Recent research indicates that there are risks for older people in relation to both driving and driving cessation (permanent retirement from driving). This study aimed to further investigate driving cessation with the purpose of developing an approach to improve outcomes for retired drivers. Mixed methodology within a post-positivist framework was used in two stages.
The initial qualitative stage investigated the process, outcomes, supports and barriers to adjustment to driving cessation from the perspective of key people. It involved in-depth interviews with nine retired drivers, three family members and six health professionals. A matrix was used in the analysis to demonstrate that, although driving cessation was a highly individual experience, common phases occurred. These phases were: driving in the past, incorporating the general life history of driving; predecision, characterised by changes to the driving experience without any intention of ceasing driving; decision, involving the time around the decision being made; and postcessation, including the practical and psychological adjustments following the cessation of driving. The outcomes of driving cessation included lifestyle losses and changes. Based on these findings, driving cessation was conceptualised as a life change (transition), centred on a decision, leading to a behaviour change (caused by transport loss).
The second stage aimed to further investigate the outcomes and differentiate using quantitative and qualitative methods between driving cessation as a transition and a loss of transport. Measurement of lifestyle outcomes was conducted using previously published tools including life satisfaction, time use, roles, health-related quality of life, self esteem and depression. A sample of 234 community-dwelling older people participated (mean age: 75.0 years; 59.4% female) including current drivers, retired drivers and people who had never driven. Because initial analyses indicated that the groups differed on sociodemographic variables, these were included in further analyses to control for their impact. The three groups were compared using multiple regression, chi square and logistic regression analyses, with the lifestyle outcomes as dependent variables and driving status and the sociodemographic variables as independent variables. To differentiate between the mechanisms of impact of driving cessation, outcomes were compared for current and retired drivers (who differ in both transition and transport issues) and retired drivers and the group who had never driven (who differ in transition only). When compared to current drivers, retired drivers had significantly lower life satisfaction (p꞊0.01), fewer present roles (p < 0.0001) and were less likely to participate in volunteer (p = 0.005) and family member roles (p꞊ 0.009). Retired drivers spent less time on social leisure (p = 0.002) and away from home (p = 0.0001), and more time in solitary leisure (p꞊ 0.0001). They were significantly more likely to use walking (p꞊0.01), taxis (p = 0.009) and private transport (p = 0.003) options.
Comparing the lifestyle outcomes of retired drivers with those who had never driven indicated that retired drivers spent significantly less time in volunteer work (p = 0.009). Sociodemographic variables including age, gender, health, living situation and functional independence were also independently related to both lifestyle outcomes and transport use. Within the retired drivers sample, participants with fewer health conditions and higher self efficacy demonstrated improved adjustment.
Qualitative data were also gathered and analysed using template analysis techniques. Findings supported the stages of driving cessation proposed in the first stage of the study. They also indicated that driving held different meanings for people, ranging from an essential role linked to self-identity to practical convenience only. Current drivers planned poorly for driving cessation and their expectations of the experience were strongly negative. Retired drivers also reported generally negative outcomes of ceasing driving.
Results from the two stages were used to develop a framework for supporting older people’s adjustment to driving cessation. As well as changes to the current transport systems, resources that encouraged planning and assisted people to maintain their lifestyles were required. It was recommended that in the driving in the past and predecision phases, general information about driving cessation should be sensitively delivered to the general population to encourage planning for a potential transition to driving cessation in the future. In the decision and predecision phases, more intensive and detailed information, practical exercises and support would be required to maximise drivers' feelings of control during decision making. Resources to assist family members and health professionals in their roles with older drivers were also recommended. Future research should evaluate the effectiveness of the suggested resources.