Driving Behaviors and Community Mobility of Older Adults Living Independently

Abstract

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.

This mixed-methods online survey collected self-report data from 88 older adults on self-restricting driving behaviors. Data identified trends in various factors, including overall driving behaviors, community mobility, use of alternative transportation, and age of older adults independently living in urban and suburban California. Increased self-restricted driving behaviors were reported with the increased age of respondents. This change in driving results in diminished occupational participation.

Primary Author and Speaker: Winifred Schultz-Krohn

Additional Authors and Speakers: Elisa Chan, Alyson Bothman, Lisa Bullard, Nicholas Chambers, and Derek Colvin

Contributing Authors: Chiao-Ju Fang

Older adults experience physical and cognitive changes as part of the typical aging process including changes in eyesight, hearing, and reduced reaction times (National Institute on Aging, n.d.). These physiological changes can impact driving skills and performance (National Institute on Aging, n.d.). However, older adults value driving their personal vehicle in order to maintain their lifestyle and independent mobility (Karthaus & Falkenstein, 2016). Driving restriction and cessation in this population results in a significant disruption to identity and is associated with increased rates of depression, poorer general health, and decreased participation in the community (Sanford et al., 2018). Previous studies about driving cessation and restriction primarily recruited participants aged 65 to 75 and older (Marottoli et al., 2015). By sampling adults beginning at age 55 and expanding the age range to pre-retirement years, this study identifies changing driving habits during the transitional period between work and retirement. This research used the lens of the Model of Human Occupation to explore the trends of self-restricting driving behavior as it relates to changes in one’s meaningful roles and occupations.

PURPOSE: This investigation describes the self-identified, self-restricting driving behaviors of adults, aged 55 years and older, and living independently. The personal and environmental factors that influence decisions to self-restrict driving were identified. The study also examined how alternative transportation methods support or limit this population’s community mobility.

DESIGN: Descriptive investigation using both quantitative and qualitative analyses.

METHOD: An original mixed-methods online survey developed following a comprehensive literature review. The online survey was distributed to older adults living primarily in urban and suburban areas of California. In total, 88 older adults (N = 88) participated in the online survey. Quantitative data was analyzed using Chi-square analysis and Spearman correlation, and thematic analysis was used to interpret the qualitative data.

RESULTS: A significant correlation was found between aging and when/how often one drives as well as between age and the number of reasons to limit driving. Both environmental and personal factors were identified that influence decisions to self-restrict driving. This study also found that alternative transportation options other than driving oneself (public or private transportation) were not preferred compared to driving oneself even if these options were made more readily available in the community. Four themes were identified from the qualitative data analysis which inform the understanding of self-restricting driving behavior and the importance of driving.

CONCLUSION: The increased self-restricting driving behaviors reported by older adults may contribute to the social isolation experienced by this population. This may be explained by their perceptions of inadequate alternative transportation methods, both private and public. Perceptions of the appeal and suitability of alternative transportation as well as the meaning embedded in the occupation of driving are important factors for occupational therapists to consider when creating community mobility interventions for older adults.

IMPACT STATEMENT: This descriptive investigation examined older adults’ self-restricting driving behaviors and what personal and environmental factors influence the decision to restrict driving. Findings contribute to the body of literature aimed at exploring the behavioral trends and unique needs of the growing population of older adults in the United States. This new data will support occupational therapists working with this population.

References

Karthaus, M., & Falkenstein, M. (2016). Functional changes and driving performance in older drivers: Assessment and interventions. Geriatrics, 1(2), 12. https://doi.org/10.3390/geriatrics1020012

Marottoli, R. A., de Leon, C. F. M., Glass, T. A., Williams, C. S., Cooney Jr., L. M., Berkman, L. F., & Tinetti, M. E. (2015). Driving cessation and increased depressive symptoms: Prospective evidence from the New Haven EPESE. Journal of the American Geriatrics Society, 45(2), 202-206. https://doi.org/10.1111/j.1532-5415.1997.tb04508.x

National Institute on Aging. (n.d.) Older Drivers. https://www.nia.nih.gov/health/older-drivers

Sanford, S., Rapoport, M. J., Tuokko, H., Crizzle, A., Hatzifilalithis, S., Laberge, S., & Naglie, G. (2018). Independence, loss, and social identity: Perspectives on driving cessation and dementia. Dementia, 18(7-8), 2906–2924. https://doi.org/10.1177/1471301218762838