Most of us do not give a second thought about the mechanics of driving. We have been doing it since our teens, and while we may no longer remember stopping distances measured in feet, we know from experience how much space we need in front of us to safely stop our vehicle. (The exceptions to this are “aggressive drivers,” who ignore safety practices in their desire to get ahead.) As we get older we understand that there may come a day when we will no longer be able to drive, but few of us look forward to handing over the keys of not only our car, but our independence as well. It seems like every year we hear on the news about some older driver involved in a tragic accident where pedestrians were injured or killed. These reports inevitably bring up questions about the safety of older drivers, so let’s look at that issue.
What does the research tell us? The CDC (Center for Disease Control) reported in 2008 that more than 5,500 older adults were killed and more than 183,000 injured in motor vehicle accidents. While these are large numbers, they need to be put into the context of the total number of older drivers. The CDC stated that in approximate same time period (2009) there were 33 million licensed older drivers. This means that the percentage of those injured or killed is very small. In another study the AAA (American Automobile Association) followed crash rates for a fifteen year period (1995 – 2010). The AAA found that the mileage-based crash rates for drivers in their 70’s was the same as drivers in their 30’s, and for drivers in their 80’s the mileage-based crash rate was the same as drivers in their 20’s. Does this mean that there is no cause for concern about older drivers? Not necessarily. The CDC also reported that the incidence of injury and death increases with the driver’s age. Furthermore, the physical changes that occur as people age, such as decreased reaction time, visual acuity, and medical issues like arthritis, all make driving more difficult. The AAA lists two key warning signs of when some type of intervention may be needed: having 2 or more traffic tickets or warnings in a two-year period, or having two or more collisions or near misses in a two-year period.
Resources for older drivers: Fortunately, there are resources for older drivers that can help ensure safety behind the wheel. Space does not allow for an exhaustive list, but one of these resources is the AARP Driver Safety Course. There is a charge for the course, but satisfactory completion may help get a discount on auto insurance. By going to their website, www.aarpdriversafety.org, you can find locations and times the course is being offered. There is also an option to take the course on-line. Another resource is provided on the AAA website, www.seniordriving.aaa.com. It is well worthwhile exploring the tips and suggestions they list. Certified Driver Rehabilitation Specialists can provide a professional assessment of someone’s driving ability and make suggestions that will increase that person’s safety behind the wheel. There are two organizations that certify these specialists. By going to their websites you can locate a specialist who works in your area. These are www.aota.org/olderdriver and www.aded.net. If these resources are used in a timely manner, older drivers may be able to safely extend their driving days.
What about dementia? Dementia in an older driver, especially as it progresses, is a real concern because the impaired cognition it causes can result in the driver failing to recognize and follow traffic signs and signals. An individual with dementia can become disoriented and lost, even on a familiar route. To further complicate the problem, because of the cognitive impairment, it is usually futile to try to reason with the individual about giving up driving. However, the first thing which should be done when dementia is an issue is to get that individual to his or her physician for a thorough medical evaluation. There are some causes of dementia, such as a urinary tract infection, that are reversible, and when the underlying condition is treated, the dementia goes away. The second reason for getting the individual to his or her physician is that, if the dementia is irreversible as in the case of Alzheimer’s disease, the physician has an obligation to report to PennDOT any medical condition which impairs a person’s ability to operate a motor vehicle. Based upon the medical evidence, PennDOT can either require the driver to undergo further testing or it can revoke the person’s driving privileges. Unfortunately, due to the impaired cognition and impaired memory that comes with dementia, the solutions to keeping that person from driving will likely involve one of the following: taking the keys away, replacing the keys with keys from a different vehicle so the car cannot be started, disabling the car so it cannot be started, or removing the car altogether. None of these options are likely to be accepted without protest from the older driver with dementia, but they may be the only way to keep that person from driving.
What do I do when I can no longer drive? Fortunately there are resources to help people who no longer drive get to get to those places they used to drive to themselves. The Cumberland County Transportation Department (CCTD) helps many older people get to appointments at little or no cost. They can be reached at 717-240-6340 or through the county’s website, www.ccpa.net (click on “Government,” then “Health & Human Services,” and then “Transportation”). In addition to the county transportation, some churches and civic organizations help seniors with transportation. Many agencies that provide private-duty care will also provide transportation. Of course there are taxis and, in some areas, public bus service. Some people rely on a network of friends and family. For many people it is through a combination of these resources that they manage without driving.
While it may seem as though driving is a “right,” Pennsylvania makes it very clear that it is a “privilege.” Safe driving is possible for most older drivers, but If we do not want to lose that privilege, we need to make sure that we, as well as our family members, utilize the available resources to remain safe drivers as we age.
John W. Reese, M. S., CDP
Elder Care Coordinator