Researchers from the University of Colorado Anschutz Medical Campus along with the AAA Foundation for Traffic Safety released a report this month examining how health care providers play a key role in often difficult conversations about driving safety and driving retirement with older adults.

Led by Colorado faculty Drs. Emmy Betz and Carolyn DiGuiseppi, and PhD student, Mr. Kenneth Scott, and Dr. Jacqueline Jones, with the CU College of Nursing, the report entitled `Older Adults’ Preferences for Communication with Healthcare Providers About Driving,’ examines how older adults prefer to talk with their healthcare providers about driving safety and planning for future “driving retirement.” They found that healthcare providers play a key role in addressing these questions with older adults, but when and how to have these conversations are complex.

After reviewing the preferences of older adults – in 22 published studies representing 518 older adult drivers – researchers identified five tips to navigate this difficult topic:

1. Driving discussions are emotionally charged.  Most older drivers said these conversations triggered negative emotions and indicated that they are afraid of the consequences of this conversation, especially losing their driving privileges. Healthcare providers are uniquely positioned to engage in positive, yet tactful, conversations with older adult patients regarding the risks and benefits of driving and future transitions to other forms of transportation. These conversations should be a routine occurrence.
2. Context matters. Older adults spoke of the desire to be recognized as an individual. Their age, health, gender, availability and accessibility of resources and alternative transportation must be part of this conversation. For example, rural values such as self-reliance and independence, coupled with the lack of access to alternative forms of transportation, can play a role in driving discussions.
3. Healthcare providers are trusted and influential figures. Many older drivers want to have this conversation with their doctor and see healthcare providers as an authority figure. Efforts could include embedding appropriate questions within the electronic medical record to ensure that respectful and effective communication on the topic is part of a regular check-up.
4. Continued communication over time: Older drivers need time and support to reflect on the impacts of new physical challenges or medication effects on driving. They also need to adjust to the emotional consequences of driving retirement. Conversations should occur over a period of time, allowing for advanced planning, to avoid the need for abrupt and unexpected changes.
5. Desire for agency: Older adults want to control their decisions over whether to seek assistance or retraining or to self-restrict their driving. Providers should engage and empower these drivers to make informed, rather than forced, decisions.

Safe mobility is essential to healthy aging. Lifestyle changes, along with innovative technologies and medical advancements will have a significant impact on the driving experiences of the Baby Boomer generation.

Researchers hope the results will inform the future development and refinement of messaging to older drivers, which could support the integration of questioning about driving into routine clinical care. This could also be used by doctors, other healthcare providers, caregivers, driver licensing officials and others to help older drivers make decisions about driving cessation. The full report can be viewed here.

Drs. Betz and DiGuiseppi, and Mr. Scott are all affiliated with the Program for Injury Prevention, Education and Research (PIPER), a collaborative initiative of the Colorado School of Public Health, the University of Colorado School of Medicine, and Children’s Hospital Colorado.