To drive or not to drive, that isn't the question-the meaning of self-regulation among older drivers.

PROBLEM: This research examines older drivers and how they rationalize and cope with their own changing psychological and physical functioning vis-à-vis self-regulation and driving. METHOD: A national survey was mailed to a sample of drivers over the age of 50. An overall response rate of 53.11% was achieved, with 3,824 valid responses returned. This paper discusses the qualitative findings of the open-ended questions in this survey. RESULTS: A rich, multidimensional description of self-regulation emerged from the data. Driving self-regulation was not simply a checklist of behaviors performed but a combination of attitudes and behaviors, including important social and psychological processes and automobile attributes. Household composition played an important role in determining what one's options were for getting around and how serious they were in enforcing self-regulation behaviors. DISCUSSION & SUMMARY: As a society, we must realize the importance of driving in maintaining independence, feelings of self-worth, and being connected to life and society. This research presents the qualitative findings of a nationwide survey of drivers over the age of 50. The results revealed that older drivers define self-regulation as much more than the changes in behaviors due to declining health and ability. The older adults in our research strongly emphasized the psychological processes surrounding independence, self-worth, remaining connected to life and society, and what role the automobile plays. Household composition impacted decisions related to self-regulation. For instance, those from a two-person household were more willing to let their partner drive or share in the driving, while those who lived alone were less likely to self-regulate their driving. IMPACT ON INDUSTRY: Education programs targeting older adults need to be expanded to include not only the behavioral components of self-regulation, but also the psychological factors that play an equally meaningful role. Legislators devising policy programs need to reconsider what are viable transportation options for the older adult.

Health, safety, self-regulation and the older driver: it's not just a matter of age.

PROBLEM: The purpose of this research was to examine the impact of age and health on patterns of driving and self-regulation among older adults who still drive. METHOD: This analysis presents the results of a nationwide survey of drivers who are 50+(N=3,824, 53.11% response rate), focusing on questions about the impact of their self-reported health on attitudes toward and self-regulation of driving. RESULTS: The data indicate that as age increases, so too does reported self-regulation of driving, increasing sharply among those ages 70 and older. The data also indicate that respondent's reported confidence in driving and their enjoyment of driving decline as they age. Health status bears a significant relationship with all three of these variables, positively related to confidence in driving skills and to enjoyment in driving, but negatively related to self-regulation reports. As self-reported health declines, respondent's report engages in greater voluntary restrictions of their driving. DISCUSSION: All too often, the driving decision is linked primarily to chronological age. Analysis done here indicates that age alone is not the best indicator of self-regulation and how older adults change their driving behaviors. SUMMARY: This research presents the results of a nationwide survey of 50+ drivers and their self-reported driving, self-regulation behaviors, and health status. Strong support was found for the argument that chronological age is not an adequate measure of self-regulating behaviors and driver safety among those 50+. In particular, it was found that a person's health status and the interaction between age and health are essential considerations in the decisions around self-regulation and driving. People tend to self-regulate more with age, but the effect becomes much more pronounced as health status declines. IMPACT ON INDUSTRY: In the coming years, if older adults can't get to where they want to go and continue to be viable consumers in our national fabric, all industries will eventually suffer. Transportation is a key component to the nation's social contract with older individuals and their families.

At the crossroads: development and evaluation of a dementia caregiver group intervention to assist in driving cessation.

Deciding when an individual with dementia must reduce or stop driving can be a stressful issue for family caregivers. The purpose of this study was to develop a group intervention to assist these caregivers with driving issues and to provide a preliminary evaluation of the comparative effectiveness of this At the Crossroads intervention. Participants were randomized to one of three arms: (1) active intervention (four 2-hour manualized educational/support group meetings; n = 31); (2) written materials only (participants received written materials after a pretest; n = 23); and (3)control (participants received written materials after a posttest; n = 12).Participants were administered a battery of self-report and interview-based questionnaires at baseline and again 2 months later. At follow-up, the active intervention group scored significantly better than both other groups on key outcome variables, including self-efficacy, communication, and preparedness. The At the Crossroads caregiver intervention appears to effectively provide education and support needed for caregivers to address driving-related issues with their loved ones.

A qualitative exploration of self-regulation behaviors among older drivers.

While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.

Gender differences in self-regulation patterns and attitudes toward driving among older adults.

The automobile is essential for many older adults to fulfill their daily needs, especially since many live where they lack access to public transit or other acceptable modes of transportation. Increased self-regulation is one way older drivers continue to drive safely and maintain mobility. This research considers whether self-regulation attitudes and patterns differ by gender. Results indicate that women and men report distinct patterns of self-regulation behaviors. Age, health status, and household status also interact with gender, influencing the extent of self-regulation. The results also show that women report lower levels of confidence in their driving skills than men, although the difference varies based on whether or not a woman lives alone. Implications of these results are considered for an aging population--particularly women--that over the coming decades will be more reliant on the automobile for transportation than ever before.