Mobility, Transportation and Other Barriers for Seniors Seeking Help
Transportation and environmental barriers can have a disproportionate impact on seniors' ability and opportunity to seek help for alcohol problems.
A. Recognizing Transportation and Mobility Barriers
Receiving help obviously involves being able to where the help is being offered. Here is a checklist for uncovering potential barriers:
If you offer a support group,
There are other important environmental considerations:
B. Why Should We Care About These Matters?
A large number of seniors who have alcohol problems have impaired mobility (trouble walking). For example, a study of older clients being seen by an outreach program found that one third (33%) of the men, and six out ten (59%) of the women being referred to the program had mobility impairments.
This and other impairments or disabilities, can create significant barriers for the person trying to access most of the standard treatment resources. The mobility impairments can also negatively affect their ability to meet many of their day to day needs.
It is important to understand the nature and impact of these problems for seniors.
C. Understanding How and Why Transportation is an Issue
Although many service providers drive, many seniors dont.
According to the 1991 National Survey on Aging and Independence, 92.4% of men and 80.6% of women aged 45-54 had valid drivers' licenses.(1) However only 69.4% of men and 22.0% of women aged 75 and over did. A smaller proportion of seniors with alcohol or substance abuse problems drive.
Some cannot afford a car. Others no longer can drive because of health reasons, such as deteriorating eyesight. That social isolation from loss of capacities may be one of the reasons they are drinking more now.
Of seniors who do drive, many may only feel at ease driving in their immediate neighbourhood. Some older drivers find it overwhelming if expected to drive to an unfamiliar location or where there is heavier traffic. Many seniors have poor night vision, and avoid driving after sunset. (2).
D. An Example: The Current Situation in One Community
When we conducted an Environmental Barriers Study in British Columbia in 1997-8, we found that 59% of the A.A. support group meetings in the Lower Mainland of British Columbia were offered at night. Another 25% were early morning meetings (before 9:30 a.m.)
In Kelowna, British Columbia (a community with a high proportion of seniors), 77% of the AA meetings were being held in the evening or early morning. These meeting times may meet the needs of working adults, but not the needs of many seniors.
In many smaller communities in the Lower Mainland (e.g. Cloverdale, Pitt Meadows, and even West Vancouver), there were no daytime support group meetings. That effectively excluded a lot of seniors who are seeking help.
Whether we are talking about support groups, outpatient clinics, residential treatment or detox centres, how does that person get there? If the senior is fortunate enough to live in a large urban setting, she or he may have access to alternate transportation for people with disabilities (for example, HandyDart).
However even when available, there are still challenges. In Vancouver, for example, the study found that a person was required to schedule the HandyDart appointment about 5 days ahead of time.(3) Imagine how tough that would be for a senior who has short term memory problems. Using using alternate transportation, a persons trip (not including the hour for counselling) can easily take four hours of waiting and travel time.
Some seniors rely on buses. One third of the buses in the Lower Mainland offer accessible service with low floor buses- so the person does not have to step up to the floor level of the bus. This is great for someone who has difficulty with stairs, uses a walker or a wheelchair. However, even in the Lower Mainland, only 25% of the stops on a bus route have to be let a disabled person on or off for the route to be designated as "accessible".
As you travel outside of the downtown core, fewer stops are accessible. That means longer stops to get to an accessible one. So, the nearest stop may not be close to the seniors final destination. A senior can easily have to walk a half mile to an accessible stop. Once again, think of that in the context of the 59% of women in the Seniors' Health Study who had mobility impairments and were trying to get help for their alcohol problem.
Lack of shelters and benches at bus stops in hot weather or cold, wet, or snowy weather also make it harder for a senior who has a mobility or other physical impairment to access whatever is available in his or her community.
For seniors who live in rural areas, travel becomes a lot more complicated. In the winter for those who drive, theres impassable or icy roads, and long distances. It is easily 50 miles round trip to the closest outpatient clinic in some parts of the province.
E. But Cant They Just Get Someone To Drive Them?
This is a common misconception. For many seniors, there simply isnt anyone. In the Seniors' Health Study, for example the majority of the people were single, divorced or widowed ("unattached"). This is particularly true for older women.
Canadian figures indicate that seven of ten women aged 75-79 are unattached, as are 9 out of 10 women aged 85 and over. (4) For approximately one half of seniors in Canada, their "closest child" lives more than 10 kilometres away (5). Thirty percent of seniors have two or less friends, and those friends may not drive either.
Many seniors living on their own consider it extremely important to avoid asking family or friends for "favours" such as rides-- certainly not on a regular basis, and certainly not to some place where they are going to learn that you have "a drug problem".
Last updated: July 5, 2002
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