Going Nowhere?
Lack of transportation is a hard — and sometimes life-threatening — reality for many who live in Rappahannock. And that can spiral into social isolation.
Wendy Oien still remembers the call.
It came last summer, when Oien, working in the Call Center of the Foothills Area Mobility System (FAMS) in Culpeper, took a call from a woman in Amissville. The caller was tentative at first, convinced the conversation wouldn’t amount to much. She said a social worker had suggested she call, then added, “But I don’t really believe you’ll be able to help me.”
Oien started asking questions. She learned that the woman had a serious medical condition, but because her husband needed to use the family car to get to work, she hadn’t been able to make it to treatments. The situation was getting desperate.
Oien reassured her. She would be able to arrange for volunteer drivers to get the woman to and from her appointments. Soon, drivers affiliated with VolTran, a nonprofit serving Fauquier, Rappahannock and northern Culpeper counties, began providing her with free rides.
Not long ago, Oien checked in with the woman. She seemed a changed person. “She has so much more energy now,” Oien said. She also was struck by something the woman told her.
“She said, ‘If you guys hadn’t started getting me rides when you did, I know 100 percent that I’d be dead now.’”
That’s one of the success stories. But for each of them, there are countless others of people who don’t make it to medical appointments, or go food shopping, or get to a job or to the classroom because they simply don’t have a way there. Maybe they no longer drive or don’t have a car, and aren’t aware of other options. Or, they feel too proud to ask for help.
That’s an increasingly common predicament in rural America. Nearly all transportation innovations, from driverless cars to high-speed trains, are being designed to move people within or between urban areas. Ride-sharing services, such as Uber and Lyft, which have transformed how people get around in cities and suburbs, aren’t well-suited for rural communities. From the drivers’ standpoint, there’s not enough business; from the riders’, the long trips would mean very pricey fares. Based on the Uber Fare Estimator, a roundtrip from the town of Washington to Warrenton would cost about $72. A similar trip between Washington and Culpeper would run even higher — about $78.
Public transportation also usually isn’t a very good fit the farther you move out from cities. Again, there’s not enough population density, and the business model is built around big employment and retail centers or campuses, and also structured around routes with easy access. Even in towns the size of Warrenton and Culpeper, bus and trolley service is limited to daytime, and not at all on Sundays.
The situation is complicated by the tendency to take mobility in rural communities for granted. Jenny Biche, who oversees the FAMS Call Center, offered an example.
“Say, you want to open a free clinic,” she said. “Everyone gets on board with it. Someone donates space and maybe local governments chip in some money. They get volunteer doctors and volunteer staff and everything seems wonderful.
“But it’s in a location that’s not accessible by public transportation so people can’t really get there. They create something that can be a great community resource, but transportation is an afterthought. And, then we’re scrambling.
“We want our communities to remain rural and we want people to be able to age at home,” she added. “And, this is one of the big challenges of trying to do that. When you’re having conversations about those things, transportation needs to be part of the dialogue.”
So, what does that mean for a place like Rappahannock? How do you keep a population mobile in such a sparsely populated, spacious county?
“We’re so rural in many places,” said Biche, “that it kinda has to be individualized.” Which means connecting — one at a time — people needing rides with people who volunteer to drive them.
A spiral into social isolation
Most of the time — as much as 80 percent — those rides are for health reasons. People want to get to medical appointments or treatments. They need to see an eye doctor or dentist. Without transportation help, though, they can end up going without proper care for long stretches of time. The consequences, unfortunately, go beyond physical decline. As rural communities get older, particularly those with as many remote corners as Rappahannock County, social isolation takes its own toll.
“Think about the cycle here,” said Dave Litaker, a retired doctor who’s now a volunteer driver. “People get socially isolated. They have medical issues. And that leads to depression and issues of self-worth. It just keeps spiraling downward.”
It’s a plight that defies easy measurement. Instead, the evidence is largely anecdotal, in stories related by coordinators of volunteer ride programs or the drivers themselves. They tell about people who don’t leave their homes for weeks at a time. Or the woman who asked if someone could pick up shampoo for her because she couldn’t get to a store. Or those who regularly call the fire and rescue squads, not because they have an emergency, but more because they need help — or just want company — and they know someone will show up.
“We definitely see signs of the social isolation,” Oien acknowledged. “I would say that in a week’s time, we get six or seven calls from people where the caller just doesn’t want to get off the phone.”
In times past, those conversations would likely have been with family members. That’s also where they would have turned for rides to the store or doctor’s appointments. But these days, it’s usually not an option.
“That world where people just relied on their families is disintegrating,” said Montse Vittitow, hired recently as community coordinator by the Benevolent Fund to follow up with people the nonprofit has aided in the past. “That worked for a long time, but it’s no longer working very well.”
“Think about the cycle here. People get socially isolated. They have medical issues. And that leads to depression and issues of self-worth. It just keeps spiraling downward.” DAVE LITAKER, volunteer driver/retired doctor
Volunteers at the wheel
Instead, rural mobility now depends heavily on networks of volunteer drivers. It’s an arrangement offered by a handful of social services or nonprofits in the region. There’s RappMedRides and RappRides, coordinated for Rappahannock-Rapidan Community Services by Darcy Canton, who also runs the Rappahannock Senior Center in Scrabble. She sets up rides to medical appointments through one, and shopping trips on Fridays through the other. Together, they address a lot of needs.
During one two-week period in December, for instance, volunteers working with Canton drove a Woodville man to and from an eye doctor’s appointment in Centreville; a Washington woman to a see her doctor in Warrenton, then a few days later to another appointment in Front Royal; an 86-year-old woman to Culpeper twice to see her doctor and have blood drawn; and the same woman on another trip to Culpeper for an eye examination and to do a little shopping. RappRides drivers also took four other women shopping in Culpeper and made three trips with passengers to the Food Pantry outside Sperryville.
Though the service is limited to people age 60 and older, Canton’s drivers — there are now 23 of them — made 111 trips to medical appointments and another 36 for shopping last year. They also picked up bread, fresh vegetables and other food in Culpeper for lunches at the Senior Center. Altogether Canton said, her volunteers made 410 trips, covering almost 22,000 miles in 2017.
Then there’s VolTran. It’s a volunteer transportation service based in Fauquier County, which recently expanded into Rappahannock and northern Culpeper counties in response to a grant from the PATH Foundation in Warrenton. Unlike with RappMedRides and RappRides, there’s no age restriction, and, while almost 75 percent of its trips are to medical appointments, VolTran also provides drivers to help people with what it calls “critical needs.” That, according to volunteer coordinator Larry Stillwell, could include a trip to the Social Security office, or maybe even a social event.
“Seniors get isolated,” he said, “They can sit at home seven days a week. So, we’re petty open. If they consider it critical, we will try to help them.”
In 2017, VolTran drivers made 470 roundtrips and logged almost 17,000 miles transporting residents of the three counties.
A more recent addition to the volunteer driver network is Rapp at Home, a nonprofit that focuses on helping older county residents stay in their homes. It offers a range of activities and services to its 104 members — 20 of whom pay no fee — including transportation. Last year, it provided 60 rides.
Finally, there’s Road to Recovery, the ride service coordinated by the American Cancer Society that only takes patients to cancer treatments. About 35 volunteer drivers handle those trips in this region, including 15 Rappahannock residents.
Better coordination
For all the good intentions, though, the resulting mix of volunteer services had been more of a patchwork quilt. Each had its own contact information, and largely operated within its own sphere of connections. Each also had its own application, vetting process and training for volunteers, which made it complicated for someone to drive for more than one service.
That began to change in late 2016 when the FAMS Call Center stepped up its role as a regional transportation hub, one that not only provided information and told callers of their options, but also referred them to the volunteer organization that could best help them get where they needed to go. It had been doing that to a lesser degree for several years, but grant money enabled the staff to expand to include two full-time mobility specialists and move into their own office in the Culpeper Senior Center. It now operates 8 to 4:30, Monday through Friday.
Better coordination has already brought a small victory. The different services have agreed on a common application for volunteers. Next up is reaching consensus on vetting drivers — checks on their insurance, driving records and whether they have a criminal past — and on training them.
There’s also little doubt that FAMS has a higher profile than it did a year ago. In 2016, the Call Center handled about 700 requests; last year the total was more than 2,300. Only 7 percent of the requests came from Rappahannock, but that may be because people in the county are more familiar with RappMedRides and Rapp at Home, and call them directly. Biche believes there’s more awareness of the FAMS Call Center in Rappahannock now, thanks to its collaboration with the local services.
“Some people just don’t want to take the help. They’re fiercely independent. They don’t want to impose on other people. And, they need to be able to trust the person. Many people don’t want a stranger to come to their house. They can feel very vulnerable.” CAROL SIMPSON, right, Aging Together executive director, with WENDY OIEN, FAMS Call Center mobility specialist
That said, many in the community, particularly the elderly, still don’t know that they can arrange free transportation, according to Carol Simpson, executive director of the nonprofit Aging Together, which provides support for older adults. The organization has received a small grant to do outreach in Rappahannock through doctors, health workers, and church pastors, and encourage them to pass on FAMS’ contact information to patients or members of their congregations. Simpson and others like Wendy Oien and Larry Stillwell say they look for opportunities to pass out pamphlets or speak to community groups to get the word out.
But awareness, they’ve come to realize, is only one hurdle.
A matter of trust
“Some people just don’t want to take the help,” said Simpson. “They’re fiercely independent. They don’t want to impose on other people. And, they need to be able to trust the person. Many people don’t want a stranger to come to their house. They can feel very vulnerable.”
Canton, the RappMedRides coordinator agreed. “Many of these people really need help,” she said, “but they’re hesitant because they don’t want to get in a car with a random person.”
To ease any anxiety, volunteer drivers are asked to call their riders at least a day before a trip to confirm details, but also, hopefully, to raise the comfort level. They’re encouraged to describe their car, and, if the person seems receptive, share a little about themselves. Even so, women have been known to request a female driver, mainly because it makes them feel safer. But some have also suggested that on the long drives to medical appointments, it can be easier to talk to another woman. Fortunately, there’s no shortage of women volunteer drivers in Rappahannock. Of Rapp at Home’s core 25 drivers, 17 are women. Of the 15 Road to Recovery drivers in the county, 10 are women. And the group of drivers for RappMedRides and RappRides includes 12 men and 11 women. At VolTran, 15 of the 21 drivers are women.
Often, once the ice is broken, drivers and riders go on to develop friendships, even
“We want our communities to remain rural and we want people to be able to age at home...When you’re having conversations about those things, transportation needs to be part of the dialogue.” JENNY BICHE, FAMS Call Center head
when they might seem to have little in common. Tony Cunningham, who coordinates Road to Recovery rides in the region, shared one of his own experiences. “This one woman I drove, she baked me a cake,” he said. “And she’s blind. And, on top of her cancer, she was going to dialysis three times a week. A woman with those kinds of problems, but she still had such a positive outlook. That’s what makes you feel good.”
But Aging Together’s Simpson said it’s also important to make a more public show of appreciation to volunteer drivers, particularly since most cover all their own expenses, including gas. So, the nonprofit organized a recognition dinner in Culpeper last fall for people who drive for various services in the area. More than 50 drivers showed up.
“They really enjoyed meeting each other and sharing stories,” she said. “They’ll tell you it’s not a big deal, but you could see they felt honored to be recognized.”
Simpson said Aging Together hopes to hold an event for volunteer drivers every year.
The forgotten people of Rappahannock
Still, a transportation system built around volunteers teeters on a demographic fault line. Invariably, the drivers themselves are past retirement age, especially in a community like Rappahannock that grows older every year. In 2011, according to U.S. Census Bureau figures, fewer than one in five county residents was 65 or older; by 2016, it was closer to one in four.
And so, the window of availability for most volunteer drivers is not that wide. No one knows that better than those who rely on them to transport people in need. “We lost a driver to back surgery, another to macular degeneration,” said Cunningham, of Road to Recovery. “Others just reach the point where they don’t feel safe driving people around.”
M.J. Wooldridge, who’s been a volunteer driver for more than three years, put it this way: “We’re kinda stuck with an aging population trying to help an even more aging population.”
For the foreseeable future, that’s the most likely scenario. Some companies are exploring new mobility models for rural America – part two of this series will focus on a few – but adapting them to a community like Rappahannock, with its fiscal constraints and such infrastructure limitations as patchy broadband access, could prove challenging.
That worries Sharon Pierce, head of Rapp at Home’s board of directors. For her, it again comes down to the matter of social isolation.
“Thinking about the people out there who are isolated all by themselves keeps me up at night sometimes,” she said. “These are the forgotten people of Rappahannock.
“We are blessed in this community to have a very strong volunteer spirit. But that’s also what we have to depend on.”