It’s not shocking that the No. 1 issue of concern to senior citizens is health. No. 2 might be a little more surprising – its transportation, research from the AAA Foundation for Traffic Safety finds.
Access to transportation for an aging population has even been given a name in recent years: transport care.
As baby boomers age, communities across the country, including those in the Chattanooga area, are grappling with the issue. A quick look at statistics dramatizes the need: About 52.5 million people are older than 65. That’s roughly 16 percent of the total population, Pew Research Center statistics reveal. The number is expected to climb to 73.1 million – or 21 percent of the population – by 2030.
Another sobering statistic from that research: More than 80 percent of the elderly depend on someone else to drive them all or some of the time.
There are transportation choices for senior citizens Chattanooga and Hamilton County, although advocates for the aging say there aren’t enough and expect services to grow to meet demand in coming years.
Lisa Suttles, general manager/ADA coordination and mobility manager at Chattanooga Area Regional Transportation Authority, says demand is growing for the agency’s Care-A-Van service, which provides curb to curb van transportation for the disabled and elderly.
“A senior with any issue that prevents them from riding a fixed-route bus qualifies them to ride,” Suttles says. “I would say a good percentage, probably more than 50 percent, are over 55. Our service is growing. For example, we transported 613 more (riders) in August 2018 than August 2017.”
Care-A-Van is also beginning to contract with other agencies and nearby cities to meet senior transportation needs.
“We have a contract with [the city of] East Ridge to transport just their seniors and disabled community, and it, too, is growing, Suttles adds. “We also have a verbal contract with Silvertree Senior Center every Tuesday from 10 a.m. to noon. We also have a verbal contract with John Calvin Apartments to take them every Saturday to Walmart.”
The Jewish Federation of Greater Chattanooga operates a modest van service that drives clients to routine destinations such as medical appointments, exercise classes, the bank and the grocery store.
Michael Dzik, executive director of the Federation, says the agency’s service is limited in the amount of people it can help, but points out the Federation is a United Way agency that serves the wider community, not just the Jewish community.
“Anybody is welcome; we partner with anybody and everybody,” Dzik points out. “If we can’t help, we’ll get you to the right people.”
Like Suttles, Dzik sees the needs for transportation services for the elderly growing at a fast clip.
“You look around and see there’s not much offered [to seniors] in terms of transportation,” Dzik says. “There’s been a gap for a long period of time.
“Of course, people want to keep independent for as long as possible. When they do lose the ability to drive, there’s just not enough in place to help them,” Dzik continues. “I expect communities will be facing this issue with more and more seriousness [as baby boomers age.]
Chattanooga is also home to Alexian Brothers PACE (Program of All-Inclusive Care for the Elderly), a nursing home alternative that provides a holistic continuum of care, including transportation, adult day care and medical care, to Hamilton County residents over the age of 55.
According to the agency, Alexian Brothers PACE is the only organization in Tennessee that integrates comprehensive services for the disabled and frail seniors with the goal of keeping them out of a nursing home.
Clifford Seab has been using the Alexian Brothers PACE program since 2015, which is when his wife of 35 years died.
“With PACE I don’t have to stay in the house and stare at four walls, and with their transportation, I can get out and see people more,” Seab says. “There really needs to be more barrier-free options to help people. Especially being someone who uses a motorized wheelchair, I see there still needs to be a lot of work done to help people gain access.
“My wife was a big advocate and spoke up about how much handi-capable people need access in the community, for housing and transportation. I’m not as outspoken as she was, but I still think it matters so much.”
Seab notes besides the PACE service, he has one other friend who can sometimes help with transportation.
“Without them I’d be in a nursing home,” he says.
The Herald recently spoke with Rachel Tinaya, director of marketing at Alexian Brothers PACE, to find out more about the program and its philosophy of senior care, including transport care.
Can you give an overview of Alexian Brothers PACE?
“PACE stands for Program of All-Inclusive Care for the Elderly. It is for folks in Hamilton County who are 55 years or older who need nursing home level of care but want to remain at home. We offer a full array of medical care, homecare, adult day care, rehab, transportation and social services.
What does the transportation component of your program do for clients? How does it work?
“PACE participants receive transportation to the day center and medical appointments including dialysis. Because PACE is a blended medical and social model, we also coordinate transportation to agencies like Food Bank or Social Security. Our home care aides can bring participants to the grocery store if able, or they shop for folks who may get worn out from a trip to the store.
Can you describe a few different scenarios that show how a senior citizen might use your service? I’m trying to get at “human interest” here and paint a picture.
“I’m thinking of one particular gentleman who is in our program. He uses a motorized wheelchair and lives alone. On Monday, Wednesday and Friday, transportation brings him to PACE center for activities and socialization with his peers. While at the center, he might see a variety of specialists such as audiologist, optometrist, podiatrist or dentist who come to our campus.
“He might also go to the primary care clinic on campus if he needs follow up on any symptoms he is experiencing. He can work with physical therapy to help increase his safety and maximize his function.
“Occupational therapy added a peep hole at his wheelchair level in his front door so he can see who is at the door. An automatic key fob button was added to lock or unlock his front door to help his safety and independence when his dexterity in his hands decreased. On Tuesdays and Thursdays, he attends another program so that he can connect with another peer group. When that group goes on field trips to baseball games or pottery class or movie, we provide his transportation as well. When financial issues came up, his social worker arranged to go with him to meet with Social Security to seek resolution.
“When he needs some extra food when money is tight, transportation delivers a food box from the local Food Bank. Transportation also delivers his weekly prescription medication, medical supplies and home delivered meals to his home.
Can you speak about the issue of transportation and the elderly in general? How big of a problem is it? Is society coming up with enough solutions? What do people who really shouldn’t be driving or who can’t drive end up doing without access to services?
“It is such a delicate matter of self-determination and autonomy versus individual and public safety. Another layer is the damage of ageism. Just because someone is an older adult does not mean they should stop driving. Considering vision, reflexes, cognitive status, medical conditions and medications, individuals should always consult their physician about whether or not they should continue to drive.
“Unless folks have access to family, neighbors, church ministries or community members who offer to give rides to important places like the grocery store or doctor, many older adults are taken advantage of by neighbors charging astronomical prices for a ride. I’ve heard about older adults in our community being charged extra fees per bag of groceries when they have paid for a cab to pick them up from the grocery store.
“That’s one of the many reasons I am so grateful for a sister program at St. Alexius Outreach. They have a senior shopping shuttle that goes to senior subsidized housing complexes and runs three trips a day four days a week to area grocery stores.’’ [St. Alexius is an outreach ministry in Chattanooga offering friendship to homebound older adults, assisting in alleviating isolation and loneliness.]
A lot of baby boomers are retiring and getting older. How much do you think this will affect services like PACE in the future?
“There really needs to be a PACE in every major city. Comprehensive healthcare coordinated with transportation and social services which supports aging in place and thriving in the community — who wouldn’t want that? No one wants to have to end up in a nursing home, especially not baby boomers who want to remain as active and independent as possible. The PACE model of care is ideal for partnering with families and informal caregivers to support older adults remaining safe and maintaining desired quality of life.’’
If you could wave a magic wand and have society structured in a way that met the transportation needs of the elderly — what would it look like?
“I would love to see multigenerational communities such as cottage clusters or tiny home communities or young/older adult house-sharing scenarios become affordable and accessible in more areas of the US.
“I’ve heard about wonderful settings in Finland and other European countries as well as in the U.S. Pacific Northwest. What a rich and meaningful community we could all experience if more people helped and supported one another. If a young family could offer a ride to an older adult neighbor and that older adult could read stories to the young children, then everyone is better connected.’’
To sign up for Alexian Brothers PACE:
Call 423 495-9114 or 800 441-8883. There is no fee if you are financially qualified for TennCare long term services and supports. If you are eligible for Medicare only, there will be a fee involved. Those without Medicare or TennCare may pay privately. The PACE enrollment coordinator will help you apply for TennCare.
To sign up for Care-A-Van
CARTA Care-A-Van service is available to residents and visitors in CARTA’s service area for those who due to injury, illness or functional incapacity of a temporary or permanent nature, are unable to use CARTA’s fixed route transit vehicles. Care-A-Van service requires an application and physician’s statement to verify eligibility in compliance with the Americans with Disabilities Act.
In order to accommodate as many riders as possible, advance notice is requested for scheduling Care-A-Van trips. Reservations are accepted on a next-day basis. However, Care-A-Van makes every effort to accommodate on-demand trips. A one-way ticket is $2.50 and a round trip ticket is $5.00. For more information call 423 698-9038.
Jewish Federation of Greater Chattanooga
The Federation provides van service to medical appointments, exercise classes, the grocery store, visits to friends, events at the Jewish Cultural Center, etc. Service is available from 8 a.m.-4 p.m. Monday through Thursday by appointment. Van service is free to members of the community, but new riders must call the social services department at 423 493-0270 ext. 16. (There are only two van drivers so numbers of clients are limited.)