'Even if they're late or it takes forever … I will get home': Exploring lived experiences of older paratransit users

Older adults with disabilities face significant transportation barriers, limiting healthcare access and social participation. Paratransit services aim to address these gaps, but usability challenges persist. This study examined the experiences of older paratransit users to identify barriers and facilitators affecting their healthcare access and community engagement.

Semi-structured interviews were conducted with 12 participants aged 55 and older, recruited via purposive sampling from Baltimore, Maryland. Interviews, lasting 30-75 min, explored eligibility processes, scheduling experiences, interpersonal interactions, and the perceived impact of paratransit on healthcare and social activities. Data were analyzed using inductive thematic analysis guided by a conceptual framework addressing logistical, environmental, and social factors.

Six primary themes emerged: independence and social connectivity, staff professionalism and equipment maintenance, logistical barriers, misalignment of service provision with needs of older riders, environmental and safety factors, and the role of social support. While paratransit services supported independence and engagement, barriers such as complex eligibility, scheduling inefficiencies, extended wait times, and equipment failures compounded physical and emotional strain. Environmental and safety concerns, including inclement weather and fears of crime, further limited accessibility. Social support from family, peers, and staff mitigated some challenges, though negative staff interactions and system inefficiencies often heightened frustrations.

Paratransit systems are essential for older adults with disabilities, yet systemic and logistical barriers reduce their effectiveness. Targeted reforms, including enhanced funding, workforce training, and user-centered design, are necessary to improve equity and reliability, ensuring paratransit services meet the needs of an aging population.