Policy Areas Impinging on Elderly Transportation Mobility: An Explanation with Ontario, Canada as Example

As countries face the challenges posed by rising numbers of older persons, the need to reassess their respective policies to address transport needs in aging societies is increasingly recognized in relation to health and sustainability goals. This paper proposes the examination of six interrelated policy areas affecting elderly mobility in a country or administrative region. A general survey of policy developments in each of these areas could improve current strategies and existing processes in the planning and implementation of mobility services that will be responsive to both elderly and the general population now and in the future. These include: 1) general transport policy framework; 2) travel mode preference; 3) alternative transport infrastructure stock and investments; 4) housing-land-use-transportation linkage; 5) research and technology applications that improve travel mode and environment; and 6) institutional and legal reforms. These policy areas are discussed and given concrete elucidation in the case of Ontario, Canada. Reflections and recommendations for further research and policy action deemed critical in the case region are highlighted.transportation, aging, regional policy, Canada

Improving Pathways to Transit for Persons with Disabilities

Persons with disabilities can achieve a greater degree of freedom when they have full access to a variety of transit modes, but this can only be achieved when the pathways to transit – the infrastructure and conditions in the built environment – allow full access to transit stops, stations, and vehicles. Since passage of the Americans with Disabilities Act (ADA) in 1990, many transit agencies and governmental jurisdictions have made significant progress in this area. Policy initiatives, incremental enhancements, modifications, and other measures undertaken by transit agencies and their partners have significantly improved access to transit for persons with disabilities, others who rely on public transportation, and individuals who chose to utilize these services. This research study explores, through case study work, efforts that have been effective in improving pathways to transit. Interviews and site visits were conducted with five transit agencies, along with their partners, that are actively engaged in improving pathways to connect transit consumers – particularly people with disabilities – with transit stations and stops. These agencies are: Broward County Transit (Broward County, FL), Memphis Area Transit Authority (Memphis, TN), NJ TRANSIT (Newark and New Brunswick, NJ), Tri-County Metropolitan Transportation District of Oregon (Portland, OR), and Link Transit (Wenatchee, WA). Promising practices and/or lessons were identified through the case study analysis; these should be considered by any transit agency seeking to create improved access to its services for persons with disabilities

United We Ride National Dialogue

The Coordinating Council on Access and Mobility (CCAM) asked the National Academy of Public Administration and Easter Seals Project ACTION to develop and host the first United We Ride (UWR) National Dialogue. The goal of the Dialogue was to help shape future policy direction and provide input to the next CCAM strategic plan. The National Academy also assembled a small work group with representatives of the Federal Interagency Coordinating Council on Access and Mobility, Easter Seals Project ACTION, and the National Resource Center on Human Service Transportation to help guide the process of design and implementation.The CCAM includes 11 federal departments, nine of which are responsible for providing transportation for people with disabilities, older adults, and people with limited incomes. CCAM officially launched United We Ride in 2004 to (1) provide more rides for target populations while using the same or fewer assets, (2) simplify access, and (3) increase customer satisfaction.Key FindingsThe process used to create coordinated transportation plans needs improvement. Significant federal policy barriers still exist to strategies that would facilitate access to transportation services. Mobility management strategies are underutilized in communities across the country, and missed opportunities to bridge gaps between transportation and other community services still need to be addressed

An Action Plan for Seniors Transportation in Manitoba: Strategic Priorities

Report: 16pp.; ill., Digital file.There is growing recognition in Manitoba that the transportation options available to older adults are a crucial factor in aging successfully. Throughout the last decade there have been a range of community efforts to improve the mobility of the oldest members of society both in rural and urban areas of the province. More recently, research has been conducted to evaluate potential options for improvements to transportation and to determine the level of governmental and community engagement that is required to implement identified strategies. As follow-up to the report Mobility Options for the Aging Population of Manitoba: An Action Plan for Regional Solutions, commissioned through the Seniors Transportation Working Group by the Manitoba Seniors and Healthy Aging Secretariat in 2007, a one-day workshop was held in Winnipeg on March 20, 2008 (Appendix A). The gathering brought together a group representative of civic, provincial and federal government departments, senior-serving organizations, service providers and researchers (Appendix B.1/B.2). The goal of the workshop was to review the recommendations of the report and to identify strategies that should be prioritized. This report examines the strategic priorities for seniors mobility/transportation in Manitoba that were established at the workshop.Seniors Transportation Working Group, Manitoba Seniors and Healthy Aging Secretaria

The role of public transport in addressing sustainable mobility for the elderly population in Malta

Over the past few years, several countries have continued experiencing a growth in their elderly population. Similarly, a number of towns and villages in Malta registered a high elderly population in the last census (NSO, 2012). The elderly people are one of the dominant ‘transport disadvantaged’ groups in the community. This research aims to analyse whether the current public transport system in Malta is providing effective and efficient mobility for elderly in the town of Luqa. In order to analyse this, the study analysed spatial accessibility, sought to identify barriers encountered by the elderly when using public transport and determine temporal accessibility to medical care. Data was collected using telephone surveys, travel time and bus frequency surveys. Statistical analysis was carried out using IBM SPSS 20 and Geographic Information Systems. The study showed that proximity to bus stops in Luqa does not affect public transport use amongst the elderly. The main barriers that elderly encounter when using public transport are mainly related to long waiting times, lack of comfort on bus stops and inaccessible travel information. Finally, temporal accessibility from Luqa to the State’s general hospital, Mater Dei, still requires improvements as it does not meet the desired time budgets of elderly people. By identifying the main concerns this study seeks to encourage policy makers and planners to target future development in public transport taking into consideration the requirements of the growing elderly population.peer-reviewe

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Caring for Our Kupuna: Building an Aging in Place Movement in Hawaii

Government funding for elder care in the United States is becoming increasingly strained as the number of seniors and the cost of healthcare rise. Medicare paid $560 billion for hospital visits, prescription drugs, and other services in 2010 and expects to pay out just over$1 trillion by 2022. Medicaid, which covers long-term care for individuals with low income and assets, is the source of payment for 70% of nursing home stays across the country and paid $48.2 billion for senior residential care in 2007.As the costs of Medicare and Medicaid soar, practitioners in Hawaii and around the country have experimented with preventive and supportive aging-in-place services that reduce the cost of service while improving the lives of seniors. Rather than rushing an elder to the emergency room after a dangerous fall in the bathroom, providers have begun installing hand and safety rails in the home to prevent falls. Other providers are offering preventive health and nutrition classes that help seniors maintain their health and delay the need for long-term residential care. By focusing on preventive services rather than treating only advanced health needs, aging-in-place service providers are helping seniors maintain independence at home, avoid nursing home admission, reduce hospitalization, and minimize social isolation. Studies show that those who choose to age at home have better health outcomes while incurring significantly lower health costs than those who age in nursing homes. In addition to saving financial resources, aging in place is popular among seniors: a full 90% of American seniors share the desire to remain in their homes as they age.The value of aging in place is particularly relevant in Hawaii, which has the highest life expectancy of any state and the second highest cost of living in the country. By 2030, Hawaii expects to have an older population of 475,000 individuals, representing 29.7% of the population and a 310% increase during the 55-year period from 1980-2035. As the number of seniors aging in Hawaii rapidly increases, the state faces limited capacity in its residential care homes. With only 4,200 beds in nursing homes and 7,000 spaces in residential facilities in 2010, Hawaii's current facilities would be able to serve only 30% of the 38,000 older adults projected to need long-term care in 2035.6Increasing the portion of seniors aging in place could increase the happiness of Hawaii's seniors ("kupuna") and save significant resources for society. However, a continuum of wrap-around services must be available to seniors if they are to age in place effectively. Aging-in-place services must be available to transport elders, support needs in the home (safety, cleaning, cooking, etc.), connect elders with a community, provide respite for caregivers, and monitor and address health/nursing needs. Without this comprehensive support, elders living alone are not empowered to age with dignity and are more likely to become ill or incur injuries

Collaborating to Create Elder Friendly Communities in New Hampshire: A Scan of the Current Landscape

The fact that the population of the United States is aging is no surprise; the demographic projections are well documented. There have never been as many older adults living as there are today, and this number will only increase. Northern New England is aging more rapidly than the rest of the country, with Vermont, Maine, and New Hampshire having the oldest populations in term of median age (U.S. Census, 2014). New Hampshire is expected to be the fastest aging state in New England through 2030, with nearly one-third of its population being over the age of 65 (Norton, 2011). This phenomenon is anticipated to place substantial pressure on publicly-funded health programs and long-term services and supports in the Granite State. But the story of the aging of the population is not only about increased numbers. As longevity increases, the average age of the older population will see a dramatic increase. The number of persons over the age of 85 in the United States is expected to increase five-fold by 2040. As the possibility for functional limitations and disability increases with age, the need for long-term, formal, and informal supports is expected to increase as the number of older adults, particularly those over the age of 85 increases. In addition, women continue to live longer than men; on average, life expectancy for women is three years longer than for men. These factors create a complex picture of aging, which includes a growing population of older adults, a majority of whom will be women; and a growing number of those over the age of 85, who are more likely to require some type of assistance as they age. It is a mistake to look at our aging population in a singular way. Although we tend to make generalizations about older adults, as a group, they are more physiologically and socially diverse than any other age group (Brummel-Smith & Mosqueda, 2003). As we age, we become more and more diverse, as there are no two people who have had the same life experiences, shaping who we are over our lifetimes. The baby boomers (those born between 1946 and 1964) are likely to be the most diverse cohort of older adults we have seen to date, and it is likely that they will redefine our conception of age and aging. Older adults bring a diverse set of skills, talents, and knowledge that should be tapped as a significant natural resource to support a new and exciting vision of aging