Health care providers can play an important role in assessing and counseling older adults in driving retirement.

Cars are ubiquitous in the US and mass transit services have declined. With the exception of a few cities such as New York and Chicago, visiting cultural attractions, attending public events, dropping off the grandkids, shopping for groceries or a long list of other errands and tasks often requires traveling by train. car. Driving is important for the independence and mobility of elderly people, deciding whether they should stop driving is a difficult topic for doctors to discuss with their elderly patients.

A recent study highlights the challenges that health care providers face in relation to retirement discussions including driving skills assessment and counseling. The research team spoke with physicians and media professionals about the many aspects of this issue, including balancing the problems and needs of older adults with the implications for public safety as a health care provider supports elderly people in this critical period of life.

“”You just have to be careful how you do it’: A qualitative study of the Healthwise decision aid for older drivers” is published in the journal Traffic Accident Prevention.

“Despite the emotional stress of stopping driving, our research shows that it’s worth starting to talk about factors that can affect the quality of life and the greatest safety margin for your patient,” he said. Regenstrief Center and Indiana University School. Medical researcher Nicole Fowler, Ph.D., co-author of the study. “Driving and other safety issues such as gun ownership are topics that primary care providers often bring up in conversations with older adults and their families.

“Even though it doesn’t sound like a medical decision, it has a huge impact on their quality of life. It’s like a conversation with the patient—and maybe their family—about advanced care planning, discussing safety before time – especially driving – to help the patient and their family in a way that I think they really value.”

The themes that emerged were included in interviews with nurses (physicians, physician assistants, nurses and social workers) and subject matter experts:

• The importance of planning ahead for driving stops.
• Concerns about aging and damaging provider-patient relationships.
• Physician concerns about insufficient information about social factors related to an older person’s need to continue driving.
• The need for integrated, easily accessible tools for providers and patients.
• Benefits of integrating tools, including decision support aids for older adults, into electronic health records.
• A printed tool rather than an online decision support tool is more likely to be acceptable to older adults.

Comments from study participants regarding the retirement of older drivers included:

• “…we get that question a lot. I find that the patient… is often very negative. That’s been my experience for 15 years.”
• “I think the most effective supply is going to be from the doctor. If they go to an annual visit, the doctor gives it. [decision support aid] to see and talk to them about it if they have time because I am someone who has the authority to talk to them about the issue against a lot of paperwork at the rec center, they might not pay attention to that. ”
• “… even for five minutes [is] about a quarter of the time we spend with our patients. But something that can be done at home or done in advance, is included in (for example) Medicare health visits, as a questionnaire that we usually send to patients in advance.”

This study evaluated an online decision-making tool completed by older drivers and used by clinicians to learn more about the older person’s perspective on driving cessation. In the first study, the team found that the decision aid significantly reduced decision conflict and improved cognition among older adults who were considering stopping driving.

“In the current study, we spoke directly with health care providers and other professionals to understand their views on how these discussions take place in their daily practices,” said the lead author. former Emmy Betz, MD, MPH, professor of emergency medicine at the University of Colorado. Anschutz medical campus.

Research provides information on the potential implementation of a decision aid in clinical or community settings, including individual, human, institutional, and cultural factors that may affect use and impact.