Perspectives on transportation among rural Appalachian older adults

Abstract

Background and Purpose: Driving is critical for retaining independence and aging in place for older adults, particularly in rural locations. In recent years, while an increasing number of studies have examined senior transportation, mobility options for older adults in rural environments has been understudied. To ensure their independent mobility, continued access to the community, and aging in place, it is essential to encourage advance planning for driving cessation and to improve knowledge and use of alternative transportation for older adults in traditionally underserved rural areas such as Appalachia. This study aimed to explore how the aging population in Appalachia manages transportation to meet daily needs, their degree of preparation for driving cessation, and role transition from being independent drivers to being dependent passengers.

Methods: Four focus groups were conducted (60-90 minutes per group; 8-11 participants per group; N=38). Study participants were recruited through Faith Moves Mountains, a community-based research organization located in Appalachian Kentucky. In focus group, we used semi-structured questions addressing the following topics: (a) how older adults in Appalachia manage their transportation to meet their daily needs, (b) whether and how older adults have considered and planned for possible driving cessation, (c) whether and how baby boomers may differ from older adults in terms of transportation management and needs, and (d) what potential solutions might address the scarcity of transportation services.

Findings: Results indicate that fewer Appalachian residents own cars and many older adults, especially women, have never learned to drive compared to older adults living in other parts of the United States. Few alternative transportation systems exist, except a local paratransit service that requires advance scheduling and only offers daytime use. Therefore, informal transportation support, including rides from neighbors and family members, plays an important role in mobility among Appalachian older adults. However, irrespective of age, participants are pessimistic about receiving transportation assistance from their children when they are unable to drive, perceiving younger generations as more self-centered and caring less about their aging parents. None of participants have enrolled in education/training programs for driver safety or mobility transition. We found no differences between baby boomers and current older adults in preparation for the transition to non-driving. However, baby boomers reported a greater willingness to use mobile phones and the Internet to manage transportation needs if mobile apps or Internet-based rideshare programs were available in their community. One solution that participants recommended was to use existing vehicles (e.g., church vans) to better meet seniors’ needs.

Conclusions and Implications: While rural residents face a number of mobility barriers as they age, our results suggest some promising practices to promote mobility, particularly for Baby Boomers. We will discuss implications for social workers working with older adults to develop effective interventions, especially using mobile technology and existing vehicles in the community, to reduce the negative consequences of driving cessation and to promote mobility among older adults in traditionally underserved rural areas.