Exploring Community Mobility Needs & Perceptions Among Older Adults

A qualitative phenomenological approach was taken to research the needs and perceptions of older adults related to community mobility, including driving, fall prevention, and alternative transportation. This is an area where little research exists. Participants completed an electronic pre-survey to obtain demographic information, engaged in a virtual focus group and fall screen, and completed a post-survey. Focus group questions, devised by the research team, included ‘what may prevent you from using alternative transportation?’ Tools from the CDC’s STEADI were used for the Fall Screens. Community resources for alternative transportation and fall prevention were emailed out with a post-survey, which aimed to get feedback on the research experience. Inclusion criteria included being 60 years or older, having a physical address in FL, WA, or NC with email access, and the ability to participate in a virtual meeting. Convenience sampling was used to recruit participants. Seven people with a mean age of 75 years, including three males and four females, participated in the study. Three had a history of falling while four indicated a fear of falling. Three of the six participants who completed fall screens were identified as being at an increased fall risk. The research team, five OT students and their research advisor, independently analyzed Zoom transcripts from the focus groups and pre/post survey and fall screen data using content data analysis. They then collectively reviewed their findings to finalize themes. The data revealed four themes. Theme 1: Meaning and Significance of Driving: Driving is a Necessity- 4/7 identified as primary drivers and 5/7 drove at least five days a week, Driving is Independence- Participants felt limited if they had to depend on someone else Theme 2: Driving Retirement: Reasons to Stop Driving- Failing eyesight and decreased cognition were identified as factors that would cause participants to consider driving retirement, Emotions- 4/7 reported that they are not prepared to retire from driving and it’s a decision participants want to come to on their own Theme 3: Alternative Transportation Supports, Barriers, and Perceptions: Not Necessary for Daily Life- Participants did not think about alternative transportation when they did not need it, Factors Impacting Use of Alternative Transportation- ‘Fear of falling getting on and off the bus’ and cost impacted alternative transportation use, Need for More Alternative Transportation Options- Current alternative transportation options were identified as ‘inadequate’ Theme 4: Fall Prevention: Limited Knowledge of Fall Prevention Resources- Participants expressed a desire for more fall prevention education, Conscious of Risk of Falling- Participants reported being conscious of their risk of falling but not overly concerned and steps taken to reduce fall risk included the use of mobility devices and removing rugs Occupational therapy practitioners can address community mobility and driving retirement throughout the OT process to help meet the community mobility needs of older adults. Practitioners can provide clients with local transportation and fall prevention resources that are accessible and affordable. Client education can be provided on how to operate rideshare apps and other technologies. Client factors, including vision and balance, can be addressed to help increase safety and independence while engaging in community mobility. OT practitioners should continue to advocate for better community mobility resources for older adults. It is also important to determine what driving means to the client, and to provide client and caregiver education on driving safety and how to plan for driving retirement. Limitations of the study include a small sample size.

References

American Occupational Therapy Association. (2016). Research opportunities in the area of driving and community mobility for older adults. American Journal of Occupational Therapy, 70(4). https://doi-org.courseinfo.wssu.edu/10.5014/ajot.2016.704001

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