Decoding the Miss Daisy Syndrome: An Examination of Subjective Responses to Mobility Change

Abstract

The subjective responses associated with personal life space and mobility status were explored. Thirty individuals participated in focus groups based on self-rated disability status, current places visited, and availability. Qualitative analyses revealed that most participants equated personal mobility with driving a vehicle. Attitudes concerning mobility status and preparedness for change varied based on disability level and personal experience. Fear of dependence from future mobility loss was prominent in all groups. Few participants acknowledged significant planning for future retirement from driving or other mobility challenges. An understanding of common attitudes, perceptions and meanings can inform professionals who intervene and support older adults experiencing mobility changes.

The stages of driving cessation for people with dementia: needs and challenges

“…Other studies have suggested that driving cessation for other groups of drivers is a process or transition, with stages of readiness and adjustment (Messinger-Rapport and Rader, 2000;Liddle et al, 2008;King et al, 2011), and this study supports this view for people with dementia and provides rich data about the needs of various Table 3. The perspectives of the three groups of participants were combined to explore the complexity of the process for all concerned.…”

Older Adults’ Driving Reduction and Cessation

“…Driving issues force adult children to think ahead toward their parents' old age and even death, even if they choose to avoid direct conversations or are uncomfortable with probable changes in family roles and responsibilities. In fact, the communication challenges described by adult children in this study (i.e., avoidance and side-stepping, resignation and refusal, and burden and reciprocity) are remarkably similar to those expressed by older drivers (King et al, 2011). Although both adult children and their aging parents are reluctant to communicate openly about the driving cessation process, they share similar and significant concerns that merit increased attention in the research, intervention, and policy arenas.…”

“I Wish We Could Normalize Driving Health:” A Qualitative Study of Clinician Discussions with Older Drivers

“…5 Drivers in our study reported needing help preparing for that transition, including learning about transportation alternatives, which is also in line with prior work. 24,47 When asked specifically about the concept of ADDs as an example of a communication tool, drivers and clinicians thought they could be useful for some patients. Prior studies have shown support for physician involvement in these discussions 41,47 and for the basic idea of ADDs, 20,21 which might be helpful both now (in beginning conversations to plan for eventual driving changes) and in the future (when the time comes to make those changes).…”

“…5 However, the paucity of affordable, acceptable transportation options 23 may contribute to a propensity to continue driving beyond a period of safe skills. 24 Recognizing that driving cessation is an inevitability for many older drivers, we previously explored the concept of "Advance Driving Directives" (ADDs) 20,21 as a way for clinicians, families and older drivers to prepare for future mobility changes. Although not legally binding, these forms could facilitate conversations about drivers' preferences for future testing or decision-making assistance (Appendix, available online).…”