There’s no getting around the fact that Tennessee’s senior citizens are having trouble getting around.

Not simply in terms of physical mobility; a decrease in that happens to most everyone as they age. The problem facing Tennessee, especially in its rural communities, is a lack of transportation options for the aging and elderly, especially those who live alone.

The problem is multifaceted and defies one-size-fits-all solutions. While many seniors can and do drive, family and friends worry about them behind the wheel.

For those who cannot or choose not to drive, reliance on a loose confederation of family and friends to get them to and from the grocery store or other errands, as well as important healthcare appointments, is a constant source of anxiety. For those family members or others providing transportation, it often means significant time away from work or other responsibilities, because many seniors need more than door-to-door service, but rather require someone to remain with them to provide aid and support.

In the state’s more populated areas, senior transportation programs have been in existence for decades, in some instances. They are usually a part of an overall public transportation system or run by agencies that provide other senior-oriented services. Now they are joined by other public-private partnerships, nonprofits and for-profit companies, and even so they are having trouble just keeping up with a rapidly growing population.

“We did a survey back in 2016, and one question we asked was about barriers getting to their destinations,” says Jocelyn Briddell, associate executive director for active aging at FiftyFoward in Nashville. “About 30 percent raised mobility as an issue, but when we dug deeper into other barriers more than half of those were about driving at night, traffic and parking, and driving on the interstate. So, it all comes back to mobility, and just getting around.”

Growth is creating problems in Nashville and, to a lesser extent, Tennessee’s other metro areas, for seniors who have spent decades on streets that are now much more crowded, she says.

“Transportation is an issue for so many reasons, and that’s why a lot of different groups have begun to look at not just van and bus programs, but ridership programs that will provide support to seniors in different ways,” Briddell adds.

“They have their own issues to sort out, however. Cost will be a barrier to some seniors who may not be able to pay for a service or can only pay a nominal fee. So, operations income will have to come from somewhere else. There will also have to be a lot of work around awareness, because senior citizens, especially those in outlying areas, aren’t going to see or hear a social media campaign as readily as a younger audience will.

More traditional outreach will be necessary.

“And lastly, with low unemployment, it’s going to be hard to find people who can work as drivers or other employees for these kinds of services, so there will probably need to be a strong volunteer component. That means those people have to be found and trained.”

The solution, she points out, is being found through partnerships. FiftyFoward and other aging-oriented organizations are longstanding partners with multiple other entities, and newer players in the transportation and mobility scene are likely to follow that model.

“When you’re thinking strategically, you have to look at who else is in the space, what they’re doing, and how you can collaborate,” Briddell explains. “We have to make sure that we are covering our membership with the ride service we offer, and then look at gaps where someone else can step in. Eventually we will all probably start meeting to talk about who’s doing what, so that we can all look at the issue at the same time, identify problems and move forward.”

Rural issues

In Murfreesboro, senior transportation has become an increasingly visible and popular service at the St. Clair Street Senior Center, says Connie Rigsby, director.

“Our job is to provide well-rounded activities so that people can stay mentally, physically and socially active, but we have to get them here to do that,’’ Rigsby says. “And we have a growing population: in Rutherford County right now, there are around 50,000 people in the 60-plus age bracket, and we’re growing thanks to being so close to Nashville.

“If people are in Murfreesboro, they have access to the Rover bus system, but if they are more rural they don’t have that. And even if they are on a bus line, they may not be able to physically walk to the stop, so it’s a difficult situation all around.”

The center is forging partnerships with ride-share organizations and community resource such as church groups, as well as families, so that it can serve as a hub for connecting seniors with transportation. Being in the center of that means Rigsby is seeing all kinds of innovation, but also having to work with seniors who may not be comfortable getting into a car with a stranger, and are not likely to have a smartphone and, even if so, use an app like Uber to get around.

“They are very set in their ways, they are sometimes mad that they can’t drive, and they can be stubborn,” Rigsby acknowledges. “You have to think outside the box. We have a semi-retired taxi driver who works with us – all he does is provide rides for seniors. It keeps him busy and he’s familiar to people.

Seniors climb into a van at FiftyForward’s  Patricia Hart Building at the Tennessee State Fairgrounds, one of several Senior Centers in Nashville.

-- Michelle Morrow | The Ledger

“We have to think of ways that are unconventional, especially in the rural areas. As a state, we are doing better about getting medical and other services into those places, but we’re not doing very much about getting people out of them.”

The issues remain the same in the Chattanooga area, says Christin McWhorter, a community relations manager with the Southeast Tennessee Area Agency on Aging and Disability.

“We have that same huge gap in services for urban and rural areas, and for the same reasons,” McWhorter says. “There are so many barriers: lack of service, inability to access, cost. We have been really watching the rise of volunteer-assisted transportation programs, because we think they are going to fill in a lot of these gaps.

“We are in touch with MyRide, which has begun operating out of the Southwest Tennessee Area Agency on Aging and Disability and is being started out of some funds from a state settlement (see related story on page 7). We believe those are going to grow and expand across the state, because the groundwork is being laid for them.”

Like anything else, creating a transportation network from volunteers, just like building one in the public or private sector, is a project that requires a long view, she notes.

“It will take a while for the volunteer programs to make a huge impact, and there will be some limitations, but it’s a good step toward making sure that everyone’s needs are getting met.”

Knoxville’s longstanding program

In Knoxville, the longtime collaboration with the city of Knoxville and its fixed-route transportation system and the Knoxville-Knox County Community Action Committee was supplemented a decade ago by a volunteer assisted transportation, or VAT, program for people within city limits.

However, outside the public transit service grid, county residents are not served at all, says Warren Secrest, program director.

Terrell Scruggs, Sr., care pilot with Caregivers by WholeCare helps load Jane Young, 69, into a van outside The Meadows senior community in West Nashville. Scruggs has driven for Caregivers by WholeCare for a year.

-- Michelle Morrow | The Ledger

“There are a lot of seniors who find it very difficult to use the bus, and that’s why we created the VAT almost 10 years ago,” Secrest says. “And you can’t design a ‘one size fits all’ model. Over time we have grown in many ways to meet the needs, and now we utilize 11 Toyota Prius sedans because they get great gas mileage, as well as seven wheelchair-accessible minivans.

“The program, which now has a budget of around $250,000, has remained cost-effective because originally it was begun with almost all federal funds, and we still utilize Federal Transit Administration dollars for the purchase of vehicles and operational costs.”

The program also receives funds from the Tennessee Department of Transportation, and is administered by the Knoxville Regional Transportation Planning Organization.

The program’s core ridership census is made up of not just seniors, but anyone who cannot drive or ambulate easily and requires an escort to travel safely. Volunteer drivers can provide door-to-door service, but more often accompany the individual for shopping, doctor’s appointments and similar errands.

And the VAT is busy. Last year it made close to 7,000 trips for 230 individuals and utilized more than 60 volunteer drivers who donated 8,000 hours. Fares run to $3 for a one-way trip, $6 for a round trip with multiple stops. Riders are asked to fill out an application so that they can be entered into a database, and when possible matched with a driver they request.

And luckily for riders, the VAT is a program that was operational ahead of the major need that is happening now, Secrest says.

“We are in the right place at the right time,” he points out. “We knew what we were doing when we applied for federal funds, and so we were able to get good cars that are affordable to operate and perform well. We also are able to supply our drivers with a polo shirt with a decal, so it’s easy to see who they are, and clients like that.’’

Another way the VAT eases the minds of riders, and their families, is through an extensive background check process.

“We do fingerprinting, we get national-database information from the FBI and other states, we get their motor vehicle record, we do a physical and we have a random drug-screening program as well as drug and alcohol awareness,” Secrest recounts. “We want to make sure they are capable of this type of work, and so we’ve been very successful in getting and keeping great volunteers.

“We also have training for first aid and CPR, and we work with the AAA and AARP on driver improvement programs, so overall our riders can be assured these folks are pretty well trained.”

New entity in Nashville

In booming Middle Tennessee, Senior Ride Nashville tackles the transportation issue identified by FiftyFoward and other entitles and agencies in its service area.

After a three-year study period of different models convened by a senior transportation leadership coalition anchored by the Council on Aging of Middle Tennessee and folding in representatives from transportation services, government and the aging community, Senior Ride Nashville debuted in November 2017 and began providing services soon after. Now, almost a year later, the feeling is that it could have debuted at twice its size and still not been enough, says Carrie Brumfield, executive director.

“We have provided 1,500 to 1,600 trips so far,” Brumfield says. “We are similar to the VAT in Knoxville in that our riders are members, but different in that we pair riders who use their own vehicle to drive older adults around rather than operating a fleet of vehicles.

SRN staggered its Davidson County rollout, beginning in Bellevue and then moving into West Nashville, Belle Meade, then Sylvan Park and the Nations. It then hopped the Cumberland River to Madison, and now has moved east into Donelson, Old Hickory and Hermitage. Even with that cautious approach, logistics caused some headaches.

“We would have a volunteer in West Nashville who really didn’t want to give a ride all the way over in Madison, for example,” Brumfield explains. “This program really is about neighbor serving neighbor, so we had to work hard to reach into each community and build that volunteer driver base as best we could, so we could enroll riders.”

Like its counterparts, SRN also put heavy-duty driver checks into place, starting with an orientation and training class which includes not just health and safety info but also some pointers on working with an older adult population.

Drivers then move through criminal and driving record checks using a program called Verified Volunteers that engages directly with the drivers. Then one-on-one interviews are conducted, along with reference checks and insurance verification.

The cost is in line with other programs, with an annual membership fee of $25 and a rate of $6 per round-trip ride, which can last up to three hours and have two stops.

Those funds hardly put a dent in an annual budget of around $360,000, which is met with support from the Community Foundation of Middle Tennessee, the West End Home Foundation, United Way of Metropolitan Nashville, The Memorial Foundation and healthcare entities such as the HCA Foundation and Tivity Health, among others. As the organization ages, it will begin fund-raising efforts and seek individual donations, Brumfield says.

And as in every other corner of the state where this or any other kind of transportation program has begun, Brumfield says the response has been overwhelmingly positive.

“Some of these people have only recently given up driving, and they told us they felt like they had been incarcerated,” she continues. “Others didn’t want to be a burden, or they didn’t have family or a network of friends to reach out to for help. Now they know they can get where they need to go, and it’s priced in a way that most can afford to pay for it without a problem.”

Another similarity between SRN and its fellow ride-providing groups around the state is the community that springs up. Drivers get to know other drivers, and deep bonds form between them and their passengers.

“It’s so much more than a ride,” Brumfield says. “Quality of life improves when these people get out, and we are seeing the sweetest relationships form. You’re spending time with someone who cares about you, and who is donating their resources and their time.

“Knowing that you’ve got a friend waiting in the lobby for you at the doctor’s office, or helping you get that item off the top shelf of the grocery store, is a very big deal.

“It’s an intimate experience, and I hear the phrase “answer to a prayer” an awful lot.”