Share on Social

mobility ecosystems that support aging in place

By 2034, U.S. adults aged 65 and older are projected to outnumber children for the first time in history. This should fuel renewed urgency to create transit options that meet the unique needs of seniors and support aging in place.

Aging in place often allows seniors to retain their existing social networks, dictate when and how they want help, and experience greater comfort in a place where they have created a home. Research by the AARP found that nearly 90% of older adults want to stay in their own homes as they age. Furthermore, a four-year analysis of aging in place by the University of Missouri-Columbia found that those who received care in their homes experienced improved mental and physical health compared to individuals who resided in nursing homes. 

Transportation is vital for aging in place since it increases opportunities for many older adults to reach medical appointments, shop for groceries, or attend social activities.

Most communities recognize this and provide free or discounted bus, rail, or microtransit trips for older adults. Others are re-thinking how they operate to better serve older adults’ mobility needs. For example, Worcester Regional Transit Authority is considering deploying contactless fare payment, including alternative fare media like wearables that are particularly helpful for people with disabilities or those who use a mobility device. Additionally, the Bay Area Transportation Authority in Traverse City, Michigan, transformed its dial-a-ride program into a microtransit service to reduce wait times, increase operational efficiencies, and better serve its aging population.

In addition to these solutions, more can be done to fully support aging in place. Here are four approaches they can take:

1. Getting from A to B should be intuitive and easy to navigate 

The focus on technology-driven mobility solutions has some seniors feeling left behind. As new technologies are introduced or updated, transit providers should conduct outreach to ensure that anyone can use the system, regardless of level of tech fluency. Additionally, alternatives must be in place for those who do not have access to smartphones, tablets, or computers. Many microtransit providers, such as Memphis Area Transit Authority, provide a phone number that riders can use to reserve trips. Earlier this year, the AARP Public Policy Institute, RAND Corporation, the Urbanism Next Center, and the University of Oregon developed a framework for planning, designing, and operating high-tech mobility as a service initiatives to help public and private transportation providers better center the needs of older adults.

2. Universal accessibility should be prioritized in infrastructure, programming, and policies 

Universal accessibility means that infrastructure, programs, and policies are designed to be accessible, usable, and convenient for everyone regardless of age or ability. This is key for first-mile/last-mile infrastructure, like sidewalks and intersection crossings, since using fixed-route or microtransit often requires riders to walk between their transit stop and destination. Features like curb ramps with running slopes, tactile detectable warnings, and audible pedestrian signals at crossings ensure that street infrastructure supports people with disabilities, and provides crucial infrastructure for older adults who aren’t using door-to-door transportation services.

Accessibility doesn’t end with the built environment; programs and policies must be universally accessible too. For example, the font type and size, color combinations, and overall design of marketing and outreach materials can impact older adults’ ability to interpret and understand important messages about their transportation services. Similarly, paratransit operational policies, such as requiring a 48-hour reservation in advance, limit mobility options for people with disabilities, some of whom are older adults.

3. Public and private mobility providers should coordinate with one another

In most communities across the U.S., a patchwork of programs provide door-to-door mobility services for specific trip types. Non-profits, assisted living and nursing homes, and medical centers and hospitals administer primarily non-emergency medical trips, but may also organize grocery shopping outings or trips for social activities. It is difficult for these single trip providers to coordinate services with one another. Many of them have different operating hours and eligibility guidelines, making it difficult for older adults to organize door-to-door service for their daily needs. In response, many communities are hiring mobility managers and/or utilizing scheduling software to ensure a coordinated and cohesive mobility ecosystem between the fragmented service providers. 

4. Health insurance payment for transportation should be simple

One of the reasons that the door-to-door mobility landscape for older adults is so fragmented is because of how those services are funded. The health insurance landscape in the U.S. is complex, but many older adults are covered by Medicare, Medicare Advantage, and/or Medicaid. Each one funds transportation differently:

  • Medicare generally only pays for ambulance trips to hospitals or nursing facilities — though, there is currently a pilot program that is covering ambulance trips to urgent care clinics and doctors offices. 
  • Some Medicare Advantage plans cover non-emergency transportation to healthcare providers. 
  • Medicaid covers non-emergency medical transportation, but many states limit this service because of funding issues. One study found that 3.6 million Medicaid beneficiaries “miss or delay” medical care because they cannot get to the doctor.

Operators must work within these funding regulations and create strict eligibility criteria that riders need to meet to qualify for services. This can be difficult to navigate for older adults who may not have an insurance plan with a straightforward policy. Furthermore, none of these insurance plans cover non-medical transportation. Who owns the financial burden of funding trips to the grocery store or the community center is up for debate, but there is no arguing the fact that these non-medical trips are crucial for aging in place and the long-term health of older adults. Which brings up the issue: should aging in place only be available for those who can afford it? 

These goals aren’t easy to accomplish, but we can get there by centering older adults — particularly those with disabilities and lower tech fluency — in decisions that shape mobility ecosystems. These decisions include the types of services provided, as well as how these services are funded, operated, marketed, and incorporated into a community.

By making strides together, we can build communities that support the mobility, health, and well-being of future generations as they age.

After all, reliable, comfortable, and convenient transportation is ageless.