Driving and Independence

A new study found that older adults who are able to continue driving safely are less likely to enter long-term care than those who have given up driving or who have never driven. The study included 1,593 older adults, ages 65 to 84, and was conducted over a 10-year period. While driving itself did not produce this effect, the independence driving represents enables older adults to delay entry into a long-term care community. Non-drivers were four times more likely to enter long-term care than drivers, and the risk doubled for non-drivers without any other drivers in the home. Although the slower driving habits of some seniors often steam impatient younger motorists, researchers at Johns Hopkins School of Medicine have found that elders who stay behind the wheel are less likely to enter nursing homes or assisted living centers than those who have never driven or who have given up driving altogether. “We are not recommending continuation of driving for seniors who are a threat to themselves or others on the road,” said the study’s lead author. “Instead, we hope that understanding the very real health impact that losing the ability to drive has on seniors will encourage families to plan contingencies to assist elderly members with transportation issues.” The researchers also pointed out that losing the ability to drive poses an especially significant hardship to seniors living in isolated rural areas or any place without good, accessible public transportation for the elderly. “We set out to learn whether or not the loss of driving ability played a measurable role in an older person’s eventual need for long-term care,” according to John Hopkins School of Medicine. “The independence that accompanies a driver’s license and car has long been linked anecdotally to a better quality of life for seniors.” This probably isn’t so much about the process of driving but rather the larger issue of mobility as it relates to a person’s independence. When someone becomes a shut-in due to the loss of their primary transportation, the likelihood that they will require living assistance categorically increases. Non-drivers across the entire age group studied had four times the risk of long-term care entry compared to drivers, and the absence of other drivers in the home doubled the risk of entering long-term care. Nine percent of those studied entered long-term care for three months or more. By the end of the study, 29 percent of men and 58 percent of women had no other drivers in the household, and 22 percent of people who were driving at the beginning of the study reported that they stopped driving during the study. These findings point to the importance of research into how to keep seniors driving and independent as long as is safely possible.

Mobility and Gardening

This week I am combining suggestions for people with limited mobility and/or vision impairment and one of my favorite hobbies – gardening! The timing for this topic is fitting – with the official start of summer this week. When you think about moving around in your yard, do you think how limited mobility can make it difficult to enjoy your garden? Do you have physical impairments or does someone with physical limitations live in your house or visit frequently? Another factor that may be keeping you from enjoying your garden may be problems with vision or hearing. Even minor sensory problems multiply problems of movement, as do problems of balance in such disorders as inner-ear disturbances or diabetes. Don’t focus on being able to pronounce the next word, just work on understanding its meaning. Proprioception is the technical name for the collection of senses and brain functions that tell you where you are spatially at any given moment. Certain conditions can damage or destroy the nerves of proprioception in the legs and feet, so that a person has to rely on visual orientation only. A person who has problems with proprioception is likely to sway or wobble especially in bad light. Enjoying a garden means different things to different people. Some want just to look to take in the beauty and some want to dig in the dirt. The best way to make gardening easier is to move the plants closer to the gardener by constructing raised beds. There are two measurements to consider – height and width. Two feet is a good height. Topping the retaining wall with a foot wide (or wider) stone or concrete seat offers a convenient place to sit or lean, or to keep tools handy. The bed should also be no wider than is convenient for you to reach; perhaps 2-3 feet wide if it’s only accessible from one side or 3-4 feet wide if it’s accessible from both sides. Rounded corners eliminate sharp edges. Another way to bring the plants closer to the gardener is to plant in containers. Plants grown in pots generally need to be watered more often than plants grown in the ground, so make sure there’s a faucet or other water source convenient to where the pots will be set. Select low maintenance plants that do not need frequent deadheading or complicated pruning. Many plants are identified as “low maintenance” at the nursery. Easy to handle tools are also available to make your gardening easier. Look for tools with long handles, which increases your reach, and those with cushioned or oversized grips, which are more comfortable to handle. Make sure the tools you select aren’t too heavy, since it can be awkward to use. For even slightly limited mobility, transitions can be tricky. Some front walks are too narrow to accommodate a quad cane or walker and the uneven grass strip can be treacherous. A person with a leg brace, or even a cane, needs a hard surface that is wide enough to walk in a straight line, with additional space for changing or reversing direction. A 4-foot walk that’s ample for the agile is tight for someone with a cane walking alone. Consider a 6-foot minimum for high use walks, so a helper can walk on the same surface, if necessary. Steps and sloped paths should have graspable railings or other firm handholds at crucial spots. Make sure the steps and stairs are well lighted. Make sure the light source is well above or below eye level. Blinding lights can be hazardous, because as one gets older, your eye’s response to changes in light slows with age. There are 10 million blind and visually impaired people in the United States. 5.5 million people over the age of 65 are blind or visually impaired. Gardening may seem like an activity for only the sighted, but it doesn’t have to be. Gardens can be a haven of sound, fragrance and textures. According to American Foundation for the Blind, by continuing to garden, people who have experienced vision loss gain self-confidence and that self-confidence bleeds over to other areas of their life. If you continue to garden, you set aside limitations set upon yourself. Longtime advocate for those with disabilities say that growing plants provides inspiration and that vision loss is simply not enough reason to hang up the watering can and trowel. Some safety tips for people with visual limitations include: Clear plants hanging over paths Carefully coil hoses and store them out of the way Use labels or tags with large, readable letters or Braille or colored stakes to identify different plants Use tools with bright colors to make them easier to find Use an apron or tool belt to store tools while in the garden Avoid spraying pesticides Avoid thorny plants Making the garden lower maintenance in general can help the vision impaired gardener say independent. Simple enjoyment is a good reason for making your garden accessible for those with limitations. Even if you don’t want to or can’t completely re-landscape your garden, you should be able to make a least some of your outdoor space easily accessible to someone who has trouble walking, bending or kneeling.