Health Care, Mobility and Elders

In general this presentation focused on mobility for elders, but a lot of the discussion was about using volunteers. Since Medicare does not guarantee nonemergency medical transportation it seems to make sense that so many people were relying on volunteers for non-ambulance trips. Since a lot of the elders seemed to need help getting in and out of the house or in and out of the facility, and help while in the doctor's office or at the pharmacy, it seems like one-on-one rides were more efficient, because you didn't have a situation where a driver had to help somebody in or out while everybody else using the transportation had to wait. At the same time, there are a lot of issues with using volunteers: training them, retaining them, relying on them, etc. And I wonder if there were any cases where a volunteer had to be fired, and how to handle that. It looks like there are quite a few programs for volunteer medical advocacy for older adults – like this one in Maine [http://www.smaaa.org/volunteer_medical_advocates.php] – but as many people mentioned, transportation is an issue that involves liability and it is also a technical skill. It would be interesting to know whether defensive driving and similar types of training were also part of the volunteer training. Coordination was also a big issue: coordinating with different agencies and nonprofits. But in light of some of the other panel discussions, it seems like it might be worthwhile to ask what kinds of collaboration was working best. Did resource sharing – things like vehicle maintenance – work well? Or trip coordination? What kinds of coordination were the most helpful with this population of elders? It seemed like Tri-Met did a lot of that resource coordination while in Massachusetts the coordination was largely trip coordination. What circumstances dictate which kind of coordination will work better?

Having a medical advocate partner with a senior to assist them in keeping track of their health is a great idea! I think this extra training is essential to being a partner in the senior’s health.