The influence of spouses and their driving roles in self-regulation: A qualitative exploration of driving reduction and cessation practices amongst married older adults

Ang, Boon Hong; Oxley, Jennifer Anne; Chen, Won Sun; Yap, Michelle Khai Khun; Song, Keang Peng; Lee, Shaun Wen Huey

doi:10.1371/journal.pone.0232795

Cited by 14 publications

(28 citation statements)

References 21 publications

(42 reference statements)

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“…Further study using a gender lens on such transitions should also be considered. While the influence of gender was beyond the scope of the current study, there is recent evidence to suggest differential roles with respect to driving by gender, which, in turn, might affect self-regulation of driving as well as driving cessation in later life (Ang et al, 2020;Barrett et al, 2018).…”

Section: Limitationsmentioning

confidence: 89%

A narrative analysis of the transition from driving to driving cessation in later life: Implications from an occupational lens

Bertrand

Jonsson

Margot-Cattin

et al. 2021

Journal of Occupational Science

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The transition from driving to driving cessation in older adulthood is considered a major life transition where resulting disruptions can impact sense of self. Such transitions at this life stage offer both a challenge and opportunity to consider the relationship between disruption, adaptation (or not) of occupational patterns, and perceptions of life roles. The current study examines this process of adaptation where the focus is on exploring how disruption, loss, and identity over time are negotiated at this life stage. Semi-structured interviews with each participant explored this process. Based on these interviews and corresponding narrative analysis, the trajectories of each of the five older adults (4 male, 1 female; aged 73-90) were categorized and mapped. The analysis indicated the narrative slopes of three participants were 'progressive' (more ups than downs), one participant was 'stable' (landing where one started), and the remaining participant was 'regressive' (more downs than ups). Results from this study suggest the process of negotiating the transition from driver to non-driver was non-linear, meaning the ensuing adaptations to everyday life involved a major reorganization of occupations and routines. Social support and finding alternative ways of doing were key to negotiating this transition. Challenges experienced during the transition and/or, a failure to adapt, suggests an ongoing and growing disconnect in life roles. Further study of the impact of such disconnection and the ramifications on not only the person but also their social network is warranted.

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Section: Limitationsmentioning

confidence: 89%

A narrative analysis of the transition from driving to driving cessation in later life: Implications from an occupational lens

Bertrand

Jonsson

Margot-Cattin

et al. 2021

Journal of Occupational Science

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show abstract

“…A greater proportion of DCAS decedents were widowed than non-DCAS decedents. Ang et al (42) found that older couples develop strategies, such as sharing driving duties, splitting between the more "active" role as the driver and the more "passive" role as the passenger, and regulating each other's behavior to ensure safe driving. In addition to the bereavement, being widowed could conceivably increase suicide risk via the large disruption to an aging adult's social network and ability to participate in daily routines (43).…”

Section: Discussionmentioning

confidence: 99%

A Data Science Approach to Estimating the Frequency of Driving Cessation Associated Suicide in the US: Evidence From the National Violent Death Reporting System

Kalesnikava

Jurgens

et al. 2021

Front. Public Health

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Driving cessation is a common transition experienced by aging adults that confers both a symbolic and literal loss of independence due to the central role of automobiles for mobility in the US. Prior research has shown that driving cessation has negative implications for mental health, social participation, and access to healthcare. Given these sequelae of driving cessation and prior work showing that late-life transitions related to independence (e.g., transitioning into residential care) are associated with suicide, we sought to estimate the frequency of driving cessation associated suicide. Data include suicide (n = 59,080) and undetermined (n = 6,862) deaths aged ≥55 from the National Violent Death Reporting System (NVDRS, 2003–2017). Each case in the NVDRS has both quantitative data (e.g., demographic characteristics) and qualitative text narratives, derived from coroner/medical examiner reports, which describe the most salient circumstances and features of each death. To identify cases associated with driving cessation, we employed a supervised random forest algorithm to develop a Natural Language Processing (NLP) classifier. Identified driving cessation associated cases were then categorized and characterized using descriptive statistics and qualitative content analysis. From 2003 to 2017, there were an estimated 305 cases of suicide/undetermined deaths associated with driving cessation in the NVDRS, representing 0.04% of all cases. Cases associated with driving cessation were older, more likely to be male, more likely to have a physical health problem, more likely to have experienced a recent crisis, and more likely to have lived in a rural county than other decedents. Qualitative analysis identified functional impairment, alcohol-related driving limitations, loss of employment, and recent car accidents as common themes among cases associated with driving cessation. This analysis illustrates the utility of NLP in identifying novel correlates of suicide in later life. Although driving cessation associated suicide is a rare outcome, further research is warranted on understanding the conditions under which driving cessation is associated with suicidal behavior, and how to support the well-being of aging adults during these types of major life transitions.

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“…The main outcome is the implementation of self-regulation strategies in driving. Self-regulation strategies will be measured by the participants' scores on the DPPQ “Current Self-Regulatory Practices” subscale ( 29 ). The 2-month and 6-month scores of the control group and the experimental group will be compared.…”

Section: Methodsmentioning

confidence: 99%

“…However, the interaction between patient and natural caregiver appears to be at the heart of this process ( 17 , 28 ). A recent study showed that spouses play a significant role in their partners' decision to self-regulate their driving ( 29 ). The authors pointed out that intervention programs for driving cessation needed to consider the importance of interdependency in couples and its impact on their driving decisions and outcomes.…”

Section: Introductionmentioning

confidence: 99%

An innovative therapeutic educational program to support older drivers with cognitive disorders: Description of a randomized controlled trial study protocol

et al. 2022

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Older drivers face the prospect of having to adjust their driving habits because of health problems, which can include neurocognitive disorders. Self-awareness of driving difficulties and the interaction between individual with neurocognitive disorders and natural caregiver seem to be important levers for the implementation of adaptation strategies and for the subsequent voluntary cessation of driving when the cognitive disorders become too severe. This study aims to evaluate an educational program for patient/natural caregiver dyads who wish to implement self-regulation strategies in driving activity, and to improve self-awareness of driving ability. The ACCOMPAGNE program is based on seven group workshops, which target the dyad. The workshops deal with the impact of cognitive, sensory and iatrogenic disorders on driving. They tackle questions about responsibility, and about autonomy and social life. They also provide alternative solutions aimed at maintaining outward-looking activities even if driving is reduced or stopped. A randomized controlled trial is planned to evaluate the effectiveness of the program 2 months and 6 months after inclusion, and to compare this to the effectiveness of conventional approaches. The main outcome of this trial (i.e., the implementation of self-regulated driving strategies), will be measured based on scores on the “Current Self-Regulatory Practices” subscale of the Driver Perception and Practices Questionnaire. The Driving Habits Questionnaire will be used to measure secondary outcomes (indicators of driving changes; indicators of changes in mood, quality of life and caregiver burden; and self-awareness of driving abilities). Indicators will be collected for both patients and natural caregivers. This cognitive, social and psychological program should allow older individuals with cognitive disorders to drive more safely, and help to maintain the quality of life and mood of both patient and natural caregiver despite driving limitations. The patient's care path would be optimized, as he/she would become an actor in the process of giving up driving, which will, most certainly, be needed at some point in the progress of neurocognitive disorders. This process ranges from becoming aware of driving difficulties, to implementing self-regulation strategies, through to complete cessation of driving when necessary.Clinical trial registration numberNCT04493957.

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The influence of spouses and their driving roles in self-regulation: A qualitative exploration of driving reduction and cessation practices amongst married older adults

Abstract: The influence of spouses and their driving roles in self-regulation: A qualitative exploration of driving reduction and cessation practices amongst married older adults.

Cited by 14 publications

References 21 publications

A narrative analysis of the transition from driving to driving cessation in later life: Implications from an occupational lens

A narrative analysis of the transition from driving to driving cessation in later life: Implications from an occupational lens

A Data Science Approach to Estimating the Frequency of Driving Cessation Associated Suicide in the US: Evidence From the National Violent Death Reporting System

An innovative therapeutic educational program to support older drivers with cognitive disorders: Description of a randomized controlled trial study protocol

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