Driving and Community Mobility for the Older Adult

For many older adults, driving is an important occupation that promotes freedom and independence. In addition, the Centers for Disease Control and Prevention reports that more than one out of four older people fall each year. Falling or fear of falling can impact their driving and community mobility safety. An inability to drive and/or get around the community can impact an older adult’s health and well-being, as they might not be able to safely engage in their desired and needed activities. The study to be discussed in this session took a qualitative, phenomenological approach to explore the impact driving, community mobility, and fear of falling has in the daily life of older adults. Methods, findings, and implications for occupational therapy practitioners, outlined below, will be reviewed in greater detail when presented. Recruitment flyers were emailed to senior centers and assisted living facilities in North Carolina and Michigan. Eligibility criteria included being 65 years or older and having internet access. Qualified participants completed an electronic pre-survey questionnaire prior to attending one of four focus groups. Held through Zoom, focus groups lasted between 30 and 45 minutes. The pre-survey questionnaire consisted of questions related to demographics, history of falls, driving history, and their use of community mobility options. The focus groups explored the significance of driving and community mobility, the impact that falling and the fear of falling may have on driving and community mobility, and perception of available resources. Thirteen participants were included in the study. The research team, six occupational therapy students and their faculty advisor, transcribed the focus groups and analyzed the data using an inductive analysis approach. Three themes emerged based on focus groups and pre-surveys. Theme 1 Perspectives on Falling included the subthemes Cautious and Aware - But Not Fearful, as well as Daily Life Not Impacted by Fear. Focus group participants all indicated their daily life activities were not impacted by a fear of falling. Theme 2 Driving = Independence and Freedom included two subthemes: Reluctant to Retire From Driving and Retiring From Driving Would be Emotional. Participant LE described driving as “a means of getting where I need to go without being dependent on others.” Participant emotions ranged from depression, frustration, a sense of disbelief, to acceptance with driving retirement. Theme 3, Utilization and Knowledge of Resources, included two subthemes. Subtheme one, Awareness, indicated that participants were aware of fall prevention resources such as physical therapy and Matter of Balance classes, as well as community mobility resources such as Instacart and Amazon. Subtheme two, Factors Impeding Resource Utilization, reflects that the reliability, location availability, and service requirements impacted participants utilization of resources. They explained how many transportation options require advanced notice for services, and often focus on necessities. Based on findings of the current study, Occupational Therapy Practitioners should provide education to clients about resources such as fall prevention programs, community mobility options, and driving resources. Practitioners should also spend time teaching individuals how to utilize these resources and advocate for additional resources to address issues of disparities related to community mobility. Finally, professionals need to consider the mental health and emotional aspect of driving retirement and its impact on an individual’s quality of life. Occupational Therapy services should introduce new occupations or make modifications to valued occupations impacted by driving retirement.

References

American Occupational Therapy Association. (2021). Talking points. https://www.aota.org/Practice/Productive-Aging/Driving/Practitioners/Talking.aspx

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2020, December 16). Keep on Your Feet—Preventing Older Adult Falls. Centers for Disease Control and Prevention. https://www.cdc.gov/injury/features/older-adult-falls/index.html#:∼:text = One%20out%20of%20four%20older,particularly%20among%20the%20aging%20population.&text = About%2036%20million%20older%20adults,in%20more%20than%2032%2C000%20deaths

McNeel-Moore, S., Blenden G., Creel P., & Barco P. P. (2020, October). OT Practice, 25(10), 19-21. National Center for Statistics and Analysis. (2019, March). 2017 older population fact sheet. Traffic safety facts: 2017 data. https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812684

United States Census Bureau. (2014, May 6). Fueled by aging baby boomers, nation’s older population to nearly double in the next 20 years, census bureau reports. United States Census Bureau. https://www.census.gov/newsroom/press-releases/2014/cb14-84.html