Regardless of age, many people consider driving to be a freedom or right. When it comes to older adults, however, driving conversations have focused on ‘taking the keys’ and other messages of driving cessation, also known as driving retirement. Stories of older adults involved in crashes have been sensationalized in the media. No wonder drivers, families, physicians, and clinicians avoid having conversations related to driving or driving retirement! Who wants to talk about something when the conversation leads down the road of limitation and restriction? When the conversation draws a line in the sand between the older driver and everyone else, with everyone else becoming the enemy?
Older adult conversations about driving need to change. It is time to transition the approach from one of limitation to one of empowerment, from one of cessation to one of options and choices, and when transition from driving is necessary, from one of ‘taking the keys’ to decisions supporting driving retirement.
As a population, people in the United States will outlive their driving abilities. It is estimated that men will outlive their driving ability by 6 years and women by 10 years (Foley, et. al 2002). Furthermore, that period of driving retirement is expanding. Gone are the days when people will drive their cars until their last breath, and here are the days of preparation for life beyond driving. Preparing for driving retirement is a significant concept shift for the general population, but especially for older adults. As occupational therapists, it is our role to talk to all clients about their driving plans and help them prepare for driving retirement.
A research study out of New York, looking at older adult drivers with vision changes, found that it requires 2 to 3 years for an older adult to accept, accommodate, and to transition into driving retirement (Reinhardt, et. al, 2012). Discussing driving transitions is not a one-time conversation. Driving cessation needs to be conceptualized as a process, rather than as an event. (Reinhardt, et. al, 2012, page 270). Of note with this study, was that those drivers who knew they were facing a progressive condition and were educated on the need for driving retirement, then did so more readily. They were able to make an informed decision about when it was time to transition, and felt empowered by having a plan in place.
The research from these two studies reinforces important considerations for OTs. First, we will all most likely outlive our driving abilities and it is important to plan for life beyond driving. Second, driving retirement is a process that requires time and planning. The decision to stop driving is a dynamic process reflecting the interplay among an individual’s personal, social and environmental resources. (Reinhardt, et. All, 2012, page 269). It is the job of occupational therapists to start conversations about driving and community mobility early and often. It is imperative to provide the education and start the conversation, even for those clients who may readily return to driving with physician clearance.
Many OTs work in positions that cross various settings and levels of care, and are positioned to make a positive impact on the lives we touch. Our foundational training makes us the perfect profession to help address this highly valued instrumental activities of daily living (IADL). In addition, with the evolving roles of clinicians in healthcare settings, for example the addition of case management responsibilities, this cross-over of practice settings helps OTs to build sustainable relationships with clients to help ensure good healthcare management and wellness.
