.