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How to Help Elderly Adults with Transportation Challenges

by Madhuri Reddy | Jul 06, 2016 | eldercare | 0 Comments


It can be tricky to help elderly adults who have limited movement, or people who don't understand instructions well, to get positioned comfortably in the car.

Common Transportation Challenges in the Older Adult

Many conditions may occur more commonly as we age. Several of these changes can cause transportation and travel challenges. Be patient while assisting.

Vision Impairment

  • When transporting an older adult with a vision impairment, explain exactly what you are doing and why.
  • Ask if they would like assistance before providing it.
  • If they use a cane, always lead by standing on the opposite side of the cane, and stay one-half pace ahead.
  • If possible, have them exit from the non-traffic side of the car.

Problems with Balance

As people age, they are more likely to lose some muscle strength, develop arthritis and have changes in the inner ear, all which affect balance. This can make getting in and out of a car and positioning in the car difficult for some elderly adults.

Allow an older adult plenty of time to enter and exit the car. Also give plenty of time for them to regain balance when shifting positions, such as moving from sitting to standing.


People with joint pain, such as arthritis, may find it painful to enter and exit a vehicle. Give your passenger extra time and provide assistance with a gentle touch.

People with dementia often will not be able to tell you they have pain, or where they pain is, but they can become very agitated. If you ask them directly if they are having pain, they may be able to correctly answer yes or no.


A few tips to help elderly adults dealing with transportation challenges.

Positioning an older adult in a vehicle

  • Make sure that the older adult’s seat belt is securely fastened while in transit and that they do not unfasten it until the vehicle has come to a complete stop.
  • Provide assistance when the person enters or exits the vehicle, but do not make them feel rushed. Give the older adult extra time to do what is needed.
  • If the older adult has had a stroke and has right-sided or left-sided weakness, seat his affected side nearest the door (i.e. if a left-sided weakness, then seat on the driver-side of the back seat). This can help with balance and allows you to position the weaker side into the car and also encourages the older adult to assist.
  • It may be helpful to keep a pillow in the car to help with positioning. A shoulder strap seat belt can also help.

Providing Assistance to Agitated Passengers

Agitation in older adults with underlying memory issues may be due to a number of issues including pain, illness, inability to verbally communicate what they need (such as the need to go to the bathroom), or fear or frustration at the current situation. For example, they may be agitated because they forgot who to enter the car or where they are going. Being patient and offering simple directions in a calm way can help to diffuse the situation.

If an older adult becomes agitated, resistive or argumentative, it is usually best to stay calm and agreeable, as if you are going along with their desires. Validating their current feelings, and incorporating why a car ride is necessary, is much more effective in leading to cooperation than disagreeing, re-orienting or arguing. ask the older adult why he does not want to get in.

In an older adult that frequently gets agitated during a trip, it is a good idea to:

  • Suggest they use the bathroom before each trip
  • Seat the older adult in the rear passenger-side seat so that the steering wheel is out of reach, and he is not directly behind you. This way you can avoid being startled from behind when you are driving.
  • If your car has child safety locks, it’s always a good idea to have them on – allowing the rear door to be opened only from the outside. This will ensure that the door cannot be opened by the older adult while the car is moving.
  • Using a seat belt buckle cover can discourage unbuckling the seat belt during your ride.

If agitation persists during the ride, try playing music, or offering a book, magazine or photo album of family pictures. It’s also a good idea to have snacks and water available.

Picture of Madhuri Reddy

Madhuri Reddy

Dr. Reddy is a specialist in Internal Medicine & Geriatric Medicine, and holds appointments at Harvard Medical School & Hebrew SeniorLife in Boston, MA. For years she has seen first hand the struggles that families and caregivers go through while caring for older adults.

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