Mobility shortfall damaging health, well-being of our elderly.
It’s a challenge that is staring Canada in the face as it ponders the situation of its fast-growing seniors population, but the issue has yet to capture public attention in any serious way. A new report, Managing Mobility: Transportation in an Aging Society, prepared by the Conference Board of Canada, is clearly and properly an effort to remedy matters and place that complex task prominently on the national agenda.
The report would have us push forward with the urgent work of sorting out, researching and, yes, commencing to deal with the transportation needs of Canada’s senior citizens. “Canadian seniors need access to affordable and appropriate transportation options to maintain their health and overall quality of life,” the 40-page report pronounces in introducing its subject.
We all know that the number of seniors in Canada is growing fast: in 2015, Canada’s seniors population – 5.8 million people – made up 16 per cent of the population; in 2025, the proportion is expected to reach 20.7 per cent and by 2040, some 24.4 per cent of the population – 11 million people – will be seniors.
But beyond actual population levels, the urgency of the situation is tied to one single, but very large, element of contemporary living: the car, and a fact that is central to the transport problem seniors face. The car is the main means of transportation for the great majority of Canadian adults, seniors included. But it is mainly members of this fast-expanding cohort of older Canadians who are at risk of losing their capacity to drive and driver’s licences, due to the mental or physical impairment that can come with age.
They will in that case no longer have the mobility that has delivered a full, active and healthy life – unless they find a replacement for the lost transport. More likely, they will discover that, cars excepted, transport out there is, as the Conference Board describes it, “often scarce, inaccessible, inconvenient and, for some, unaffordable.”
With their licences gone, the Conference Board tells us “too few seniors have access to affordable and appropriate transportation options.” The catch is that if they don’t retain their mobility, they have difficulty sustaining their health and quality of life.
It’s worth noting that 68 per cent of seniors aged 65 to 74 name driving their car as their main mode of transportation, as did a still-high 31 per cent of people aged 85 and over. It’s interesting to note, meanwhile, that fewer than eight per cent of all seniors were shown as dependent on public transit in a national survey – perhaps in part because transit systems have generally lagged in adding accessibility features to their vehicles…
It is also important to note that a goodly number of seniors, serious mental or physical impairments are using their cars on a regular basis. A 2011 national survey found seven per cent of seniors with serious vision loss named driving their own vehicles as their main form of transport, as did 17 per cent of seniors diagnosed with Alzheimer’s disease or dementia.
“With more people entering the seniors cohort and with many of them likely to continue to drive even as dementia and other cognitive impairments set in (as turned up in a British Columbia survey), we are likely to see greater risks on the road unless action is taken,” the Conference Board worries.
On the horizon according to board’s report, is a development that can be looked on as hopeful: the advent of automated vehicles. The Conference Board points to potential benefits named by AV suppliers: fewer physical and mental demands made on drivers, increased safety and improved mobility in communities built primarily for cars. The Conference Board itself is already on record suggesting AVs “could play a significant role in preventing 1,600 of the current 2,000 annual road fatalities in Canada.”
Let it be noted that it is early days to be discussing mobility. Activities and programs needing improvement, and the research that could reshape them, are mentioned in a general way, but the baton is passed up to the next level for the wide-ranging research and action that has to follow. Accompanying this is the board’s oft-repeated plea that the strategies brought forward must “strike a balance between maximizing benefits, minimizing risks and respecting the rights and dignity of seniors and other citizens.”
The policies, this entreaty continues, “should aim to support a rich ecosystem of transportation options for seniors, provided by many actors.” Health professionals, urban planners, businesses and many others would be involved.
Some of the strongest instructions from the authors concern driver cessation policies: the termination of drivers licences. It’s a policy area the Conference Board deems critical.
“More effective driving cessation policies and practices will require clearer standards about what constitutes fitness to drive, as well as guidance for all stakeholders about how to assess fitness and take steps to transition individuals from driving to other modes of transportation.
“For health professionals, clearer and more accurate assessment standards are needed, as is clarity about their role in managing driver cessation among their patients.”
There are interesting directives, too, to governments and public transit agencies. The urging that they better align routes and frequency of service to seniors’ living arrangements and transportation needs – and “move away from an almost exclusive focus on the needs of those who commute for work.
“Assessing seniors’ need for accessible and specialized services, and identifying ways to improve these services, is urgent,” the board insists.
But as this document gently notes, addressing the challenges will not be easy. And it prescribes a rational backup. “At a minimum, we should give much more prominence to the needs and abilities of seniors as we assess and discuss transportation and other policies.’’