Dr Adrian Davis

Top line: As the population ages and lifespan increases, disabling conditions affecting elders will require transport solutions which both enables them to maintain a minimum acceptable level of accessibility but which are not so reliant on informal family care and potential negative effects on the health and wellbeing of informal care providers.

With an ageing society there is a need to consider how elders maintain a sufficient level of accessibility to goods, services, and facilities as well as social support networks through friends and relatives. This is important in order to sustain their health and wellbeing. Increasingly adults in the UK will have grown up through an epoch of mass motorisation and developed habits and lifestyles around car use.

An expanding research stream is addressing aspects of an ageing society. This includes the impact of cessation of car driving. One well cited study explores how the loss of driving privileges by impaired drivers affects households.1 The particular focus is on the travel behaviour and perceptions of people living in households where an elderly driver has had his or her license revoked due to Alzheimer’s disease or a related dementia. The data for this analysis were drawn from a 1996 survey of households in California which queried the caregivers of people with dementia on how the former drivers access necessary destinations once they can no longer drive, and on the difficulties faced by other household members in seeking alternative means of transportation. After losing their license, the vast majority of people surveyed depended on informal support systems for transportation, such as rides from family and friends. Although such arrangements were not reported to be a problem for the majority of households, certain groups of non-drivers reported difficulty accessing services, particularly social and recreational destinations.

The most commonly reported problem was a lack of available licensed drivers to chauffeur non-drivers. Importantly, no increase was observed in the number of people walking, using public transit, taxis, or van services following license revocation. People who did not live with at least one licensed driver and those who were younger and healthier reported the greatest mismatch between their need and desire to travel and the availability of transportation. In addition, 42% of caregivers, the majority of whom were women (as wives, daughters and daughter-in-laws), reported that they frequently missed work, and 13% appeared to have stopped working entirely in order to care for and chauffeur people in the former drivers’ household. Overall, these findings reinforce the importance of both developing transportation policies to support the functioning of informal transportation structures and in improving the range of alternative transportation options for those individuals with particular disabilities – like dementia – who are not well served by either informal arrangements or by formal transportation services for the disabled.

In this study social and recreational trips were most affected by driving loss, and that overall participation in social activities diminished. Reductions in social activities reduces levels of social support which is known to increase the risk of higher levels of ill-health.

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1 Taylor, D., Tripodes, S. 2001 The effect of driving cessation on the elderly with dementia and their caregivers, Accident Analysis and Prevention, 33: 519-528.

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