Safety on the Roads: Mobility Transitions
Driving is often seen as a key to independence, and most people want to hold onto the privilege as long as possible — especially in a society so dependent on cars.
However, as a person ages, there’s a greater chance that changes in vision, cognition, reaction time, motor control and functional health can make driving unsafe. That, along with the aging population in America, means more and more people will need to transition from the driver role to that of passenger, which can be scary for someone who has been driving for a lifetime.
Dr. Tom Meuser, director of the Gerontology Graduate Program at UMSL, is working on various ways to help individuals make this transition successfully. According to Meuser, this work is intended not only “to facilitate a healthy transition to non-driving mobility for older adults who need to do so for reasons of functional compromise,” but also to help their families with the transition and to increase safety on our roads.
A clinical psychologist and applied gerontologist, Meuser has received a number of grants while at UMSL supporting his work in this area including awards from the University of Missouri Research Board award from the Missouri Department of Transportation (MoDot).
With $30,000 from the Research Board for his project entitled “Validation of a Clinical Tool in an Enriched Sample,” he and his co-investigator, Marla Berg-Weger, Ph.D., professor of social work at Saint Louis University, studied the predictive validity of the Assessment of Readiness for Mobility Transition (ARMT) in community dwelling older adults.
Meuser and Berg-Weger developed the ARMT, a tool for mobility transition counseling, in 2011. This assessment tool measures attitudes about the aging process and changes in mobility status so as to identify persons who might struggle if suddenly needing to transition away from driving. For example, those who show strong self-reliance and want to avoid being a burden on others are considered to be at risk if they need to transition to non-driving mobility. Information collected in the ARMT allows for tailored discussion and planning when a driving mobility transition seems imminent; it also provides counselors and social service workers necessary insight when holding such discussions with people who put great importance on mobility and independence.
To test the predictive validity of the ARMT, Meuser collaborated with ITNAmerica, a membership-based, non-profit transportation service with affiliates in more than 20 cities. ITNAmerica recruited adults over 60 years of age to complete the scale twice, six months apart. The ARMT, which has received national attention, was demonstrated to have good test-retest reliability, and the predictive data are being analyzed now. If the scale predicts future transportation choices as expected then its value for mobility counseling will be confirmed.
Also, in October, Meuser began working to review and revise Missouri’s medical evaluation process for at-risk drivers. A $91,310 award from the Missouri Department of Transportation (MoDOT) supports this one-year project entitled, “Physician Input on Cited Older Drivers.”
This new effort revisits work Meuser conducted when new at UMSL in 2007. At that time, he and a team of colleagues worked with staff of the Driver License Bureau of the Missouri Department of Revenue (Missouri DOR) to collect data on more than 4,000 older drivers reported as unfit and subsequently evaluated. The medical form in place then was found to have some serious weaknesses. Meuser and his team helped implement the new Form 1528 in 2009, which provides greater guidance for the physician to evaluate fitness to drive and relevant information for licensing decisions. “Since 2009, over two thousand older adults have been evaluated with 1528,” says Meuser, “and I can’t wait to see the impact of this new approach on safety indicators.”
Because the form addresses dementia and cognitive impairment, which often can be hard to self-identify or see in those close to you, better decisions can be made about a person’s ability to drive safely that was possible before.
The MoDOT grant will allow Meuser to collect data from more than 2,000 older individuals who were evaluated by a physician using the Form 1528 and link it with historical crash data for those individuals, including crash patterns and police citations, going back a decade. Meuser says that the resulting linked data, which will be ”unique in the field of older-driver-safety research. Obtaining detailed medical data on large numbers of older drivers is challenging in itself,” Meuser said. “The ability to link to crash and citation data back two decades really makes this project valuable. For sure, we will learn information that is additive to the field of older driver safety.” ♦
||Physician Input on Cited Older Drivers
Dr. Tom Meuser (pictured above) joined the faculty of UM-St. Louis in August 2007, as director of the Gerontology Graduate Program in the School of Social Work. He is a clinical psychologist and an applied gerontologist, and coordinates the UMSL Life Review Project - a combined teaching, service and research initiative to facilitate integrative life story work in aging adults. He is a Fellow of the Gerontological Society of America and known internationally for his long-time work on older driver safety and more recent focus on life review in aging. He will give the morning keynote lecture at the 2013 Annual Meeting of the International Institute on Reminiscence & Life Review in November.
His teaching interests include gerontological assessment, loss and grief in aging, and interviewing older adults and life review. Dr. Meuser's current research focuses on older driver safety and mobility - important issues in our aging society. He has also published on grief and loss issues in aging and dementia, including a widely used measure called the MM Caregiver Grief Inventory. Dr. Meuser and his long-time collaborator, Dr. Marla Berg-Weger, developed the Assessment of Readiness for Mobility Transition (ARMT) instrument in 2010 to facilitate person-centered mobility transition counseling with older adults.
He has received grant funding from the Alzheimer's Disease Centers Program of the National Institutes of Aging, the Alzheimer's Association, the State of Missouri's Alzheimer's Disease & Related Disorders Research Program, the National Center on Senior Transportation (a division of Easter Seals funded by the US Department of Transportation), and the National Highway Traffic Safety Administration. His work has been published in various journals, including the Journal of the American Geriatrics Society; OMEGA: Journal of Death & Dying, Death Studies, The Gerontologist, The American Family Physician, Social Work in Health Care, Journal of Gerontological Social Work, Accident Prevention & Analysis, Educational Gerontology: An International Journal, and Alzheimer's Disease & Associated Disorders.
||Missouri Department of Transportation (MoDOT)