If you missed our live online chat with Elinor Ginzler, former AARP vice president for health and current senior director for supportive services at the Jewish Council for the Aging in Rockville, Md., read the transcript of the conversation below.
Comment from Chantilly@BiculturalMom: I know that many communities offer support for transportation through insurance or local initiatives. How can we find out if our community has a free or reduced rate program for elder transportation?
Elinor Ginzler: You are right that many communities have programs to help seniors get around without driving their cars. The best way to find out about the resources in your community is to call your local aging office. For help finding your local office, use the Department of Health and Human Services-sponsored Eldercare Locator online tool (eldercare.gov), or call them at 1-800-677-1116 to find the aging office for your community.
Comment from Ron: My dad is too wealthy to qualify for Medicaid, but he cannot afford private taxis too often. What transportation options exist for seniors of moderate means? Does Medicare pay for transportation services?
Elinor Ginzler: Many people find themselves in the exact same situation as your dad. If he used to own a car or still does, it can be eye opening to calculate how much it costs to maintain a car. The Hartford has a great worksheet available. Fill it out, and when you finish adding up the costs of fuel, maintenance, repair, insurance and more, you'll find that your dad has a transportation allowance available to him that will mean many, many taxi rides.
Comment from Dorothy Kane: My husband was diagnosed with MCI [Mild Cognitive Impairment] about four years ago. His short-term memory has definitely gotten worse. However, he still drives every day. He goes to three different parks that are about two miles from our house. He has done fine so far, but as time goes by I am concerned that he will cause an accident. He loves to be able to go out on his own when I'm not with him. What suggestions do you have for getting him to stop driving?
Elinor Ginzler: It's good that you're concerned — and it's really good that he's doing fine so far. If he gets more impaired, however, you'll need to be on the lookout for signs that driving is no longer safe. It's a good idea to start talking about this now when his driving is still OK. Ask him to think about what he wants to do to stay safe on the road. Find out about local transportation options so he will still be able to go to those parks he likes so much.
Comment from Lorie: I currently work full-time while taking care of my aunt. It is very hard to take time off of work to take her back and forth from home to doctors' appointments. She doesn't qualify for any services, but we can't afford to pay transportation costs all the time. Are there volunteer programs that help with transportation?
Elinor Ginzler: Volunteer driver programs are alive and well in communities across the country. Many communities rely on volunteer programs to help provide needed services to seniors. It does take some detective work on your part though, because it might be a church or local help group that is offering the service. I know that some "Senior Villages" that are cropping up in neighborhoods around the country report that transportation is the most-requested service and that they rely on neighbors helping neighbors to volunteer and provide those rides.
Comment from Guest: What transportation resources are available in small towns? In larger cities, cabs are available.
Elinor Ginzler: Small towns can be rich with transportation services. It is often the nonprofit world of churches and community-based organizations that steps up to help seniors get around. Check your local aging office for groups in your community who can help. Also, remember that the government-maintained Eldercare Locator online tool can help you find the aging office near you.
Comment from Bridget: What if my mom needs to get to medical appointments outside her county of residence? Are there transportation services that cross jurisdictional boundaries?
Elinor Ginzler: Most senior transportation services recognize that doctors are often spread around several jurisdictions. This is a great question to ask when you are finding a transportation service, but I think you will find that many are quite flexible. If one organization tells you they can't help you, ask them if they know of a service that will. Services run by not-for-profit organizations are very likely to have flexible policies about crossing over boundaries.
Comment from Russ Parish, Arkansas Transit Association: Many senior centers and other nonprofit agencies employ or use volunteer seniors. There are valid concerns about reaction time, vision and good judgment regarding these valued workers and volunteers. Are there any resources, checklists or standard evaluations available to assess safe driving skills for drivers over 70?
Elinor Ginzler: Most seniors make changes to their driving behaviors to stay safe on the road. A typical example is no longer driving at night. There are professional groups that provide driving assessment and offer rehab treatment if appropriate. Usually it is an occupational therapist that performs the assessment. Another important program to remind seniors about safe driving is the AARP Driver Safety program. This course, offered online and in person, reviews rules of the road and offers tips for staying safe.
Comment from Craig: My mom called me recently and expressed concern about my dad's vision and driving abilities. Since I live in a different state, I wasn't sure what to do, so I contacted the DMV about getting him retested. I gave his address and contact information, and they sent him a letter suspending his license until he can get retested. He is now really angry with me. I didn't expect the DMV to take this action, but at the same time I feel I needed to step in and help protect my dad (and possibly others). Did I do the right thing? And how do I handle my dad's anger toward me? He did pass the test for daytime driving, but now he is restricted from driving at night.
Elinor Ginzler: You sure did the right thing, even though it seems to me that the DMV handled it poorly. The most important issue is safety — for your dad and for others on the road. Even he would agree that he does not want to have a bad accident with a bad outcome because of his declining abilities. I am surprised that the DMV revealed the source of the complaint. Most have policies that protect the confidentiality of the person reporting the concern.
However, it sounds like the outcome was a very fair one — he is still driving but modifying his driving behaviors to match his abilities. Many seniors restrict themselves to driving only in the daytime because they recognize signs that night driving is getting to be unsafe for them. Let your dad know that you love him and want him to be safe for a long, long time, and driving only during the day seems to be a great solution for now.
Comment from Mary Dunlap: I missed the testing for older drivers because I was going out of town. Is there a way to sign up for it?
Elinor Ginzler: I think you're talking about the AARP Driver Safety program. To find out where and when the course is offered, check out the course locator. The course is also offered online so you can take the class at your own pace in the comfort of your own home. Good luck!
Comment from Kristy: I am caring for my cousin who has dementia. I am not her power of attorney, but I need to help her apply for transportation services from our local transit company. What is the best way to go about doing this? Will not having a power of attorney make it difficult to act on her behalf?
Elinor Ginzler: Many times a doctor's evaluation is needed for someone to qualify for paratransit services from the local transit company. You can help her obtain and submit the necessary medical forms and help her complete her portion of the information so that she becomes eligible for transportation assistance.
Comment from Susan: As a caregiver, what warning signs should I watch for with my dad and driving? I fear he's holding back on telling me what is happening. His heart isn't so well.
Elinor Ginzler: Most people want to continue driving for as long as they can safely do so. However, a time will come for many when they must limit or stop driving, either temporarily or permanently. To really find out how your dad's driving is going you have to get in the car with him. These are some warning signs that indicate a person should begin to limit or stop driving:
- Almost crashing, with frequent close calls;
- Finding dents and scrapes on the car, on fences, mailboxes, garage doors, curbs, etc.;
- Having trouble seeing or following traffic signals, road signs and pavement markings;
- Misjudging gaps in traffic at intersections and on highway entrance and exit ramps;
- Having a hard time turning around to check the rear view while backing up or changing lanes;
- Receiving multiple traffic tickets or warnings from law enforcement officers
Comment from Sarah: How do I find information on the local transportation services in my area?
Elinor Ginzler: Your local jurisdiction's transportation department likely describes public services on its website. And most senior directories created by local communities and towns include listings of mobility/transportation organizations, as it is such an important issue.
Comment from Sandy: My dad has always been fiercely independent. Driving has been his favorite thing to do for many, many years. Unfortunately, his eyes have begun to fail, and it is very evident that driving is becoming difficult for him. I know that it is time to talk to him about not driving, but I am afraid that he will become angry or depressed and just flat out refuse to stop. What should I do?
Elinor Ginzler: This is one of the most difficult conversations that families face. Good for you for recognizing that it is time to talk and for realizing that you need some help to be sure it goes well. The good news is that AARP can help. We Need to Talk (aarp.org/weneedtotalk) offers a terrific set of modules that take you through all the steps of how to talk to a family member about not driving. Check it out and get tips and techniques for this important conversation. You'll be glad you did.
Comment from Molly: How common are at-home services? By that I mean in rural areas how can I get a physical therapist to come to my mom's house?
Elinor Ginzler: Many community services, especially in rural areas, realize that to treat older patients who no longer drive, the services have to go where the patients live. Speech therapy, occupational therapy, physical therapy and even skilled nursing services can be provided in the home and covered by Medicare if the person is not able to leave their house. And telemedicine — using computers and technology to virtually consult with patients from their homes — is becoming more and more commonplace.
Comment From Dan: How do I find out the background of the driver who takes my dad to his doctors' appointments?
Elinor Ginzler: It is really important to be sure that the folks driving your folks are legitimate. If the driver is from a driving agency, ask them if they conduct background checks on their employees. If they don't, find another agency. If you've hired this driver independently, you can check with your state motor vehicles department on his driving record.
Comment from maccascruff: My parents are now in independent living. Their car is gone. It was my dad's decision. How do we get him to consider using the shuttle bus the facility provides so he can run his errands, such as grocery shopping? He is adamant that he will not use it. This makes it very difficult for my sister and me because he has to go on a certain day at a certain time.
Elinor Ginzler: It is hard to transition from the independence of driving your own car any time you want to relying on a shuttle bus. One idea may be to speak to other residents who use the shuttle bus. They may be helpful in convincing him to give it a try. Also, try talking to the residence staff to find someone to help with this, and be patient.
Comment from Chuck: How do I learn to use the bus in my town? I've never used it before and am afraid to ask the city.
Elinor Ginzler: It's never too late to learn new things. Many communities now offer travel training that teaches people all about the public transit in their cities. The training is done in a classroom and also includes a group excursion. Montgomery County, Md. offers Ride Smart travel training through its Connect-A-Ride program. It's just one example of how communities are helping people learn to use transit. Good luck!
Comment from Rachel: Are there any funds to help pay for the cost of getting an accessible van?
Elinor Ginzler: I am aware that the Veterans Benefits Administration will help with the financial end of equipping a van for accessibility. You might ask your motor vehicle administration about other funding sources.
AARP: Thank you for participating in today's chat with independent living expert Elinor Ginzler. Continue the discussion on our Discussions Boards in our online community. And, as always, you can find online caregiving resources in our Caregiving Resource Center or call our free Caregiving Support Line at 877-333-5885 to find services and support groups, both nationally and locally.
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