Aging in America News

| Observations of a Newly Minted Older Person
| Louis Tenenbaum

| Our cab dropped us across the street from our hotel when we arrived in Hanoi for a family vacation in early December. Friends had warned us to be careful crossing the street, but nothing could have prepared us for what we faced. We stood on that sidewalk for several minutes, studying the rush hour traffic, trying to calculate how crossing could even be possible. As anyone who’s visited this part of the world knows, it’s not the cars that overwhelm you—it’s the thousands of scooters weaving in every direction, a mechanical river that never stops flowing.

Over the following weeks, we came to understand that traffic rules as we know them simply don’t exist here. It’s not that pedestrians don’t have the right of way—no one does. There are no stop signs, although there are a few traffic lights. The whole system operates as an intricate game of chicken, where everyone moves forward with confidence and somehow, miraculously, it works. By the end of our trip, we’d grown bold enough to step into traffic without hesitation. But the lessons we learned from navigating those chaotic streets went far beyond awe and bravura.

Scooters are critical in Vietnamese life and culture. People scooter in traffic while texting. Four or five people ride on a scooter at once, even holding children without helmets, some of them texting too. Scooters are loaded with furniture, construction tools and equipment, and all kinds of freight, much longer or wider than the scooter itself. Clearly, OSHA has not yet made its mark here.

The scooter—the opportunity for independent mobility—is a game and culture changer. Seeing how impactful it is gives our own desire for independence some perspective.

Those of us in the aging field know how important transportation is to positive aging experiences. Joe Coughlin, the provocative head of MIT Age Lab and leading researcher and commentator on the aging experience, focused our concerns with “Three Questions to Lead You to a Quality Retirement”:

1. Who will change my lightbulbs?
2. How will I get an ice cream cone?
3. With whom will I have lunch?

Joe is spot-on in exposing the issues facing aging Americans so succinctly. Two of his questions rely on transportation. Though my career advocating home modifications has focused on question #1, I have always known that transportation is critical.

Aging and Transportation

Vietnamese scooters and American aging infrastructure intersect at the question of how mobility underpins autonomy. The role I saw scooters fill emphasizes the tie between transportation and independence. Scooters embody mobility and independence. Sure, we saw buses, but many times more people were riding scooters. This was true in both urban and rural areas, day and night, for families and commerce.

For those of you who thought the title of the article meant the focus would be technology to alert about falls, schedule and report caregiving experiences, or monitor vital signs remotely, and communicate among medical professionals and care teams, or even robotic companions, think again. Review my last column, What Is Independence? for Aging in America News. If independence is about control of one’s comings and goings, mobility is key, no matter what age—or homeland.

This column is meant to embrace YES, AND. Sure, the shiny-penny technologies we read about and invest in are important. AND it is important to keep track of the basic factors of the human condition—social connections, affordable and appropriate housing, access to thoughtful and comforting medical care, family, and spiritual growth that we strive to control through our aging process.

Just as scooters enable Vietnamese independence across all aspects of life, we’re beginning to recognize this in American aging policy through benefits like medical appointment rides becoming standard in many Medicare Advantage Plans. How fortunate that in the world’s wealthiest nation, we’ve finally managed to ensure older adults can get to their doctor—as long as it’s scheduled in advance, approved by insurance, and doesn’t involve stopping for ice cream on the way home. I am not suggesting we buy older Americans scooters to get around. But as we see the overwhelming impact of independent mobility in Vietnam—a far less wealthy and developed country, where families of five can spontaneously go anywhere on a single scooter— we must recognize that medical appointment rides, while welcome, are not enough.

Our aging services infrastructure must support the full range of mobility that confers dignity, joy, and respect for choices in well-lived older lives.

Louis Tenenbaum is a longtime advocate for aging in place, co-founder of the HomesRenewed™ Coalition, the HomesRenewed™ Resource Center, and HomesRenewed Ventures, LLC and a nationally recognized expert on home modifications that support independent living. Discover more columns in this series.