Transportation and Aging: An Updated Research Agenda to Advance Safe Mobility among Older Adults Transitioning From Driving to Non-driving

Abstract

Engagement in civic, social, and community life plays an important role in health, well-being, and quality of life, and requires individuals to be mobile in their environment. In this article, we review what is currently known about 2 areas relevant to safe mobility for older drivers and identify future research in these areas. Using a framework for transportation and safe mobility, 2 key areas were selected for review: the process of transitioning to non-driving and the maintenance of mobility after driving has ceased. This article serves as a companion to another article that used the same approach to explore safe mobility issues for older adults who are still driving. We found that although there has been progress in supporting transitioning process to non-driving and improving mobility options for older adults following driving cessation, many knowledge gaps still exist. We identified several research topics that would benefit from continued scientific inquiry. In addition, several themes emerged from the review, including the need for: multidisciplinary, community-wide solutions; large-scale, longitudinal studies; improved education and training for older adults and the variety of stakeholders involved in older adult transportation; and the need for programs and interventions that are flexible and responsive to individual needs and situational differences.

Getting out of the house: the use of community transport as a third place for rural-dwelling older adults

“…Car ownership in rural areas generally has had a knock-on effect on the 'market' for public bus services, with declines observable since the 1950s (Farrington and Farrington, 2005), and therefore there is increased disadvantage to those rural dwellers who do not have access to, or cannot use, a car (Gray et al, 2006;Lucas, 2012). Decreasing health is a primary cause of driving cessation (Siren and Haustein, 2015;Dickerson et al, 2017) and those who have given up driving are more likely to rely on other means for essential trips and sacrifice those journeys that are more discretionary, and possibly more pleasurable (Burholt and Scharf, 2014). Driving cessation is also associated with lower income, less physical activity and fewer social activities (Anstey et al, 2006), and the consequences have been described as being similar to bereavement (Ziegler and Schwanen, 2011) or having a limb amputated (Davey, 2007).…”

“…Driving cessation is also associated with lower income, less physical activity and fewer social activities (Anstey et al, 2006), and the consequences have been described as being similar to bereavement (Ziegler and Schwanen, 2011) or having a limb amputated (Davey, 2007). Non-drivers are more likely to be female (Dickerson et al, 2017), living alone, report poorer self-rated health, and have impairments in cognition, vision and hearing (Anstey et al, 2006). However, driving cessation may be more difficult for males, who are more likely to stay at home once they stop driving rather than use community transport schemes (Ahern and Hine, 2012).…”

“…The community transport service not only permits older people to exercise executional autonomy by, for example, being able to make impulsive choices in shops and cafes, and visiting family, but also delegated autonomy, by being able to access readily available, appropriate support, such as help lifting groceries on and off the bus. It can also assist with the difficult transition that older drivers make as they make decisions to reduce their driving or choose only certain times or routes for driving (Dickerson et al, 2017), an issue apparent for some of the sample interviewed. Budget cuts and restrictions threatening community transport services are not only threats to health and socialisation but also to autonomy, especially for those less well off (Boyle, 2008).…”

Social Disconnection Among Older Adults Receiving Care in the Emergency Department

“… 3 , 10 , 30 Targeting these factors in the ED may improve older adult social outcomes. For example, health factors addressed through ED-based physical and occupational therapy programs may improve function and decrease future hospitalization and readmission; 31 providing connections to transportation programs 32 may improve community engagement.…”

Coming Out of “Retirement”—Predictors of Driving Resumption Among Older Drivers

“…Mobility enables individuals to meet their needs through community resources, and the feasibility, safety, and degree of personal control an individual has on the mode of transportation impacts his or her social and emotional well-being. 1 Reliance on driving is nearly synonymous with transportation mobility in the United States, 2 and driving is associated with independence and autonomy. 3–5 Even in areas with public transportation, older residents prefer to drive, in part due to difficulties utilizing public transportation, including route locations and schedules, physical difficulties getting on/off, fear of falling or injury, and fear of crime.…”