Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-23T19:15:01.171Z Has data issue: false hasContentIssue false

Holding On and Letting Go: The Perspectives of Pre-seniors and Seniors on Driving Self-Regulation in Later Life*

Published online by Cambridge University Press:  31 March 2010

Deborah Laliberte Rudman*
Affiliation:
University of Western Ontario, formerly of the University of Toronto
Judith Friedland
Affiliation:
University of Toronto
Mary Chipman
Affiliation:
University of Toronto
Paola Sciortino
Affiliation:
University of Toronto
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Deborah Laliberte Rudman, PhD, OT Reg. (ON), Assistant Professor, School of Occupational Therapy, The University of Western Ontario, Elborn College, rm.2537, London, ON N6G 1H1. ([email protected])

Abstract

Although decisions related to driving are vital to well-being in later life, little is known about how aging drivers who do not experience a medical condition that requires driving cessation regulate their driving. This exploratory, qualitative study used focus groups with 79 such community-dwelling individuals to examine driving self-regulation from the perspective of pre-senior (aged 55–64) drivers, senior (aged 65 years or over) drivers, and senior ex-drivers. Themes resulting from inductive analysis addressed the importance of driving, mechanisms of self-monitoring and self-regulation, people who influenced decision making, and opinions regarding licensing regulations. A preliminary model of the process of self-regulation that highlights intrapersonal, interpersonal, and environmental influences on why, how, and when aging drivers adapt or cease driving is presented. The model identifies areas for future research to enhance understanding of this process, including the effectiveness of self-regulation. Findings suggest that increased public awareness of issues related to driving and aging could assist aging drivers, their families, and their family physicians in optimizing driving safety for this population. Since a near accident or accident was seen as the only factor that would lead many informants to stop driving and few informants planned for driving cessation, there is a need for interventions that help aging drivers make the transition to ex-driver in a timely and personally acceptable way.

Résumé

Bien que les décisions relatives à la conduite d'un véhicule soient fondamentales du point de vue du bien-être des personnes âgées, nous en savons assez peu sur la manière dont les conducteurs âgés, qui ne souffrent pas de problèmes médicaux pour lesquels ils devraient cesser de conduire, gèrent la conduite d'un véhicule. Cette étude qualitative exploratoire s'est appuyée sur des groupes de discussion composés de 79 de ces personnes vivant dans la collectivité, dans le but d'étudier l'autoréglementation en matière de conduite, selon le point de vue des conducteurs âgés de 55 à 64 ans et selon celui des conducteurs et des ex-conducteurs âgés de 65 ans et plus. Les thèmes découlant de l'analyse inductive portent sur l'importance de conduire, sur les mécanismes d'autosurveillance et d'autoréglementation, sur les gens qui ont une influence sur la prise de décisions et sur les opinions relatives à la réglementation en matière de permis de conduire. L'article comprend un modèle préliminaire du processus d'autoréglementation qui souligne les facteurs personnels, interpersonnels et environnementaux qui influencent la raison, la manière et le moment dont les conducteurs âgés s'adaptent et cessent de conduire. Le modèle permet de désigner les domaines dans lesquels des recherches pourraient être entreprises dans le but d'accroître notre compréhension de ce processus, y compris l'efficacité de l'autoréglementation. Les résultats révèlent qu'en améliorant la sensibilisation du public à l'égard des questions liées à la conduite et au vieillissement on pourrait aider les conducteurs âgés, leur famille et leur médecin de famille à optimiser la sécurité de cette population en matière de conduite. Puisqu'un accident ou un quasi-accident était considéré comme le seul facteur qui inciterait de nombreux sujets à arrêter de conduire et que peu de sujets prévoyaient arrêter de conduire, il est nécessaire que l'on puisse intervenir afin d'aider les conducteurs âgés à faire la transition vers un statut d'ex-conducteur au moment opportun d'une manière qui leur soit acceptable.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors would like to acknowledge the contributions of Helena Medeiros (project coordinator), Lynn Lavallee (focus group facilitator), Pam Albrecht (transcriptionist), and occupational therapy student Amy Steen. We are indebted to the people who were informants and shared their time, experiences, and viewpoints. This study was funded by the Ontario Ministry of Transportation through the Road User Safety Research Funding Program.

References

Ball, K., Owsley, C., Stalvey, B., Roenker, D.L., Sloane, M.E., & Graves, M. (1998). Driving avoidance and functional impairment in older drivers. Accident Analysis and Prevention, 30, 312322.CrossRefGoogle ScholarPubMed
Brayne, C., Dufouil, C., Ahmed, A., Dening, T.R., Chi, L., McGee, M. et al. (2000). Very old drivers: Findings from a population cohort of people aged 84 and over. International Epidemiological Association, 29, 704707.CrossRefGoogle ScholarPubMed
Canadian Council of Motor Transport Administrators (2004). CCMTA medical standards for drivers. Retrieved 9 January 2006 from http://www.ccmta.ca/english/pdf/medical_standards_july04.pdf.Google Scholar
Canadian Medical Association (2000). Determining fitness to drive: A guide for physicians (6th ed.). Ottawa: Canadian Medical Association.Google Scholar
Chipman, M.L. (1982). The role of exposure, experience, and demerit point levels in the risk of collision. Accident Analysis and Prevention, 14, 475483.CrossRefGoogle Scholar
Creswell, J.W. (2003). Research design: Qualitative, quantitative and mixed methods approaches (2nd ed.). Thousand Oaks: Sage.Google Scholar
De Raedt, R., & Ponjaert-Kristoffersen, I. (2000). Can strategic and tactical compensation reduce crash risk in older drivers? Age and Ageing, 29, 517521.CrossRefGoogle ScholarPubMed
Dellinger, A.M., Sehgal, M., Sleet, D.A., & Barrett-Connor, E. (2001). Driving cessation: What older former drivers tell us. Journal of the American Geriatrics Society, 49, 431435.CrossRefGoogle ScholarPubMed
Eby, D.W., Molnar, L.J., Shope, J.T., Vivoda, J.M., & Fordyce, T. (2003). Improving older driver knowledge and self-awareness through self-assessment: The driving decisions workbook. Journal of Safety Research, 34, 371381.CrossRefGoogle ScholarPubMed
Fawcett, G., & Roberts, P. (1998). At risk: Socioeconomic analysis of health and literacy among seniors. Ottawa: Statistics Canada.Google Scholar
Florida At-Risk Driver Council (2004). The effects of aging on driving ability. Florida: Department of Highway Safety & Motor Vehicles.Google Scholar
Fonda, N.D., Wallace, R.B., & Herzog, A.R. (2001). Changes in driving patterns and worsening depressive symptoms among older adults. Journal of Gerontology, 56B, S343351.CrossRefGoogle Scholar
Friedland, J., Laliberte Rudman, D., Chipman, M., & Steen, A. (2006). Reluctant regulators: Perspectives of family physicians on monitoring seniors driving. Topics in Geriatric Rehabilitation, 22, 5360.CrossRefGoogle Scholar
Gillespie, N.D., & McMurdo, M.E. (1999). A survey of attitudes and knowledge of geriatricians to driving in elderly patients. Age and Ageing, 28, 5357.CrossRefGoogle ScholarPubMed
Grabowski, D.C., Campbell, C.M., & Morrisey, M.A. (2004). Elderly licensure laws and motor vehicle fatalities. Jama: Journal of the American Medical Association, 291(23):28402846.CrossRefGoogle ScholarPubMed
Hakamies-Blomqvist, L., & Wahlstrom, B. (1998). Why do older drivers give up driving? Accident Analysis and Prevention, 30, 305312.CrossRefGoogle ScholarPubMed
Insurance Institute for Highway Safety (2003). Who poses the greatest risk, older or younger drivers? Status Report, 38(3), 23.Google Scholar
Johnson, J.E. (1995). Rural elders and the decision to stop driving. Journal of Community Health Nursing, 12, 131138.CrossRefGoogle ScholarPubMed
Kelly, R., Warke, T., & Steele, I. (1999). Medical restrictions to driving: The awareness of patients and doctors. Postgraduate Medicine, 75, 537539.CrossRefGoogle ScholarPubMed
Kostyniuk, L.P., & Shope, J.T. (2003). Driving and alternatives: Older drivers in Michigan. Journal of Safety Research, 34, 407414.CrossRefGoogle ScholarPubMed
Krueger, R.A. (1994). Focus groups: A practical guide for applied research. Thousand Oaks, CA: Sage.Google Scholar
Li, G., Braver, E.R., & Chen, L. (2003). Fragility versus excessive crash involvement as determinants of high death rate per vehicle-mile of travel among older drivers. Accident Analysis and prevention, 35, 227235.CrossRefGoogle ScholarPubMed
Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.CrossRefGoogle Scholar
Lyman, J.M., McGwin, G., & Sims, R.V. (2001). Factors related to driving difficulty and habits in older drivers. Accident Analysis and Prevention, 33, 413421.CrossRefGoogle ScholarPubMed
Marottoli, R.A., Mendes de Leon, C.F., Glass, T.A., Williams, C.S., Cooney, L.M., Berkman, L.F. et al. (1997). Driving cessation and increased depressive symptoms: Prospective evidence from the New Haven EPESE. Journal of the American Geriatrics Society, 45, 202206.CrossRefGoogle ScholarPubMed
Marottoli, R.A., & Richardson, E.D. (1998). Confidence in, and self-rating of, driving ability among older drivers. Accident Analysis and Prevention, 30, 331336.CrossRefGoogle ScholarPubMed
Marshall, S., & Gilbert, N. (1999). Saskatchewan's physicians' attitudes and knowledge regarding assessment of medical fitness to drive. Canadian Medical Association Journal, 160(12), 17011704.Google ScholarPubMed
Messinger-Rapport, B.J., & Rader, E. (2000). High risk on the highway: How to identify and treat the older driver. Geriatrics, 55(10), 3234.Google ScholarPubMed
Owsley, C., Stalvey, B.T., & Phillips, J.M. (2003). The efficacy of an educational intervention in promoting self-regulation among high-risk older drivers. Accident Analysis and Prevention, 35, 393400.CrossRefGoogle ScholarPubMed
Parker, D., Macdonald, L., Sutcliffe, P., & Rabbitt, P. (2001). Confidence and the older driver. Ageing and Society, 21(2), 169182.CrossRefGoogle Scholar
Persson, D. (1993). The elderly driver: Deciding when to stop. Gerontologist, 33, 8891.CrossRefGoogle ScholarPubMed
Richards, Gwendolyn. Elderly driver smashes into strip mall—Twice. (2005, May 28). Calgary Herald: A1.Google Scholar
Saunders, John. Inquest sidesteps age issue. Globe and Mail, Saturday, March 16, 2002. A20.Google Scholar
Siren, A., Hakamies-Blomqvist, L., & Lindeman, M. (2004). Driving cessation and health in older women. Journal of Applied Gerontology, 23(1), 5869.CrossRefGoogle Scholar
Stutts, J.C., & Wilkins, J.W. (2003). On-road driving evaluations: A potential tool for helping older adults drive safely longer. Journal of Safety Research, 34, 431439.CrossRefGoogle ScholarPubMed
Withaar, F.K., Brouwer, W.H., & van Zomeren, A.H. (2000). Critical review. Fitness to drive in older drivers with cognitive impairment. Journal of the International Neuropsychological Society, 6, 480490.CrossRefGoogle Scholar
World Health Organization (2002). Towards a common language for functioning, disability and health. Retrieved 9 January from ICF Web site: http://www3.who.int/icf.Google Scholar
Yassuda, M.S., Wilson, J.J., & von Mering, O. (1997). Driving cessation: The perspective of senior drivers. Educational Geronotology, 23, 525538.CrossRefGoogle Scholar