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    Dementia Symptoms & Caregiver Strategies: Transportation Services for Older Adults with Cognitive Impairment

    What transportation services are available for older adults or those with cognitive challenges?

    Public transportation, including paratransit, enables seniors and people with disabilities to remain involved in the community without having to drive themselves. Public buses and trains are often equipped with wheelchair lifts and other devices to increase accessibility. In addition, the Americans with Disabilities Act requires paratransit to be provided for individuals who cannot access other public transportation options. Paratransit usually includes vans and minibuses that are fully accessible and travel variable routes.

    Another option is a private dial-a-ride service. Some dial-a-ride services receive paratransit funding and are therefore part of a community’s public transportation system. Dial-a-ride and paratransit offer pick-up and drop-off at a person’s home but usually require advance reservations.

    Additionally, some Senior Centers and Adult Day Centers provide transportation to and from their facilities. Many also offer planned excursions and trips to destinations such as grocery stores and medical appointments.

    Another form of accessible transportation, the ambulette, is a new concept that provides non-emergency transportation to ongoing medical appointments such as physical therapy, dialysis, and chemotherapy.

    What should I look for in transportation services?

    Check with your local public transportation agencies to obtain schedules and fees for buses and trains. Find out from your local senior and adult day centers what transportation services they provide, and at what cost. In evaluating a private transportation service, you may wish to use the Transportation Service Checklist, which provides detailed questions to help you evaluate and compare providers.

    How do I pay for transportation services?

    Local transportation services often receive federal money to serve elderly individuals and people with disabilities. Additionally, certain public transportation is usually provided at a reduced cost.

    Paratransit (
    To apply for Paratransit in San Francisco, fill out the application form found online here:

    After receiving your application, Paratransit may call you to schedule a second-level assessment. This may be a telephone interview, professional medical verification, or an in-person interview. The in person interview may include a functional test to determine your ability to take a public transit trip: for example, can you walk to a bus stop? Can you read signs? If approved, you will be issued an ID card that will be good for 3 years. You will need to reapply at that point.

    To make a reservation for paratransit in San Francisco, you need to call 415-285-6945 before 6pm on the day before the day you need to travel. Rides cost $2.00 each way. Lift Van services are also available if you or the person you care for are in a wheelchair.

    In addition to paratransit, the National Transit Hotline provides lists of local transit providers who receive federal money to provide transportation to the elderly and people with disabilities. They can be reached at 800-527-827-8279.

    Medical transportation

    San Francisco option that may be helpful if you need medical transportation:

    • I-CARE Medical Transportation: 650-878-2000, Cost: $100 roundtrip within San Francisco plus $3 per mile and $3 per step. There is also a $20 cost per additional passenger.
    It’s important to note that if you decide to go with this service you should arrange pickup times at least three days in advance if at all possible.

    Private Services

    You can always hire a taxi or private driver for your loved one as well as alternative taxi services such as Lyft (available at to download the application to your mobile phone) or Uber (

    In addition there is a company called Silver Ride which provides one way, round-trip or multi-stop rides. Accompaniment is also available as an additional service whereby their drivers accompany the client during an appointment or activity. All rides include basic door through door assistance and clients are welcome to travel with one caregiver, spouse, family member or friend free of charge, providing that both passengers start and end at the same address. Contact information: (415) 861-7433,

    Cognitive Impairment can have many causes. The patient’s doctor should be consulted to determine a specific diagnosis and treatment options. But whatever the cause, the symptoms are often alike, and the Caregiver Strategies are often similar.

    The information in the resources listed above was compiled by the Ray Dolby Brain Health Center through clinical experience and commonly available published materials. For information on additional Caregiver Strategies, go to: