Too old to drive? So now what?

At what point in life are we,  you and I, "too old to drive"? When that fatal day comes, what do we do next? This is one of the unhappy surprises of contemporary life, but there is no reason that this need be personally devastating. It is after all foreseeable. In recent years we are starting to see  programs emerging to help people foresee or deal with this painful transition, which for many is almost paralyzing where they live in places in which there are no decent alternatives to car travel. World Streets intends to present a series of working papers and thinkpieces on this topic over the course of 2014. This article by Adrian Davis is the first in this series.
Living less car-dependent lives can improve overall health and well-being for much of the European population. Those who are currently habitualised into car use can be helped to reduce this reliance and much behaviour change working in transport planning focuses on assisting them. In the peer reviewed literature there is also a stream of research focused around the need for those who drive cars to begin to contemplate giving-up driving as they approach old age.

In significant part due to habitualisation, many older car drivers stall for time and do not face up to the fact that they may not be able to drive in the future.[1]

Those that suffer worst tend to be drivers who are told to give-up driving and do so without any preparation.

Older people are more reliant on cars than ever before to meet their day-to-day needs. In the UK, 50% of those aged 70 or over hold a full driving licence, which has increased from 32% in 1989. The last 30 years has shown a substantial increase in car drivers who are 65 years and over in the UK, most markedly amongst female drivers, with a 200% increase in male drivers and a 600% increase in female drivers in this age group.

Giving-up driving is associated with much angst and can result in mental and physical health problems. However, such problems can be reduced if older drivers plan to give-up driving before they need to and gradually reduce their driving. Research shows that those who plan and gradually give-up driving face far less negative affect than those who have to be told to give-up driving or do so on the spur of the moment.[2]

Planning to give-up driving can be associated with gradually giving-up on journeys that are becoming difficult to make and older people typically give-up driving in busy traffic, they avoid motorways and difficult junctions and in addition drive less often in darkness or inclement weather.

Those that suffer worst tend to be drivers who are told to give-up driving and do so without any preparation. Practical solutions for those giving-up driving are evident, including lifts, walking more and using community and public transport, but use of these varies with both provision and confidence in use.

Affective and emotional factors associated with being a car driver, including independence, freedom, control, status and roles, are also lost when giving-up driving. Hence, support for life beyond the car is needed at a younger age (while older people are driving) to help build solutions and confidence in transport use beyond the car and should involve emotional support, as well as practical support.

A social travel group is suggested as an appropriate mechanism for this, along with raising the need for early contemplation of giving-up driving and its associated social issues through the use of techniques such as community theatre.[3]

Since giving-up driving not only involves practical difficulties but affective needs not being met, then support for giving-up driving needs to be practical and emotional in nature. It should be continuous and help build confidence. Courses for older people have been developed to assist with giving-up driving in terms of emotional and practical support which reduce the negative feeling older people experience of being a burden and not paying their way for lifts while retaining a good level of mobility.

More of this support is needed as future generations of older people will have used a car almost all of their adult life and geared their life around the car, making learning alternative ways of travelling even more difficult.

Notes and references:

[1] Dr C.  Musselwhite’s website provides links to key papers in this field of research http://www.drcharliemuss.com/giving-up-driving-in-later-life.html

[2] Musselwhite, C. and Haddad, H. 2010 Mobility, accessibility and quality of later life. Quality in Ageing and Older Adults, 11(1), 25-37.

[3] Musselwhite, C. 2011 The importance of driving for older people and how the pain of driving cessation can be reduced. Signpost: Journal of Dementia and Mental Health Care of Older People, 15 (3). 22-26.

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About the author

Trained in public health and transport planning, Adrian Davis has helped pioneer this inter-disciplinary field. He has undertaken work for the World Health Organisation, for the Departments for Transport, Health, in England, and statutory and non-governmental organisations. Since 2008 he has been embedded into the City Transport team of Bristol City Council by Bristol’s Director of Public Health and publishes http://www.travelwest.info/evidence . He is an editor of the new Journal of Transport and Health www.elsevier.com/locate/jth, and Visiting Professor at the University of the West of England.

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