CU Anschutz researchers encourage safer driving for seniors

Researchers from the University of Colorado Anschutz Medical Campus along with the AAA Foundation for Traffic Safety released a report this month examining how health care providers play a key role in often difficult conversations about driving safety and driving retirement with older adults.

The report entitled `Older Adults’ Preferences for Communication with Healthcare Providers About Driving,’ examines how older adults prefer to talk with their healthcare providers about driving safety and planning for future “driving retirement”.

“Driving discussions with older adults can be emotionally charged and conversations on when to stop driving can be extremely difficult,” said report co-author Emmy Betz, MD, MPH, associate professor at the University of Colorado School of Medicine and the Colorado School of Public Health at the Anschutz Medical Campus. “Driving and mobility are linked to well-being and independence among older adults. But we are finding that most people will outlive their ‘safe driving’ period by an estimated six to 10 years. As a society, we need to be talking about driving safety while also planning ahead for both our loved ones and our own future ‘driving retirement’.”

Healthcare providers play a key role in addressing these questions with older adults, but when and how to have these conversations are complex. After reviewing the preferences of older adults made to their healthcare providers, researchers identified five tips to navigate this difficult topic:

1. Driving discussions are emotionally charged. Most older drivers said these conversations triggered negative emotions and indicated that they are afraid of the consequences of this conversation, especially losing their driving privileges.Healthcare providers are uniquely positioned to engage in positive, yet tactful, conversations with older adult patients regarding the risks and benefits of driving and future transitions to other forms of transportation. These conversations should be a routine occurrence.
2. Context matters. Older adults spoke of the desire to be recognized as an individual. Their age, health, gender, availability and accessibility of resources and alternative transportation must be part of this conversation. For example, rural values such as self-reliance and independence, coupled with the lack of access to alternative forms of transportation, can play a role in driving discussions.
3. Healthcare providers are trusted and influential figures. Many older drivers want to have this conversation with their doctor and see healthcare providers as an authority figure.Efforts could include embedding appropriate questions within the electronic medical record to ensure that respectful and effective communication on the topic is part of a regular check-up.
4. Continued communication over time: Older drivers need time and support to reflect on the impacts of new physical challenges or medication effects on driving. They also need to adjust to the emotional consequences of driving retirement. Conversations should occur over a period of time, allowing for advanced planning, to avoid the need for abrupt and unexpected changes.
5. Desire for agency: Older adults want to control their decisions over whether to seek assistance or retraining or to self-restrict their driving. Providers should engage and empower these drivers to make informed, rather than forced, decisions.

Safe mobility is essential to healthy aging. Lifestyle changes, along with innovative technologies and medical advancements will have a significant impact on the driving experiences of the Baby Boomer generation.

“This report is not about encouraging older adults to stop driving. It’s about helping them on the road as long as possible in a safe way, while also having conversations to plan for future ‘driving retirement,’’’ co-author Carolyn DiGuiseppi, MD, MPH, PhD, professor and associate dean at the Colorado School of Public Health, said. “The reality is that there is not a magic number when individuals should give up driving. But these conversations do matter whether you are a physician, family member or friend of an aging adult.”

The study was a qualitative metasynthesis of 22 published studies representing 518 older adult drivers. Researchers hope the results will inform the future development and refinement of messaging to older drivers, which could support the integration of questioning about driving into routine clinical care. This could also be used by doctors, other healthcare providers, caregivers, driver licensing officials and others to help older drivers make decisions about driving cessation. The full report can be viewed here.

This study is co-authored by Marian (Emmy) E. Betz, MD, MPH; Kenneth Scott, MPH, doctoral student at the Colorado School of Public Health; Jacqueline Jones, PhD, RN, FAAN, FRCNA, associate professor at the CU College of Nursing; and Carolyn DiGuiseppi, MD, MPH, PhD.  Drs. Betz and DiGuiseppi, and Mr. Scott are all affiliated with the Program for Injury Prevention, Education and Research (PIPER), a collaborative initiative of the Colorado School of Public Health, the University of Colorado School of Medicine, and Children’s Hospital Colorado.

About the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus: The Colorado School of Public Health is the first and only accredited school of public health in the Rocky Mountain Region, attracting top tier faculty and students from across the country, and providing a vital contribution towards ensuring our region’s health and well-being. Collaboratively formed in 2008 by the University of Colorado, Colorado State University, and the University of Northern Colorado, the Colorado School of Public Health provides training, innovative research and community service to actively address public health issues including chronic disease, access to healthcare, environmental threats, emerging infectious diseases, and costly injuries.

About AAA Foundation for Traffic Safety: Established by AAA in 1947, the AAA Foundation for Traffic Safety is a 501(c)(3) not-for-profit, publicly-supported charitable educational and research organization. Dedicated to saving lives and reducing injuries on our roads, the Foundation’s mission is to prevent crashes and save lives through research and education about traffic safety. The Foundation has funded over 200 research projects designed to discover the causes of traffic crashes, prevent them and minimize injuries when they do occur.  Visit www.AAAFoundation.org for more information on this and other research. For more information on all the free resources AAA offers to older drivers, visit SeniorDriving.AAA.com.

###