Facing the need to restrict or stop driving is devastating for many older people. For some, it heralds the first time aging has significantly limited their lives—and brings to mind discomfiting thoughts of “beginning to slip away.” For others, it sets off a fear, and in many cases a reality, of becoming more isolated from others. And for the older person’s caregivers or family members, it can signal the beginning of a nightmare of inconvenience and the need to scramble to arrange for rides to medical and social appointments.

But doing some advance planning can help ease the sting and worry for all concerned. The first step is to come up with a solid schedule of events and appointments that require alternative transportation; the second is to match those needs with locally available options. With a little creativity, inside knowledge, and persistence, you may be surprised to learn of the array of options—from free to more costly.

Come Up With a Plan

Create a simple spreadsheet or calendar page listing all upcoming appointments, meetings, and social commitments—along with specifics on how transportation needs will be covered.

For each event, be sure to list:

• The transportation provider’s name and contact information
• The time of arrival and pickup
• Any cost for the service
• Whether lead time is required to schedule the service
• A possible backup in case the first choice isn’t able to provide services

This piece of paper, which you can post prominently or keep in a visible spot such as the refrigerator door, can go a long way to helping provide peace of mind—at least when it comes to nettlesome transportation problems.

Look at Informal Options

Informal agreements with volunteer drivers such as family, friends, and neighbors are by far the top option for many seniors, who often find added comforts in their familiar cars and faces. Best choice is a person who is dependable and who will take the task seriously; it may help to have the volunteer indicate the specific days and times he or she is available on the calendar of appointments you have prepared.

But for some people, these arrangements also stir up nagging feelings of burdening or inconveniencing those around them. Encourage reluctant passengers to help even the playing field by trading a service in exchange: knitting a sweater, creating artificial flies to spec for a tackle box, buying a meal at a favorite restaurant. The bartering arrangement will not only help the senior in need of help feel less guilty, it may help impress the driver with the need to be conscientious and on time when providing it.

Get the Details Down

When sussing out services that may provide fitting transportation, be sure to get clear on a number of details, including:

• Service requirements. Some services only accept passengers who meet certain criteria as to age or income, or operate only within a defined geographical area, only on specified days of the week, or only within certain times of the day.
• Costs. It’s essential to get clear on costs and related money matters: whether tipping is allowed or expected, whether reduced fares are available, whether there’s an extra charge for an aide or companion to ride along on the trip.
• Notice and registration. Find out whether passengers must be preregistered; some services enforce stringent qualifications, which may mean a waiting period while age and income are verified, or even a personal visit to make sure needs are as claimed. Also inquire about how much advance notice is required to secure service; rides must typically be scheduled in advance—sometimes as much as several weeks in advance. Also find out the cancellation policy, and whether time limits are imposed or extra charges apply for canceling.
• Special needs. Some older passengers may need extra help getting into and out of the vehicle, getting safely from door to door, or managing wheelchairs or scooters. If such assistance is required, make sure the service can cover it.

Find Local Transportation Services

The type and scope of transportation options differ dramatically by locale—and range from free to a bit of a pricey splurge. And finding the best fits may take a bit of perseverance and a number of phone calls.

Senior transport and rideshare. Organizations offering services for seniors such as daycare or recreational programs often also have a dedicated transport service to take participants from door to door. To find referrals to such services, contact the local Area Agency on Aging.

Medical transport. Some clinics, hospitals, and specialized operators such as dialysis and chemotherapy providers offer transport to and from appointments for patients to whom they provide care. Contact the individual provider to find out whether such services exist.

Veterans transport. Some clinics and hospitals run by local Veterans Health Administrations offer transportation services to those receiving care there. Such services are often limited to a set number of daily pickups, usually originating and ending at a central spot in the community. To find local facilities and transportation offices, consult the U.S. Department of Veterans Affairs.

Mass transit. Frequent riders, senior citizens, people with disabilities, and Medicare or Medi-Cal cardholders qualify for reduced bus and train fares in many locales—and most such vehicles used for this purpose are equipped with lifts or lowering ramps to accommodate riders who have limited mobility or use a scooter or wheelchair. To find out specifics offered in a particular area, look at the American Public Transportation Association’s listing of local and state transit services.

Taxis, ridesharing, ride-matching. People who live in or near large metropolitan areas who are physically and mentally able to negotiate on their own may get help with transportation from a cab service. Some local companies offer coupons or scrip that senior residents can use like cash to pay for rides and tips. In some locales, ridesharing and ride-matching services, such as Uber and Lyft, are partnering with senior organizations in pilot programs offering discounted rates for seniors.

Paratransit. People who have physical or mental disabilities that prevent them from using the regular transit system may qualify to be accepted by a paratransit service operating cars, vans, or buses. Some communities provide free or low-cost passes for disabled or elderly residents.

Government programs in some locales provide free or subsidized paratransit services for individuals who receive Medicaid or Medi-Cal benefits because they have low incomes and few assets. To be covered, the transportation must generally be required for a “health-related reason” such as a doctor or hospital appointment or visit to an adult health care center.

Private car companies. A private car service—with costs generally ranging from $75 to $250 per hour for a basic type of vehicle—may be a viable option for those unable to arrange other transportation. For a price quote based on vehicle type, geographic location,  length of time, and wheelchair accessibility if needed, consult the website operated by the National Limousine Association.

(This article was updated in March 2024 since it originally published in September, 2016.)