October 15, 2025
A lack of reliable transportation leads to a 67% drop in specialist visits for assisted living community and nursing home residents living with Alzheimer’s disease or a related form of dementia, according to Columbia University School of Nursing researchers.
“With more supportive dementia-friendly transportation services, people with ADRD may become more mobile and independent and experience higher levels of transportation security, leading to better outcomes,” the authors wrote in JAMDA, the Journal of the Post-Acute and Long-Term Care Medical Association.
Transportation services, they wrote, should become multifaceted, with multiple features that offer a range of services to support better travel and care coordination for long-term care residents living with dementia.
“The advancement of technology in transportation services through continuous trials and evaluations can contribute to improving transportation services for long-term care facility residents and may be generalized to US facilities,” the authors said.
Little attention has been given to transportation insecurity for long-term care residents living with dementia, they said. They identified gaps related to transportation challenges by reviewing previously published studies.
Pointing to Centers for Disease Control and Prevention data cited by the Alzheimer’s Association, the authors noted that 42% of assisted living residents had received dementia diagnoses (the latest statistics put the percentage at 44%). Residents also have special challenges in using transportation services, including emotional, physio behavioral, cognitive decline and orientation-related factors, as well as financial issues, they said.
Although a few studies that the researchers looked at emphasized the importance and need for transportation services, no study explored the use and challenges of transportation services in long-term care, according to the authors.
Even with federal support for nonemergency medical transportation, various challenges persist, including increasing costs, lack of continuity among transportation vendors, long wait times and frequent driver no-shows, the investigators said. Those issues, they added, leave residents to rely on families or caregivers for transportation assistance.
Acknowledging the potential of telehealth to overcome some transportation insecurities, the authors said that a lack of technology resources and infrastructure, costs and anxiety experienced by older adults with dementia during telehealth encounters shows that telehealth cannot fully replace in-person visits.