Three-Community Transportation Project
Dan Onion, MD, MPH
Mt. Vernon/Vienna Health Officer
Last year I wrote about the issues around senior driving and what can be done to diminish crash risks without isolating our seniors. As a result of those and other conversations in town, the Mt. Vernon Community Partnership has undertaken a project to create a volunteer transportation system in Mt Vernon along with Vienna and Fayette. Several town forums have been held in November to solicit ideas of how this might be done and how it might work. We encourage all seniors who can to “age in place”, rather than move away to family or assisted living even if they can no longer safely drive. Younger citizens without cars or driver’s licenses, could also be served by the system being planned.
Nearly everybody over 45 has worried about an elderly parent or other loved one’s safety when driving. Crashes caused by older drivers are a significant public health issue, especially in Maine, which has the oldest median age of all the states and a predominantly rural environment lacking public transportation. In those rural areas, like Mt. Vernon, nearly 20% of the population is already over 65, a percentage the rest of the country is not predicted to reach until 2030. So seniors who live here must have a car and be able to drive to do most things they need to do, from shopping, to medical care, to entertainment.
At about age 70, national and Maine fatality rates per-mile-driven for drivers start to climb from those of younger adult rates; but they don’t exceed the teen rates until age 85. Not all this fatality increase is from increased crash severity or frequency; at least half the fatalities occur because older people are more fragile and break more easily than do younger riders in a similar crash. Older Mainers do “compensate” for this increased rate of crashes per mile driven by driving less than younger adults.
Not everybody ages at the same rate, so age group definitions are unfairly limiting. And not all medical limitations preclude driving with modest limits like fewer miles, daytime only, no throughways, or just in local areas. Older drivers with intact cognition usually self-impose many such restrictions; the more troublesome group are those with early dementia. They are likely to worsen over a few years and, and, because their judgment is often impaired, must rely on others to suggest or impose limitations, for their own and others’ safety. The reality is that the average person has to retire from driving 5-10 years before they die. So we all need to plan for how to recognize and decide when it’s time.
The press too, seems to recognize the problem, so we frequently hear news reports of crashes involving elderly drivers. Drivers themselves and their families must be vigilant to recognize serious limitations as they develop. Common signs are: hitting the gas instead of the brake, experiencing minor or major car damage/crashes, failing to stop for stop signs or lights, trouble making left turns, driving too fast or slowly for the traffic conditions, and family feeling it is not safe for others (like children) to ride with the senior driver. Family members can check by riding with or following the senior driver. If there is still doubt, self-screening can be done with a very helpful on-line series of tests from the American Automobile Association called Roadwise Review (http://seniordriving.aaa.com/evaluate-your-driving-ability/self-rating-tool).
And finally, to make the transition easier, planning for how the senior driver can get along without driving is crucial. That is where the Three Community Transportation Project may help. Our vision is that we will recruit volunteer drivers for each of the 3 towns. They would be scheduled by a part time dispatcher/coordinator to pick up users at their homes and transport them to Augusta or Farmington, and perhaps Livermore Falls (for Fayette, especially) on a different day each week; in other words, Tuesdays would be Farmington and Thursdays Augusta. The volunteers would drop the riders where they want to go and wait, or at a public transportation stop and go back later for the return home. For instance, in Farmington, the drop off stop would probably be the Hospital, from which riders could, for $1, ride to Walmart, Hannafords, and/or downtown on scheduled Western Mountain transportation vans. To start up, temporary grants may help; but long term, modest user fees and town support may be necessary. The public forums are helping to judge whether we can recruit drivers and riders for such a system, and how to modify the plan to maximize use and success. If you have ideas, suggestions, want to volunteer as a driver, or think you might like to use the service next summer, email or call me or Sandy Wright (firstname.lastname@example.org), who chairs the committee.