Seniors Who Don't Drive More Likely to Require Care

Being tethered to the home may put elderly at risk, study suggests

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By Randy Dotinga
HealthDay Reporter

THURSDAY, June 1, 2006 (HealthDay News) -- If you're wondering whether your aging parent is going to end up in a nursing or retirement home, check whether he is tooling around in his car or staying inside.

Elderly people's driving habits -- or lack thereof -- could offer a glimpse into their future, a new study suggests.

Researchers who studied the elderly living in a small Maryland town found that those who had stopped driving were nearly five times more likely to require assistance with meals or nursing care, even when certain health factors were taken into account. Those who never drove or lived in homes without drivers were also more prone to need care.

"We expect older adults to make good decisions about when they should stop driving, but we fail to fully recognize the hardships that not being able to drive places on an older adult," the study authors wrote.

They examined the results of a 1993-1995 survey of adults aged 65 to 84 who lived in or near Salisbury, a town of 23,000 people. Then they checked to see what happened to those seniors as late as 2003, and received close to 1,600 responses.

Those who had stopped driving were 4.85 times more likely to have entered long-term care, which was defined as a nursing home, an assisted-living facility or a retirement home that offers transportation, meal services or both, compared to individuals who continued to drive.

Those who had never driven were 3.53 times more likely to be in long-term care, and those who lived in homes with no drivers were 1.72 times more likely to be in care.

The study findings appear in the July issue of the American Journal of Public Health.

Study lead author Ellen Freeman, a researcher at Johns Hopkins University, Baltimore, cautioned that the study doesn't confirm a direct cause-and-effect relationship between not driving and winding up in long-term care. While the researchers adjusted their figures to take several health factors into account, they may have missed some, she said.

Freeman added that the study findings "should only be generalized to a similar type of small city like Salisbury, which at that time, had no public transportation." The situation may be different in a larger city where it's easier for seniors to get around, she said.

Yael Harris, a senior policy adviser with the Centers for Medicare and Medicaid Services, said the study findings may be "reasonable," although the number of seniors studied was fairly small.

It's clear that not driving can contribute to a loss of independence and send seniors into "further decline," said Harris, who cautioned that her comments don't reflect the opinions of her agency. "If you're not driving anywhere, you're less likely to leave the house, and the homebound are more likely to be depressed," she said.

Not driving may also keep seniors away from medical care, she said. "It's hard to get to a doctor, and they wait until [their medical problems] really get bad."

There are ways to help elderly people who have trouble getting out of the house, Freeman said. "Children can help their older parents figure out ways to stay mobile even after no longer driving. Also, communities and governments can help to create alternatives to driving by organizing volunteer drivers and by funding public transportation targeted toward seniors," she said.

More information

The American Geriatrics Society offers more information about seniors and safe driving.

SOURCES: Ellen Freeman, Ph.D., researcher, Johns Hopkins University, Baltimore; Yael Harris, Ph.D., senior policy adviser, Centers for Medicare and Medicaid Services, Baltimore; July 2006 American Journal of Public Health

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