Senior Driver Safety and Elderly Resources
Last Updated: April 4, 2013
After she pondered the fact that she learned how to drive as a
teenager, 72-year-old Marjorie Butler Norrie signed up for the AARP
Driver Safety Program refresher course.
"We think that we're driving like we used to drive, but [I
learned] our reactions have slowed down so much, not realizing that
we don't react as well as we used to," says Butler Norrie, who
resides in Wenatchee, Wash.
In the class, Butler Norrie learned about senior driver safety
and age-related changes that can affect her driving abilities.
Perhaps these shifts are why she had already begun to limit her
driving. She rarely travels on big city freeways, and she didn't
drive for a month last winter, saying snowy conditions kept her off
This self-restriction and self-assessment are common and healthy
practices for older drivers. Examining your own driving proficiency
can keep you safe. After age 75, the risk of being in a collision
increases for every mile a person drives, according to the
Insurance Institute for Highway Safety. Statistically, this age
group falls just below teenagers for the number of fatal crashes.
Although this ominous fact is linked to an older person's ability
to endure injury, older drivers-and their loved ones-need to pay
attention to driving skills and make the appropriate adjustments,
whether that means adapting their driving habits or hanging up
their car keys for good.
|A Self-Assessment Tool
The AAA Roadwise Review, available on CD-ROM from AAA.com,
measures functional abilities shown to be the strongest predictors
of crash risk among older drivers:
- Leg strength and general mobility
- Head/neck flexibility
- High- and low-contrast visual acuity
- Working memory
- Visualization of missing information
- Visual search
- Useful field of view
As people age, the following can affect their driving abilities
and impact senior driver safety:
- Vision and
hearing loss: Vision declines with age due to physiologic
changes and to diseases such as glaucoma. Regular hearing check-ups
are imperative, since safe driving means hearing emergency sirens,
honking, and sounds such as bells at railroad crossing.
- Cognition: When you drive, you need to integrate several skills
at the same time, including memory, visual processing, and
attention. Both our speed of processing and judgment can become
impaired, jeopardizing driving skills.
- Motor function: As people age, their joints become stiffer,
muscles weaken and flexibility lessens. Turning your head to view
traffic, using the steering wheel, and operating the gas and brake
pedals can become more difficult.
- Medications: Certain medications can reduce driving skills,
including antihistamines, sleep aids, and medications for
depression, diabetes, and pain reduction. Always ask your doctor
medications will affect your driving.
- Medical conditions that can hamper driving abilities include:
Alzheimer's disease, dementia and memory disorders, diabetes,
head trauma, high- or low-blood pressure,
multiple sclerosis, nervous system disorders, Parkinson's
disease, severe arthritis, severe
elderly depression, sleep disorders, stroke effects, surgery
after effects, thyroid disease, and the use of medical devices
including automatic defibrillators and pacemakers.
But age also reaps experience. "Older drivers have wisdom that
may make them much better drivers. Teenagers don't have years of
driving behind them," says Lissa Kapust, the Clinical Coordinator
of DriveWise, a driving fitness evaluation program at Boston's Beth
Israel Deaconess Medical Center. "Older drivers who do
self-monitoring-if they are tired or the weather is bad-this can be
a critical factor in maintaining safety."
Taking a class is a good way to assess your own skills and stay
safe on the road. Elderly resources like the AARP Driver Safety
Program refresher course is the first and largest course created
for adults 50 and older. The 8-hour low-cost course is usually
taught in two four-hour sessions, or people can complete an online
course in a 30-day timeframe (call toll-free at (888) 227-7669).
Upon completion, most auto insurance companies provide a discount.
"We assess our health from time to time; we should assess our
driving from time to time and make adjustments based on our
assessment of our own driving," says Brian Greenberg, Coordinator
for the AARP Driver Safety Program. "Just think of it as a driver
The class looks at 15 warning signals that might mean a person
should limit or stop driving. According to Greenberg, the following
five warning signs
signal the need for a formal driving assessment:
- Frequent dents or scrapes on the car or on fences, garage
doors, curbs, etc.
- More traffic tickets or warnings in the last year or two
- Having crashes, minor accidents, or almost crashing
- Trouble paying attention to or missing signals, road signs, and
- Difficulty staying in the lane of travel or changing lanes
Professional assessments: Elderly resources for drivers
Perhaps you have noticed a loved one's deteriorating driving
abilities, but she denies any problem during conversations. An
independent, objective evaluation can both judge driving competence
and give a voice of authority to a decision. Completed at
rehabilitation centers, hospitals, and Veterans Administration
Medical Centers, these tests are usually administered by
occupational therapists or driver rehabilitation specialists.
Because medical providers realize they can test a patient's hearing
and vision but cannot judge his driving skills, your loved one's
doctor may be able and willing to give you a referral for a senior
driver safety assessment. "It's such an important decision,
physicians don't want to err on the side of prematurely taking away
a license, and they don't want to wait until it's too late," says
Kapust. "One's license is the most important marker for self esteem
in the elderly. The loss of the license really marks the entrance
into old age."
Because people fear the end of driving, a person very rarely
comes in voluntarily to a place like DriveWise. Doctors, adult
children, community agencies, or a driving registry often refer
people, says Kapust. A social worker begins the evaluation,
discussing reasons for the referral and how the loss of driving
would affect the patient. A short neuropsychological exam is given;
an occupational therapist assesses the person's vision,
flexibility, strength, and cognition; and a road test is taken. Two
weeks later, the patient meets with the social worker to review the
After an assessment, a driver often works with an occupational
therapist that provides rehabilitation to strengthen skills used in
driving. Often the therapist helps fit the car around the person.
Devices include parabolic mirrors that yield a panoramic view;
knobs or a spinner wheel on the steering wheel; and hand controls
for the accelerator and brakes. Often people learn safe driving
rules, such as:
- Don't drive with the radio on or converse with your passengers
or use cell phones.
- Keep your car in the best shape, with tune-ups, good windshield
wipers, aligned headlights, etc.
- Always wear seatbelts.
- Drive with your headlights on.
- Make sure there is enough space between both the cars in front
of you and the car behind you.
When to hang up the keys
Sometimes an assessment means the driver is told she needs to
stop driving. Or perhaps a person has come to the decision on his
own, realizing driving is too stressful, and it's time to retire
the car keys. "Often we hear from patients and families it's a loss
that they never get over. They may have a memory loss but they
don't forget that somebody has taken away their keys," says
She points out that few people will drive until they die and
actively involving the person in the decision to stop driving
helps. People link the cessation of driving to an end of
independence, so it's important to keep people engaged in
activities they enjoy, and to emphasize that retiring from driving
is a normal part of aging.
Richard Hackel, a former DriveWise patient, made the decision to
stop driving on his own. He suffers from ALS or Lou Gehrig's
disease, and the muscles that would normally hold his left leg
straight are not functional. At age 64, he worried about
controlling the car in an emergency situation. "I want to live as
long as I can and minimize the possibility that I could cause
injury to anyone else," says Hackel, who lives in Brookline, Mass.
"That loss of independence is an adjustment that everybody has to
make, but I'd rather be alive and able to enjoy life than driving
and risk hurting myself or someone else."
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