We plan for so many things as we get older – finances, downsizing, and even confronting end-of-life plans such as wills, trusts, and guardianships. But you know what’s often missed?
Driving.
It’s a privilege most Australians enjoy. Transportation (which includes driving) is the second most important daily living activity for older people in Australia,i second only to using the phone. Losing the ability to drive – either voluntarily or involuntarily – can result in a major loss of independence.
How we cope when we can no longer drive has a big impact on quality of life. Driving cessation is directly linked to social isolation, depression, and a decline in health.ii Former drivers are nearly five times as likely as current drivers to enter aged care facilities.iii
Planning ahead for driving can lead to better health and wellbeing. Ride-share services and public transportation are curb-to-curb, but some older people may require door-through-door support. This is where community connection makes all the difference, especially for men and those living alone, who are at the greatest risk of becoming isolated when they quit driving.iv
A United Kingdom study found a direct correlation between access to everyday travel and the quality of life in older people, especially in rural areas where public transport is not as robust as in the cities.v
Making a case for community transportation services
In contrast to commercial alternatives such as taxis or ride-share services, community transport providers deliver person-centred support to address the complex needs of older Australians and those living with disability.vi This includes:
- Door-through-door assistance for those with mobility challenges, including help with mobility aids, getting in and out of vehicles, and navigating steps, thresholds, and doors
- Welfare checks when customers don’t answer the door
- Language support for culturally and linguistically diverse (CALD) communities
- Social connection, with drivers often being the primary person a customer speaks with that day
- Monitoring changes in regular riders, which may signal a need for additional support
- Accessible vehicles to accommodate different mobility needs, including ramps, lifts, and support for wheelchairs.
Community-based transportation initiatives around the world help older people maintain their quality of life when they can no longer drive.
United Kingdom: Transport services include community buses, group hire minibus services for social trips, and a voluntary social car scheme for medical, shopping and leisure. Local authorities in the UK also offer taxi concessions for older people.
- Sweden: The public sector is required by law to provide special transport services (STS) for people who can’t use public transport or a private car.vii
- USA: Hundreds of supplemental transportation programs are in operation, including the not-for-profit “Drive a Senior Northwest” organisationviii in Austin, Texas, which provides licensed volunteers to transport older adults to medical appointments, grocery stores, and twice-monthly Senior Day Out functions.
Throughout Australia, government programs and policies provide community alternatives for people who have difficulty using public transport. Aged care and disability service providers offer a patchwork of options for people who don’t drive, using a combination of paid staff and volunteer drivers.ix Organisations like St John also provide transport for medical appointments and, in some states like Queensland, for social outings.
Special considerations for remote and rural areas
Many transport options are centred in metropolitan areas, but similar support for people living in regional areas can be sparse. Australians living in rural and remote areas face barriers to community transportation due to geographic spread, low population density, and limited infrastructure.
For many Australians living in rural and regional areas, community transport is an essential service. On average, people living in regional areas are older than those in major cities, making targeted rural transport solutions even more importantx. Passengers in regional areas are often penalised if charged by distance travelled, limiting how frequently they can access the services compared to their city-dwelling counterparts.
National Community Transport Pricing Model (NCTPM)
The Australian Community Transport Association (ACTA) partnered with the University of South Australia and 31 selected Commonwealth Home Support Program (CHSP) transport providers for a National Variable Pricing Matrix pilot.xi The aim was to:
- develop and test a more accurate way of calculating transport costs
- develop and test alternative policy arrangements
- incorporate social engagement and client choice.
The NCTPM research discovered that passengers with high support needs incur an additional cost of $36.40 per customer compared to those with lower support needs. This reflects the extra time, specialised training, and tailored service delivery required to maintain dignity and safety for people requiring physical assistance, those living with dementia, or from CALD backgrounds.
Next steps
The evidence clearly shows older adults’ physical and mental wellbeing are affected once they lose driving privileges. We believe access to transportation keeps older Australians connected to their communities. Advocare supports the work of ACTA and other government, aged care, and community groups that support access to transportation, preventing social isolation in older people who have ceased driving.
What do you think? What else can be done to support older people before and after they cease driving? Email us: seniorspeak@advocare.org.au
References:
[i] Fricke, J. and Unsworth, C. (2001). Time use and importance of instrumental activities of daily living. Australian Occupational Therapy Journal, 48(3), pp.118–131. doi:https://doi.org/10.1046/j.0045-0766.2001.00246.x. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.0045-0766.2001.00246.x
[ii] Pellichero, A., Lafont, S., Paire-Ficout, L., Fabrigoule, C. and Chavoix, C. (2021). Barriers and facilitators to social participation after driving cessation among older adults: A cohort study. Annals of Physical and Rehabilitation Medicine, 64(2), p.101373. doi: https://doi.org/10.1016/j.rehab.2020.03.003. https://www.sciencedirect.com/science/article/pii/S1877065720300713
[iii] Freeman, E.E., Gange, S.J., Muñoz, B. and West, S.K. (2006). Driving Status and Risk of Entry Into Long-Term Care in Older Adults. American Journal of Public Health, 96(7), pp.1254–1259. doi:https://doi.org/10.2105/ajph.2005.069146. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2005.069146
[iv] Qin, W., Xiang, X. and Taylor, H. (2019). Driving Cessation and Social Isolation in Older Adults. Journal of Aging and Health, 32(9), p.089826431987040. doi:https://doi.org/10.1177/0898264319870400. https://pmc.ncbi.nlm.nih.gov/articles/PMC7901288/
[v] Graham, H., de Bell, S., Flemming, K., Sowden, A., White, P. and Wright, K. (2018). The experiences of everyday travel for older people in rural areas: A systematic review of UK qualitative studies. Journal of Transport & Health, 11, pp.141–152. doi:https://doi.org/10.1016/j.jth.2018.10.007. https://www.sciencedirect.com/science/article/pii/S2214140518303827
[vi] National Community Transport Model, Community Transport Beyond the Ride: Understanding Passenger Needs. https://communitytransportaustralia.org.au/resources/
[vii] Hansson, L. and Holmgren, J. (2018). Cost effect of reorganising – A study of special transport services. Research in Transportation Economics, 69, pp.453–459. doi:https://doi.org/10.1016/j.retrec.2018.04.008. https://www.sciencedirect.com/science/article/abs/pii/S0739885917302275
[viii] https://driveaseniornorthwest.org
[ix] National Community Transport Model, Community Transport Behind Every Ride: The People Who Make It Possible. https://communitytransportaustralia.org.au/resources/
[x] https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health
[xi] National Community Transport Model, Community Transport Beyond the Ride: Understanding Passenger Needs. https://communitytransportaustralia.org.au/resources/
