The Federal government has traditionally provided transportation to and from the services it provides, usually by partnering with local agencies and nonprofit organizations that already provide services and funding the expansion of these services (U.S. General Accounting Office, 2004).
The term “supplemental transportation programs” or “STPs” was coined to encompass both formal and informal programs (Beverly Foundation, 2001a). The Beverly Foundation suggests that such supplemental transportation programs effectively meet the requirements of its “5 A’s of Senior Friendly Transportation”: availability, accessibility, acceptability, affordability, and adaptability (Beverly Foundation, 2001b). (See Appendix B for further information on the 5 A’s). STPs exist in many communities across the country, often using volunteer drivers to transport riders to locations that are not covered by Federal rules, such as medical appointments. The importance of these trips to older people’s independence and dignity is often repeated. One example of a long-standing STP is the Independent Transportation Network (ITN), which originated in Westbrook, Maine. The ITN is currently involved in a national rollout called ITNAmerica, with programs developing in Orlando and Santa Monica.
Groups such as AARP have conducted surveys in which as many as 75 percent of respondents 75 and older respond positively when asked if they are “satisfied with their mobility” (Koffman et al., 2004). However, the U.S. General Accounting Office (2004) found — through interviews with Federal officials, evidence from nationally published research, and reports from local aging service providers — that seniors who are successful in meeting their transportation needs are often doing so with help from their families or by living in transit-rich cities. The GAO also found that seniors who rely on alternate modes of transportation often have difficulty making trips for which the car is better suited, including life-enhancing trips, and that all community mobility needs are less likely to be met for older people living in suburban or rural areas.
A 2003 Brookings Institution report (Rosenbloom, 2003) indicates that those who are unable to drive are often unable to use public transit services as well. The author determined that older Americans are likely to give up walking before they cease driving, further evidence that they would be unable to use public transportation. Since the average man will outlive his driving ability by 6 years, and the average women by 10 years, this can result in a substantial amount of time without viable transportation options (Foley et al., 2002). Even though some older people can sometimes use special transit services, most prefer to ride in a car with a friend or family member.
Special transit services typically have limited availability. They operate only during regular transit-service hours, and there are residential distance requirements (e.g., within three quarters of a mile of a regular transportation route) for one to be considered for services. The Brookings Institution report (Rosenbloom, 2003) found that many who did live near existing bus routes were still ineligible for services due to the eligibility requirements of the service provider.
Finally, the Brookings Institution report (Rosenbloom, 2003) concluded that although most communities host small, specialized paratransit services operated by nongovernmental agencies, these usually serve only a very small proportion of the elderly population, and will serve a smaller proportion as the older population grows. They will likely not be a viable strategy for addressing the community mobility needs of older individuals with dementia.