In a society built around the automobile, elderly people who give up driving often face a devastating loss of independence and quality of life. “Driving means accessibility, convenience, and safety,” says Dr. Joseph Coughlin, director of MIT’s new AgeLab, where, in addition to housing and the workplace, transportation is a key part of the aging-related research agenda.
Coughlin is studying ways technology can improve mobility options for older people, including safer cars and roadways and improved public transit systems. As the U.S. population ages, he says, helping older people stay self-sufficient for as long as possible is an important public policy issue.
“Transportation is the glue that holds all of life’s activities together,” says Coughlin, who gathers information through surveys and focus groups of older people. “It’s not just getting from point A to point B. Transportation means independence and freedom to people.”
The issue will gain importance over the next 50 years as the population ages. By the year 2050, the U.S. population at large is expected to grow by about 45 percent, but the number of people 85 and older will grow by more than 300 percent during that period, according to U.S. Census Bureau statistics.
According to Coughlin, the physical infirmities that affect driving skills – including poor eyesight, reduced flexibility and strength, and decreased reaction time – can begin as early as age 40. “Many older drivers recognize weaknesses in their driving skills, and they self-regulate, choosing not to drive under certain conditions,” he says. “But if you don’t drive at night, or on the highway, or during rush hour, or when it’s raining or snowing, when can you go out?”
As a result, older people may have difficulty getting to the doctor or the grocery store, but they may miss out entirely on social occasions. “Older adults tell us the trip that’s most important to them is for social purposes,” says Coughlin. “So without that car, their social existence starts to contract. And that leads to isolation, which can cause depression and other ailments.”
Coughlin says existing technology can do a lot to make driving easier for older people, including infrared screens to improve night vision, automated collision-avoidance systems, and better roadways. “Why as a society do we tend to say a person is too old to drive?” he asks. “We should be improving cars and roadways to better serve the people.”
Alternatives to the car
Technology can help older people drive more safely, but it can also provide better alternatives for those who choose to stop or can no longer drive. “We need to reinvent public transportation,” says Coughlin, who adds that fixed-route bus and light-rail systems don’t match most people’s activity patterns.
One answer for older people who don’t drive is paratransit systems that use smaller vehicles to provide customized service. “Instead of a 60-person bus, it will be a six-person van that goes door-to-door and has the responsiveness of an airport shuttle,” he says. “But the greatest innovation will be in the communications. You’ll have a hand-held device, which could be part of a cell phone, that you can use to order a ride wherever you are and to check on the status of your ride when you’re waiting.”
Better dispatch systems are the key to making paratransit convenient and economically viable, according to Coughlin. “The van is usually riding empty because they’re running on an antiquated dispatch system,” he says, adding that current systems require riders to call for a ride 24 hours in advance. “In some areas of the country, it’s seven days in advance,” says Coughlin. “Say you feel like getting a hair cut – you’ve got to order the ride seven days ahead?”
Coughlin tells the story of one man in his 70s whose favorite pastime was watching the Boston Red Sox on television while eating a bowl of fresh fruit. “He would never ask his wife or daughter or any of his friends to go out and shop for food for him. When he gave up driving, he also gave up his greatest joy in life – watching a game and having fresh fruit.”
It’s the individual anecdotes like this that make the research come alive for Coughlin. “Without bringing the older adult in on the discussion, you have no idea what the story is – and the story is how we understand what’s happening,” he says, adding that his interest in aging dates back to his childhood, when he shared an interest in amateur radio with a circle of elderly friends.
Helping older people lead more fulfilling lives isn’t so much a matter of new technology, according to Coughlin, as it is of public policy. “The challenge is getting this issue up on the public agenda, the research agenda, and the industry agenda,” he says, adding that the White House is considering establishing an elder technology policy.
“We’ve spent billions of dollars making sure we all live longer,” says Coughlin. “But we haven’t spent even a reasonable fraction of that amount making sure that we maintain quality of life.”