A systematic review of effective interventions and strategies to support the transition of older adults from driving to driving retirement/cessation

Anne Dickerson, T. Stapleton, Jamie Bloss, Isabelle Gélinas, Priscilla Harries, Moon Choi, Isabel Margot-Cattin, Barbara Mazer, A. Patomella, Lizette Swanepoel, Lana Van Niekerk, Carolyn Unsworth, Brenda Vrkljan
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Abstract

In most western countries, older adults depend on private cars for transportation and do not proactively plan for driving cessation. The objective of this review was to examine current research studies outlining effective interventions and strategies to assist older adults during their transition from driver to driving retirement or cessation. A search was completed across nine data bases using key words and MeSH terms for drivers, cessation of driving, and older adult drivers. Eligibility screening of 9,807 titles and abstracts, followed by a detailed screening of 206 papers was completed using the Covidence platform. Twelve papers were selected for full text screen and data extraction, comprising three papers with evidence-based intervention programs and nine papers with evidenced-informed strategies. Three papers met the research criteria of a controlled study for programs that support and facilitate driving cessation for older adults. Nine additional studies were exploratory or descriptive, which outlined strategies that could support older drivers, their families, and/or healthcare professionals during this transition. Driving retirement programs/toolkits are also presented. The driver retirement programs had promising results, but there were methodological weaknesses within the studies. Strategies extracted contributed to six themes: Reluctance and avoidance of the topic, multiple stakeholder involvement is important, taking proactive approach is critical, re-focus the process away from assessment to proactive planning, collaborative approach to enable “ownership” of the decision is needed, and engage in planning alternative transportation should be the end result. Meeting the transportation needs of older adults will be essential to support aging in place, out-of-home mobility and participation, particularly in developed countries where there is such a high dependency on private motor vehicles.
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系统审查支持老年人从驾驶向退休/退出驾驶过渡的有效干预措施和战略
在大多数西方国家,老年人依靠私家车代步,不会主动计划停止驾驶。本综述旨在研究当前的调查研究,概述在老年人从驾驶员过渡到退休或停止驾驶的过程中帮助他们的有效干预措施和策略。 我们使用驾驶员、停止驾驶和老年驾驶员等关键词和 MeSH 术语在九个数据库中进行了检索。利用 Covidence 平台对 9807 篇标题和摘要进行了资格筛选,随后又对 206 篇论文进行了详细筛选。筛选出 12 篇论文进行全文筛选和数据提取,其中 3 篇论文涉及循证干预计划,9 篇论文涉及循证策略。 三篇论文符合针对支持和促进老年人戒酒的项目进行对照研究的研究标准。另外九篇研究为探索性或描述性研究,概述了可在这一过渡时期为老年驾驶者、其家人和/或医疗保健专业人员提供支持的策略。此外,还介绍了驾驶员退休计划/工具包。 驾驶员退休计划取得了可喜的成果,但在研究方法上也存在不足。所提取的策略可归纳为六个主题:不愿意和回避这个话题、多方利益相关者的参与很重要、采取积极主动的方法很关键、将过程的重点从评估转移到积极主动的规划上、需要合作的方法来实现决策的 "所有权"、参与规划替代交通应该是最终的结果。满足老年人的交通需求对于支持居家养老、外出活动和参与至关重要,特别是在高度依赖私人机动车的发达国家。
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