Why is mobility important to people with Alzheimer’s and their care partners?
Driving demands quick reaction time and fast decision making. As a result, a person with Alzheimer’s disease will eventually become unable to drive. Because most adults have relied on driving all their lives, losing that ability can be so disruptive that it jeopardizes the ability of individuals with Alzheimer’s to live at home for as long as possible. Often, the initial response to no longer driving is to turn to informal networks of family and friends. This assistance may suffice in the short term or occasionally, but it can be inadequate as cognitive impairment compromises mobility for years, not weeks or months. Other means of transportation – transit buses, public railways, walkable neighborhoods – become necessary.
Why isn’t the existence of alternatives good enough for people with Alzheimer’s?
Alzheimer’s creates many unique barriers to the use of alternative transportation. Even those who have been frequent users of public transportation throughout their lives face new challenges as a result of their cognitive impairment. For example, individuals with dementia may need assistance in figuring out bus routes and timing (and even when they have arrived at their stop); they may need volunteer drivers and help with handling money when paying for a cab; the transportation may need to be door-to-door rather than curb-to-curb; or they may need help applying for the transportation assistance that is available to them.
Why does public health need to act?
At all stages of Alzheimer’s disease, individuals need to access medical and community-based services. In addition, participation in social activities and community life is important to health and quality of life, especially in the earlier stages. With the projected growth in the number of people with Alzheimer’s disease and the fiscal benefits of enabling people to stay in home settings as long as possible, mobility is becoming an increasingly important issue for states and communities. In fact, nearly 20 state Alzheimer’s disease plans have called for improved transportation options for those with dementia. Related policy action, however, has not always followed, especially if transportation leaders did not participate in the planning process.
What can the public health community do to improve mobility for people with dementia living in the community?
Integrating cognitive health and impairment into government planning efforts, including transportation plans, is part of the public health response to Alzheimer’s disease. To assure state or regional transportation plans result in enhanced mobility for people with dementia, the public health community can:
• Conduct needs assessments to identify disparities in affordable access to alternative transportation options, especially with regard to wellbeing, quality of life, and safety.
• Inform the state/regional transportation planning process about the unique challenges that people with cognitive impairment face in using community transportation alternatives.
• Help enable people living with the disease and their care partners to participate in the planning process.
Learn more at: alz.org/publichealth