Dr. Charles Musselwhite Senior Lecturer in Traffic and Transport Psychology,

1. 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 & SocietyCharles.Musselwhite@uwe.ac.uk 0117 32 83010

2. 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

3. Context

4. Older people as Car drivers 1. Growing % of licence holders 2. More miles driven per person 3. Growing % of journeys as driver Source: DfT (2002, 2006, 2010)

5. Older drivers and safety

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

7. 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).

8. Motivations to continue to drive

9. Mobility Deprivation • 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

10. Motivations for travel • A reduction in mobility can result in an increase in isolation, loneliness and depression and an overall a poorer quality of life. TERTIARY TRAVEL NEEDS Aesthetic Needs The need for travel for it’s own sake, to visit nature, for relaxation On giving-up driving this level of needs is adversely affected Not so easy to ask for discretionary travel SECONDARY TRAVEL NEEDS Psychosocial Needs The need for independence, control, status, roles, normalness W-H On giving-up driving this level of needs is adversely affected Isolation, no longer part of society, no longer feel normal PRIMARY TRAVEL NEEDS Practical Needs Make appointments, access shops and services, work • On giving-up driving – • this level of need is usually met • friends • accessible transport • public transport • teleshopping? Especially by car Source: Musselwhite, C. and Haddad, H. (2010b). Mobility, accessibility and quality of later life. Quality in Ageing and Older Adults. 11(1), 25-37.

11. Self-awareness and assessment

12. 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 hate any kind of right hand turns! I always go left, left and left again!” “I don’t go out at night no more, not with my eyes the way they are”

13. Interventions to improve driver safety

14. 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

15. Process of giving-up driving

16. Giving-up driving (i) LONG TERM 7(2m; 5f) (ii) SHORT TERM 8 (4m; 4f) (iii) REACTIVE 6 (6m; 0f) 1st stage TRIGGER 2nd stage INFORMATION GATHERING 3rd Stage TRYING ALTERNATIVES and CONSOLIDATION HIGHER QUALITY OF LIFE LOWER QUALITY OF LIFE

17. 1st stage TRIGGER (i) LONG TERM 7(2m; 5f) “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) • “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) • Key, respected family member • Could be taken less seriously if the “wrong” family member said it! • Recognised Health problem (ii) SHORT TERM 8 (4m; 4f) • “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)” (iii) REACTIVE 6 (6m; 0f) • 4 diagnosed health condition • 2 had keys taken by relatives The trigger is associated with external social events • retirement from work • children leaving home

18. 2nd stage INFORMATION GATHERING “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) (i) LONG TERM 7(2m; 5f) • “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) (ii) SHORT TERM 8 (4m; 4f) • Don’t gather much information, at all • Trail and error • Rely on lifts • Reciprocation discussed (iii) REACTIVE 6 (6m; 0f) • 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 “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) Meticulous planning • Either don’t have family or friends nearby or would feel a burden • Other modes • Other locations Social norms

19. 3rd Stage TRYING ALTERNATIVES and CONSOLIDATION (i) LONG TERM 7(2m; 5f) “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) • “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) • Largely trial and error • Generally good quality of life beyond the car, characterised by • Supportive family and friends • Enjoying a challenge (ii) SHORT TERM 8 (4m; 4f) (iii) REACTIVE 6 (6m; 0f) Much worse quality of life Bitter and angry • “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) • Generally pleased with outcome • Good quality of life

20. Conclusion

21. 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

22. Provide practical and emotional support EMOTIONAL • Affective elements of giving-up driving • Youthfulness • Norms • Independence • Freedom • Alternative transport • - Lifts • Bus • Community transport • Discretionary travel • Information • FAMILY • Help appropriate giving-up of driving • help bring into consciousness • Practical • Emotional PRACTICAL

23. 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 Charles.Musselwhite@uwe.ac.uk www.transport.uwe.ac.uk/staff/charles.asp