1 We Need to Talk the role of family, friends and social networks in helping older people give-up driving Dr. Charles Musselwhite Senior Lecturer in Traffic.

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We Need to Talkthe role of family, friends and social

networks in helping older people give-up driving

Dr. Charles MusselwhiteSenior Lecturer in Traffic and Transport

Psychology, Centre for Transport & [email protected]

0117 32 83010

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To come…• Context: drivers and safety

• Motivations to continue to drive

• Self-awareness and self-assessment• Interventions to improve driver safety• Voluntary and embedded

• Process of giving-up driving and quality of life

• Conclusion

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Context

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Older people as Car drivers

2. More miles driven per person

Source: DfT (2002, 2006, 2010)

010

2030

4050

6070

8090

100

1975/76 (%) 1985/86 (%) 1995/97 (%) 2008 (%)

Male 60-69

Male 70+

Female 60-69

Female 70+

Av, Miles driven per person per year by age in GB

1995/97 1998/00 2002 2005 2010 95-10 % change

60-69 3106 3327 3767 4068 3925 26

70+ 1103 1326 1562 1828 1767 60

All ages 3623 3725 3661 3682 3416 -6%

3. Growing % of journeys as driver

1. Growing % of licence holders

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Older drivers and safety

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Older drivers and safety

After Box, E., Mitchell., K. And Gandolfi, K (2010). Maintaining, Safe Mobility for the Ageing. London: RAC Foundation Report.

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Accidents and older drivers

• Older drivers are involved in collisions that generally occur in daylight, at intersection and at low speeds (DfT, 2001; McGwin and Brown, 1999).

• Less likely to be involved in single-vehicle collisions (DfT, 2001).

• Have difficulty in making critical decisions under time pressure and dealing with immense traffic conditions.

– overloaded with information when performing manoeuvres (Brendemuhl, Schmidt and Schenk, 1988),

– merging onto roads (Schlag, 1993) – junctions and intersections, especially those with no traffic control (e.g. traffic signals and

lights) and those that involve right hand turns (in the UK – i.e. across the oncoming traffic) (Hakaimes-Blomqvist, 1988; Maycock, Lockwood and Lester, 1991; Presusser, Williams, Ferguson, Ulmer and Weinstein, 1998).

– Research suggests inappropriate gap selection, high task complexity and distraction from other road use as underlying factors that contribute to intersection and turning crashes (Oxley, Fildes, Corben and Langford, 2006).

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Motivations to continue to

drive

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• Always driven – car based society

• Increasing level of services moving out of town centres and residential zones

• Sense of control over environment

• Driving increases self-confidence, mastery and self-esteem and feelings of autonomy, protection and prestige (Ellaway et al, 2003)

• Giving up driving is associated with an increase in depressive symptoms (Ra et al, 1997)

W-H

Mobility Deprivation

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W-H

Motivations for travel

PRIMARY TRAVEL NEEDSPRIMARY TRAVEL NEEDSPractical NeedsPractical Needs

Make appointments, access shops and services, work

SECONDARY TRAVEL NEEDSSECONDARY TRAVEL NEEDSPsychosocial NeedsPsychosocial Needs

The need for independence, control, status, roles, normalness

TERTIARY TRAVEL NEEDSTERTIARY TRAVEL NEEDSAesthetic NeedsAesthetic Needs

The need for travel for it’s own sake, to visit nature, for relaxation

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

• Especially by car

On giving-up driving – this level of need is usually met friends accessible transport public transport teleshopping?

On giving-up driving this level of needs is adversely affectedIsolation, no longer part of society, no longer feel normal

On giving-up driving this level of needs is adversely affectedNot so easy to ask for discretionary travel

• A reduction in mobility can result in an increase in isolation, loneliness and depression and an overall a poorer quality of life.

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Self-awareness and

assessment

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Assessing Driving Performance

• Drivers already feel they are aware of their driving behaviour and adapt and compensate for alterations caused by ageing

– Experience– Drive slower– Drive with greater headway– Avoid motorways– Avoid merging– Avoid night time driving– Avoid busy times

• But almost all consider themselves to be better than average! • Almost all consider themselves better than when they were younger (Musselwhite and Haddad,

2010a)

• Lack of noticing feedback (Musselwhite and Haddad, 2010a)– Different quieter cars– Physiology of just noticeable difference JND)

• Welcome assessment and re-learning (Musselwhite and Haddad, 2010a)

• Previous research suggests they are not good at self-assessment (Charlton et al. 2001; Cushman, 1996; Marattoli and Richardson, 1998), but maybe this can be altered through relfection-on-action (Musselwhite and Haddad, 2007, 2010a)

“I don’t go out at night no more, not with my eyes the way they are”

“I hate any kind of right hand turns! I always go left, left and left again!”

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Interventions to improve driver safety

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Improving awareness of the need to self-assess driver

performance• Social environment

– Social norms: Comparison to others– Societal norms: What should I be like at this lifestage?– The role of family and friends– How to improve?

• encourage discussion amongst family+friends• mainstream media

• Event– Retirement– Health– (Near)miss or accident

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Process of giving-up

driving

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Giving-up driving

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The trigger is associated with external social events

– retirement from work

– children leaving home

“I can’t remember why I originally thought of giving-up. I suppose it just came about. Came about really from retirement, then your children live away from home. The time is right. I don’t really need to do it really.” (female, aged 78)

Key, respected family member

Could be taken less seriously if the “wrong” family member said it!

Recognised Health problem

“My daughter told me I had to give-up. It came as a surprise she said that to me. Big surprise. I hadn’t realised I’d got that bad. Well, she said it with tears in her eyes, so I think I thought she’s being really genuine here” (Male, aged 78)

“My husband told me to give-up. He said I wasn’t any good. But then he’s always said that since I could drive at 21” (Female, aged 78)“The doc gave his diagnosis, right, I agree that I’m not as good as I used to be, but I’m not as bad as some of the youngsters on the road. It’s not fair!” (Male, giving-up driving at 78)”

4 diagnosed health condition

2 had keys taken by relatives

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Meticulous planning

– Either don’t have family or friends nearby or would feel a burden

– Other modes

– Other locations

Social norms

“I don’t have family near by to ask <for lifts> and I don’t want to burden friends, so I had to...I had to get the knowledge about the local transport” (male, aged 80)“Well I know G he’s a bit older and can’t walk. He’s registered disabled. He got one of those mobility scooters.... So I suppose I can see myself using that if I am unable to walk.” (male, aged 80)

Don’t gather much information, at all

-Trail and error

-Rely on lifts

-Reciprocation discussed

“I got to the bus stop and found when the buses go. But it wasn’t easy. I didn’t know what to expect” (male, aged 80) give-up. He said I wasn’t any good. But then he’s always said that since I could drive at 21” (Female, aged 78)

So <my daughter> takes me to the hospital and on the way back we always stop for a meal or for chips and I pay. Its’ my treat. And it’s a way of saying thank you and possibly offering a contribution to petrol and that” (female, aged 80)

“That’s the bus for old people who can’t drive. I can. I don’t have a licence – that’s different. It’s really for the really old. Those who really are ill and disabled. I can’t use it. I’d be laughed off it.” (male, aged 81)

They were not actively searching for information

All had relied on friends and family to tell them about walking and using public transport.

Barrier for information gathering: not for them

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• Generally pleased with outcome

• Good quality of life

“I’ve re-discovered my local area. Which is great. I forgot what the village has to offer. In fact I think it is better than a few years ago. But not using the car has forced me to use more local things.” (female, aged 75)“The bus out is a real bit of fun. I go on it with friends... and we have a day out” (female, aged 70)

Largely trial and error

Generally good quality of life beyond the car, characterised by

Supportive family and friends

Enjoying a challenge

“It’s trial and error. I went once and it was full of kids. So I tried the later one. Then you know not to use the 8.45 from here as it is full of kids. Mind you it’s better in the holidays then it’s emptier than the 9.45. But usually it’s the 9.45 yes” (female, aged 78)

“I don’t go to football no longer. I’d need to change buses and can’t be doing with the palaver” (male, aged 85)

Much worse quality of life

Bitter and angry

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Conclusion

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Conclusion • Many interventions aimed at improving driver performance require driver

motivation to want to improve and to need to know they need to improve– Role for family and friends crucial

• Need to create awareness early on– Amongst families, friends– Amongst society– But how? Use of wider media?

• Maintain family support –– Practical– Emotional

• Long term: information dominant• Short term: family central (stopped them being reactive?)• Reactive: dissatisfied objectors

• Reciprocation is important– Family and friends– Independent Transport Network (ITN) America

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Provide practical and emotional support

FAMILY-Help appropriate giving-

up of driving-help bring into consciousness

-Practical-Emotional

PRACTICALPRACTICAL

EMOTIONALEMOTIONAL

Affective elements of giving-up driving-Youthfulness-Norms-Independence-Freedom

Alternative transport- Lifts- Bus- Community transport

Discretionary travel

Information

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Many thanks to my participants, to Hebba Haddad and Ian Shergold my Researchers working with me on all of this, to Verity Smith and Peter Lansley for interest and dedication on the SPARC project and my current steering group.

Further reading:-Box, E., Mitchell., K. And Gandolfi, K (2010). Maintaining, Safe Mobility for the Ageing. London: RAC Foundation Report.

Korner-Bitensky, N., Kua, A., Zweck, C.V., & Benthem K.V (2009). Older driver retraining: An updated systematic review of evidence of effectiveness. Journal of Safety Research, 40, 105-111.

Musselwhite, C.B.A. (2010). The role of education and training in helping older people to travel after the cessation of driving. International Journal of Education and Ageing, 1(2), 197-212

Musselwhite, C.B.A. and Haddad, H. (2010a). Exploring older drivers' perception of driving. European Journal of Ageing, 7(3), 181-188.

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

Musselwhite, C.B.A. and Shergold, I. (2011).Contemplation and planning in successful driving cessation. Paper presented at the British Gerontology Society Conference, Plymouth, July. (+submitted to European Journal of Ageing- under review)

Further information

Dr Charles Musselwhite

Senior Lecturer

Centre for Transport & Society

[email protected]

www.transport.uwe.ac.uk/staff/charles.asp