Foundations of Gerontology and Elder Care: Analytical Essay

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Abstract

This research paper will be on older drivers and the social support or against older drivers. I will brief on four online articles that deal with the rules, regulations, and stigma that are associated with driving as an elder. After reading the class textbook (Hooyman, N. R., & Kiyak, H. A. (2011) Social Gerontology. A Multidisciplinary Perspective 9th ed.) I realized that among the many things that the elderly must relinquish because of diminishing cognitive skills is driving a motor vehicle which is something many will not stop until they are forced to regardless of their driving abilities. Driving is the single most independent and self-fulfilling form of means of transportation for a person even though there are plenty of other ways to get from place to place. Refraining from driving can feel like a big sacrifice to someone or become a life-changing event to anyone who has done it on a daily basis.

Society moves so fast that people are always in a rush to get around and drive too fast that they see older drivers as a nuisance but it’s the elder drivers who typically try to drive more cautious and obey the traffic laws. Society sees older drivers as a burden that it seems that they get in the way of others but their need to drive is just as important as any other. On the other hand, there are some examples and facts that show that elders can no longer process what’s around them fast enough that it increases the chances of car accidents or motor vehicle fatalities.

Many cities have public transportation systems to assist with this issue, but a lot of elderly people do not like the concept of waiting on strangers to take them places or knowing that they have to rely on someone else for their personal needs. The public transit system can also be complicated to the point that they will avoid its services because they don’t understand the process for its services, for example, learning how to buy metro tickets for the subway.

This paper will briefly review the problems associated with older drivers and at what age they should stop driving, the reasons on why older drivers should stop and what alternatives are available and how family support groups feel about older drivers, and what the solutions to the problems are. We will also look at some solutions to the conflict between older drivers not wanting to be regulated and what the government or society does to deal with it.

Cessation and social integration

Mezuk and Rebok (2008) discuss the impact of driving cessation on social integration and perceived support from relatives and friends among older adults. Data collected came from the population-based Baltimore Epidemiologic Catchment Area Study where participants aged 60 and older who had a frequency of interaction and social support from relatives or friends versus those who did not. Former drivers were older, more likely to be female and non-White, had lower education, had lower self-rated health, and had lower cognitive exam scores relative to continuing younger drivers. Over the follow-up period, driving cessation was associated with reduced network of friends and also showed that cessation had little to no impact on friends’ or relatives’ social lives. Social integration was negatively affected by elderly people refraining from driving even among elders who feel competent in using alternative forms of transportation.

Studies show that older drivers who stop driving are gender-based and is related to the widowed female. Most females after a certain age lose their independence and become less eager to keep the independent status and they start to develop the Informal support groups like family or friends which give emotional support. Or they start to form the reciprocal exchange (Keyes, 2002; Krause & Shaw,2000; Morrow-Howell et al., 2001; Kawachi & Berkman 2001; Temkin-Greener et al., 2006: Uchino 2004).

The article on surface transportation policy project. Linda Bailey; “Aging Americans: Stranded without options” (2004) explains on how the demographics will change dramatically in a couple of years as more baby boomers reach their 60s, and 70s and will have a greater need for assisted care of living. The U.S. Census Bureau projects that the number of Americans age 65 or older will increase from 35 million today to more than 62 million by 2025 which is estimated at an 80 percent increase. As people grow older, they often become less able to drive, making it necessary to depend on alternative methods of transportation or on their support system. Fragility

is the most single cause of this increased mortality among older drivers (Li, Braver, and Chen, 2003). Society is currently not prepared to provide adequate transportation choices for the rapidly aging population. Although public transportation is available, it doesn’t take into account the fact that the elderly still need assistance getting to the provided services (Foley, Heimovitz, Guralnik, and Brock, 2002). Alternatives to driving can also be minimal due to the locations, regions in where they live, and limited small town community services. As the number of older people increases, so too will their mobility needs. More than one in five Americans aged 65 and older don’t drive (21%) because of declining health, physical or mental, no access to a car, or just a personal preference. Addressing this issue will have significant social and economic ramifications due to the need for money and the restructuring of many locations.

This issue can increase the awareness in the need for funding in public transportation systems and the need to expand and improve services to meet the needs of older Americans. Increasing funding for existing specialized transportation programs that provide mobility for older persons, such as FTA’s Section 5310 program is one way of improving the situation. Fulfilling the needs of elders by planning transportation projects, services, and improved human service agencies can benefit everyone in the long run.

Social Learning Theory

The awareness of the dangers and safety issues with older drivers has resulted in the development of interventions that provide older drivers with ways to increase driver safety while still allowing them to maintain independence so they can continue to perform activities necessary for daily living. Crash involving older adults has been directly linked to visual processing impairments and decreased reaction time while driving (Johnson & Keltner, 1983; Owsley et al., 1998; Owsley & McGwin, 1999). Many older drivers meet the legal requirements for acquiring a driver’s license in many states despite having some disabilities that increase the chances of motor vehicle accidents. Those who do experience impaired visual capabilities may compromise their driver safety and those around them. The purpose of this article is to describe the process of developing, implementing, and evaluating the efficacy of a theory-based intervention for high-risk older drivers. The goal of this intervention is to promote the practice of self-regulation as a means to reduce crash risk and enhance public safety without restricting the older population the ability to drive. Early intervention is something that needs to be done by agencies and families. One way that can help is renewing their licenses more frequently and require more visual tests from the department of motor vehicles. Families can also intervene to ease the issue with their loved ones before problems develop by speaking with the older drivers when they’re in their late 50s or 60s or when they realize that the family member is no longer safe driving.

This type of proactive approach can benefit everyone. Telling people to stop driving is not enough. We must inform older drivers of the benefits of alternative transportation methods. Paratransit services are designed for people with disabilities who cannot take regular public transportation, these services have vans or mini-buses that pick you up and drop you off at your home. Local communities may offer discounted fares for older adults if they researched they can also find some taxis that are wheelchair-accessible. Private nonprofit organizations operate vans or buses to take people around. Some services are for people with physical or mental disabilities.

About 90 percent of drivers age 65 and older continue to drive. This age group will keep wanting to drive up to their 80s and 90s (Hooyman & Kiyak). Most accidents related to older drivers occur at low speeds but are more likely to be injured more sever because of the declined organ system, brittle bones, and longer duration of healing time. Regardless of the injuries, older adults, especially the ones 70 years and older have longer hospital stays and more health complications. However, they are more likely to avoid driving in bad weather conditions, at night time or during rush hour traffic. Driving routes become established which reduces the chances of vehicle accidents. Almost 4 percent of male drivers age 75 or older have dementia (Foley et al., 2000; Kennard, 2006). Improved road design can alleviate the confusion in older drivers. Road signs that are made to be larger and better lit can also help.

An electronic device can be added to a driver’s ear like a hearing aide which will make a loud noise or something to that effect to keep the driver awake at the wheel. Many car manufacturers are implementing changes to accommodate older drivers with wider rearview mirrors, less complicated instrument panels on cars, and booster cushions for those shorter drivers. Every possible means to keep a person save can be tried but the most effective way is to intervene and talk to the elder driver about not driving at all. Hooyman, N. R., & Kiyak, H. A. (2011). Social Gerontology. A Multidisciplinary Perspective (9th ed.) Boston, MA: Karen Hanson.

Identifying the Solutions

Langford and Koppel (Transportation Research Part F: Psychology and Behaviour; 2006) explain how the problem with older drivers and relation to the involvement in crashes has led to a widespread concern about older driver safety and future road casualty levels. Some people want to regulate the maintenance and tightening of age based mandatory assessment procedures which are seen as an effective control method to the increased statistics of older driver car accidents. The case against age-based assessment is that it has no demonstrable road safety benefits but it does prompt older people to use alternative transportation modes that are less risky than personal vehicles. It was concluded that unsafe drivers can best be identified not through mandatory age-based assessment but through a more strategic approach, relying upon referral.

This article can be argued both ways; it sums it up as the older driver should be forced to stop driving. We have to look at the flexibility of public transportation. Some transportation services require reservations ahead of time, so you must plan ahead and not many elders can do that. Some pick you up and drop you off at a time you choose at an increased price and others have a fixed schedule that cannot be changed or altered. Safety is also a concern; they may feel safer if another person accompanies them on a trip and would have to rely on social support if they had one. Some services cost more than others and most services do not provide senior citizen discounts. If safety and mobility is a concern for some or just can’t go out to get something, they have the option of having it delivered to their home. Many stores will deliver straight to their house. The public can now receive almost any prescribed medication by mail and online use can be a relief for some but they would also need to learn how to use it properly.

Conclusion

Several states are seeking to toughen licensing requirements for older drivers but have been stopped by senior-citizen lobbying groups like the AARP who say age-based measures are discriminatory. They claim that a person’s chronological age is not an accurate predictor of driving ability or disability. The lobbyists argue that if seniors are forced to take extra mandatory road tests without a history of an incident, other age groups should be required to take them as well. (http://www.smartmotorist.com/traffic-and-safety-guideline/older-drivers-elderly-driving-seniors-at-the-wheel.html). Screening could be given to all drivers for whom the age-related decline is suspected and whose performance is viewed as a safety concern for themselves and others.

We want to support their continued independence but we worry about their driving abilities and it’s unfortunate that driving is something that is taken for granted, we don’t have the luxury of being able to drive a car throughout our entire lifetime. Physical disabilities, mental illness, medications, or loss of vision can end anyone’s driving privileges permanently. We rely on cars to get to work, go shopping, or just for leisure. When the elderly lose their driving privileges, the get the feeling of being trapped or perhaps losing the will to choice how they live their lives. To be a safe driver, paying attention to road conditions at all times and being aware of our surroundings and our own bodies is essential.

References

Mezuk and Rebok (2008). The Journals of Gerontology Series B: Psychological Sciences and Social Sciences; Social Integration and Social Support Among Older Adults Following Driving Cessation. Retrieved from http://psychsocgerontology.oxfordjournals.org/content/63/5/S298
Linda Bailey, Michelle Ernst, Kevin McCarty, and Trinh Nguyen (2004). Surface Transportation Policy Project. Aging Americans: Stranded without options. Retrieved from http://www.transact.org/library/reports_html/seniors/aging.pdf
Langford and Koppel; Transportation Research Part F: Psychology and Behaviour; (2006) The Case For and Against Mandatory Age-based Assessment of Older Drivers. Retrieved from http://trid.trb.org/view.aspx?id=793711
The Development and Efficacy of a Theory-Based Educational Curriculum to Promote Self-Regulation Among High-Risk Older Drivers. (Beth T. Stalvey, MPH, PhD, CHES; Cynthia Owsley, MSPH, PhD. http://sophe.org/ui/olderDrivers.pdf
Hooyman, N. R., & Kiyak, H. A. (2011). Social Gerontology. A Multidisciplinary Perspective (9th ed.) Boston, MA: Karen Hanson.

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Foundations of Gerontology and Elder Care: Analytical Essay

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