Deciding when to stop driving is one of the most difficult decisions that seniors have to make. Driving is a profound quality of life issue- really the ultimate form of independence. Unfortunately, many of the cities and urban areas in this country fail to provide adequate public transportation—let alone transportation that seniors are able to access. When seniors are forced to give up driving, the result is people literally becoming prisoners in their own homes unless they have adequate family / neighbor sup port.. Getting to and from grocery stores and doctor appointments can be challenging at best. Maintaining any kind of social life with friends and peers becomes nearly impossible.

Many seniors argue that they have better driving records than younger drivers. It is true that older drivers have fewer accidents. Drivers age 55 and older are 25% of the driving population, yet they only have 18% of accidents. But this is because they drive fewer miles. If accidents for miles driven are considered, we get a different picture. For example, people over 75 have accident rates per mile equal to or greater than rates for teenagers (the most dangerous drivers). At about 85 years of age, the rate starts to skyrocket.

What are some of the warning signs that a driver is getting to be unsafe? 

• Moving too slowly on the highway
• Failing to come to a full stop at stop signs
• Being inattentive
• Making erratic moves
• Reacting too slowly
• Being honked at by other drivers
• Missing traffic signals or signs or being uncertain of what they mean
• Getting anxious at busy intersections, being unsure what to do or being afraid to drive
• Upsetting your passengers to the extent that they start refusing to get in the car

There are many common factors / pathologies that can affect an elderly person’s ability to drive. These may include:

• Vision changes (macular degeneration, glaucoma, cataract, depth perception changes, visual field perception
• Hearing deficits
• Memory loss
• Arthritis (limited range of motion, pain)
• Diabetes (can have sensory deficits in feet and hands, fluctuating blood sugars can lead to loss of consciousness or altered mentation)
• Medications ( can induce drowsiness, blood pressure changes, etc.)
• Stroke (paralysis or delayed reflex on one side)
• Parkinson’s disease (reduced range of motion and reflex time)
• Cardiac Arrythmias (irregular heart beats can result in momentary loss of consciousness)

Any of the above mentioned conditions can render an elderly driver extremely unsafe. So what is the answer?

First of all check with the doctor. Just because you or your loved one have some of the listed medical risk factors doesn’t mean the the keys have to be given up. If the medical conditions are stabilized and well managed, older drivers can compensate and still be safe on the road.

Consider a referral to a driving evaluation specialist. These driving specialists are usually trained medical professionals (often occupational therapists) who are skilled in working with physically impaired individuals. The driving evaluation done by such a specialist will be quite extensive at measuring and quantifying the conditions under which a driver is safe or unsafe driving. For example, many times older drivers are safe to drive in familiar places and under good driving conditions (good weather, low traffic, easy parking, etc.), but extremely unsafe in adverse conditions (rain, merging into heavy traffic, managing directions in unfamiliar places). The driving specialist can provide a quantifiable assessment of exactly what conditions a person is safe to drive in. They can also clearly show when that same driver is unsafe. The specialist can also help by recommending equipment that can improve safety (i.e. special mirrors, steering wheel adaptors for arthritic or one handed drivers, alarms to warn when the driver is backing up, etc.). There are many advantages to having this assessment done. First of all, it is fair and objective. This can take the volatility out of an emotionally charged issue. Second, it can provide excellent alternatives to what seems to be an all or nothing situation. Most seniors appreciate the objective information and take it to heart. If a driver is found to be completely unsafe, the driving evaluator is required to report this to the Division of Motor Vehicles (DMV)  and this usually results in suspension / revocation of the driver’s license. The driver can only get the license reinstated if a subsequent retest provides different results, and the driver’s doctor verifies medical stability to drive. That same driver needs to be counseled in transportation alternatives—not just left “high and dry”.

What can you do to be a safer driver?

• Have your vision and hearing tested regularly
• Know your medications—carry a list of them with you at all times
• Stay physically fit
• Check your blood sugar levels before getting behind the wheel
• Drive under less stressful conditions (check the weather in advance, avoid rush hours, avoid driving after dark)
• Plan your route in advance (drive to your appointment the day before so you know exactly where you are going, get good directions)
• Update your vehicle (make sure all the lights are working, that the mirrors are big enough and appropriately adjusted)
• Update your driving skills (taking older driver courses offered through AARP)
• Avoid driving distractions (eating, drinking, talking on cell phone, talking to passengers, etc.)
• NEVER drink alcohol and drive (alcohol can take longer to clear the system of an elderly person)

If you have to give up driving, consider hiring a driver. Hiring a  driver that  comes on particular days and times can take care of a lot of issues. This will mean some planning on your part (i.e. scheduling appointments and activities appropriately). Many companion agencies provide non medical personnel that can assist with driving as well as errand running, grocery shopping, meal preparation, laundry services, etc. This type of help varies in cost depending on regional locations, but is usually very reasonable given what they can do. You can also make arrangements with taxi services to have the same driver available. Many taxi companies provide greatly discounted rates for frequent riders.

Research public transportation. Even though the US is very deficient  in this area overall, some areas have special services available for transporting seniors (and the disabled) for appointments. It is highly advisable to research what is available in your area. You may be surprised. Check with your church. Many church organizations have transportation options available for their congregation members.

What if an unsafe driver refuses to stop driving?

• Report the driver to the DMV
• Disable the car if necessary (taking off the distributor cap, unplugging the spark plug wires, removing the battery)
• Move the car to a secured location or sell it if possible
• Hide the keys
• Call the police whenever the driver is seen driving the car. Be sure that the local police are aware of the danger. Older people can and should be arrested for driving without a valid license. Getting arrested usually convinces the stubborn, unsafe driver to quit

For more information regarding this or other issues relevant to care-giving, contact:

Elder Advocates Incorporated| 407.898.9080 | www.elderadv.com