Transportation, Ageing and Alzheimer's

As the population of older adults has grown over the years, the topic of transportation in relation to aging has become an issue.  Governments in countries throughout the world are tackling social policy issues that address how to improve quality of life for older adults in regards to transportation.

  On International Older Person’s Day in 2011, U.N. Secretary General Ban Ki-moon stated that independence, participation, care, self-fulfillment, and dignity were all mainstays of the movement towards improving quality of life for older individuals worldwide (Collins, Wacker, and Roberto, 2013). In accordance with that idea, every country “reflected by the local, state-regional, or national policies it enacts, determine what community services are needed, which entities should provide services, how they are accessed and by whom, and who covers their cost” (Collins, et. al., 2013). Transportation issues are directly related to improving the quality of life for older adults because they define how older adults get to and from visiting family, socializing with friends, doctor appointments, and other interactions within their communities. In the United States, the Older Americans Act, (OAA), largely is responsible for ensuring that policies are in place at the federal and local level to ensure transportation for older adults (Collins, et. al., 2013). The extent to which cities offer special public transportation for older adults varies “widely and is often restricted by geographic area and level of disability” (Collins, et. al., 2013).

The definition of mobility has been noted as “where people move or travel taking into account the frequency of movement and degree of independence during such movement (Knight, 2011). Having access to transportation is essential to the aging process for older adults because “loss of mobility is a predictor of physical disability and is associated with falling, institutionalization, and mortality” (Knight, 2011). Older adults that experience a loss of mobility are less likely to access primary care services and tend to preventative health care as well (Knight, 2011). According to AARP, there are nearly eight million people over the age of 65 do not drive and are dependent on others for transportation.  Through the aging process, older adults are at greater risk for functional impairments which can hinder their ability to drive safely in a car.  In addition, roadways in the United States are built for the average driver and not designed for “declines in visual acuity coordination, flexibility, and reaction times” (Dumbaugh, 2008). Combinations of physical decline and infrastructure that is not designed for the physical changes of older adults prohibit driving capability and alter the independence of the aging population. Turmoil among families can be caused when older adults lose driving capability and are forced to rely on other forms of transportation. 

Transportation can affect families in many ways.  When older adults lose the ability to drive themselves, many times it is up to family members to step in and ensure their loved one has rides to and from appointments and engagements.  Many may not feel comfortable asking for rides to activities that are for leisure rather than necessity such as a medical appointment. The stress on family arises because of possible scheduling conflicts. Caregivers that are family members might feel burdened because they are hauling their children to places and also are responsible for the transportation of their parents that can no longer drive.  Even if an older adult has access to public transit, the health of the individual might prohibit them from having the “stamina necessary to endure long bus rides or the mental acuity to follow route directions or learn transfer points” (Knight, 2011).

Another aspect of how transportation problems affect families is that there are many grandparents raising grandchildren across the country. For example, in the state of Illinois, over 200,000 children under the age of 18 live in the home headed by their grandparents. In addition, more than 100,000 grandparents care for their grandchildren. If a portion of the grandparents caring for grandkids in the state of Illinois cannot drive independently, transportation becomes a major component in how the children get to school, social functions, and maintain health through checkups at doctor appointments.

Transportation issues pose a threat to older adults in regards to their social interaction. As discussed in FCS 4846 Aging and the Family class, social interaction is related to the well-being of older adults. A stereotypical picture of old age is of a solitary person, in a tiny hotel room, staring silently into space (Hillier and Barrow, 2011). However, that is not accurate at all.  In fact, friendship is extremely important in the lives of older adults (Hillier and Barrow, 2011).  In relation to aging of an older adult and the impact it has on their family relationships, “the adage that blood is thicker than water is culturally ingrained, and it becomes easy to overlook the true impact that friends, particularly friendships of very long duration, have on our psychological and social well-being” (Hillier and Barrow, 2011). Similarly, not having means of transportation not only can affect older adults being able to socially engage, it can also interfere with their desire to stay sexually active.

     Dating and sexuality is a very important component of social interaction among older adults. Sexual contact correlates to better health, higher relationship satisfaction, and easier stress management (Schwartz, 2011). The need to be close to another person through touch remains throughout one’s lifespan.  “Old or young, we all need intimacy and social bonds with others” (Hillier and Barrow, 2011). Being able to travel to visit a significant other is essential to ensuring the act of love making happens for the older adult.  Older adults in rural areas do not have as much opportunity for access to public transit making it difficult for them to date and engage with significant others. Even though many times adult children are happy to see their parents in loving relationships, their busy schedules may impose conflicts in being able to transport their parent for dating and social engagements (Hillier and Barrow, 2011).  The ability to travel places to date and maintain sexual relationships can be directly related to the quality of life for older adults.

     For many older adults, asking for help with transportation is difficult but being able to come and go as they please is a large part of having a worthy quality of life.  According to the AARP article, AARP to Congress: Help Keep Seniors Mobile: older adults that have access to transportation might feel guilty asking for “nonessential” trips, such as going to the library, out to eat, or to a movie. Having such freedoms to enjoy a dinner out with friends, going on dates, or visiting the library is a right that any person should have regardless of their age.

     In conclusion, transportation is largely related to ensuring that older adults have the quality of life that they are entitled to. Having access to transportation services ensures that older adults can maintain their physical health by going to preventive doctor visits, seeking out social service organizations and programs, and being able to have transportation in the event of an emergency.  Access to transportation also ensures that older adults can stay socially engaged and help prevent social isolation. Transportation issues affect older adults and their families. For example, in rural areas, public transit services are not readily available and the responsibility of ensuring transportation of older adults if they are unable to drive is usually on their spouse (if they are able to drive), adult children, or other family members. The responsibility of caretaking and transporting another person to doctor visits, social engagements, and everyday tasks like grocery shopping, can cause stress and an emotional turmoil for the caretaker and impact the relationships of the family. Transportation is also a societal issue because it deeply impacts the quality of life for older adults and how they engage with the world around them. Issues of transportation affect individuals, families, society, and global policy.  Transportation issues are part of a global concern that “includes concern for the well-being and quality of life of older people” (Collins et. al., 2013).

References

Collins, S.M., Wacker, R.R., Roberto, K.A., (2013). Considering quality of life for older adults: a view from two countries. Journal of the American Society on Aging. 37(1), 80-86

Dambaugh, Eric (2008). Designing communities to enhance the safety and mobility of older adults: a universal approach. Journal of Planning Literature. doi: 10.1177/08885412208318559

Government Advocacy & Campaigns (2011), AARP to congress:help keep seniors mobile!. Retrieved from http://www.aarp.org/home-garden/transportation/info-06-2011/aarp-transportation-for-thos...

Hillier, S.M., & Barrow, G.M., (2011). Aging, the Individual, and Society. Belmont, CA: Wadsworth, Cengage Learning.

Knight, K.E., (2011). Federally qualified health centers minimize the impact of loss of frequency and independence of movement in older adult patients through access to transportation services. Journal of Aging Research. doi:10.4061/2011/898672

Schwartz, Pepper (2011). 5 Myths about sex and aging. Retrieved from http://www.aarp.org/relationships/love-sex/info-05-2011/sex-myths.print.html