Most of us have been driving since we were 16. That means that for all of us, but especially for older people who have been driving for 40, 50, even 60 years, just thinking about giving up the car keys can make us break us out in a panicky sweat. That's because giving up the car keys means more than just the loss of transportation, explained Dr. Barbara Messinger-Rapport, a geriatric specialist at Cleveland Clinic Foundation and assistant professor at Case Western Reserve University. It means loss of independence, loss of the major link to family and friends, and loss of the ability to carry out the everyday activities-grocery shopping, getting to/from church or synagogue, visiting the doctor or the grandkids, etc.-that make for a full, rich life.
Age is not the problem
Since people's bodies don't age at the same rate, chronological age is the least valid criterion to use to make a decision about whether someone should or shouldn't be driving. There are other "clues," however, that do point people in the right decision-making direction.
A very important indicator of whether people should or shouldn't be driving is physical health status, said both Dr. Messinger-Rapport and Dennis Burke, executive director of Ohio Motorist's Safety Foundation. Declining muscle and grip strength, decreased reaction time (due to a number of things, including arthritis), declining vision, hearing loss, and increased use of prescription and over-the-counter medications-which can cause drowsiness and slow reaction time-all impact ability to drive safely.
Another criterion: Problems-difficulty changing lanes or merging into highway traffic, straddling lanes or driving on the berm, missing or ignoring traffic or stop signs, getting lost or becoming fatigued (due to stress) while driving, difficulty maneuvering the car into and out of the garage or tight parking spaces, increasing numbers of dents and dings-"that indicate that there are visual, flexibility, and [car] maneuvering problems," said Burke.
Yet another: "Serious stuff, such as two or more collisions or two or more tickets for moving violations in the same year. That's a real wake-up call," Burke said.
So, said Dr. Messinger-Rapport, is the person's cognitive status. "The people who are at the most risk for adverse driving events are those who appear healthy but who have cognitive deficits.that prevent them from appreciating their lack of safety behind the wheel."
Pro-active Road Warriors
Most older adults are still driving and-with the exception of those over 85, who have the worst driving record of all drivers-they are driving as safely as those 20 and 30 years their junior.
That's because, said Mr. Burke, they have tackled the to-drive-or-not-to-drive problem pro-actively.
Some, said Dr. Messinger-Rapport, have had their driving skills assessed with an occupational therapist who is trained and licensed in driver rehabilitation. "They [occupational therapists] don't just suggest changes in driving habits or adaptive devices.[they] train the person in how to do them or use them," she said.
Others have done self-assessments and, based on their findings, have modified their driving habits to take advantage of their strengths. "They drive only in good weather and during daylight hours, avoid rush-hour traffic, travel short distances, and get very specific directions-sometimes even a map-if they are going someplace unfamiliar," explained licensed social worker Semanthie Brooks, director of clinical operations at Benjamin Rose.
A huge number of older drivers have also participated in the Safe Driver Program (formerly the 55 Alive Program) offered by AARP. "It's a classroom-based refresher course that focuses on things like how to do a driving self-assessment, older peoples' vision and hearing changes, and how to change driving habits," explained Louise Feld, who coordinates the program in the Cleveland area.
"The average age of the people attending a course is 70," she added, "and the reason it's so successful-besides the fact that you get a discount on your insurance* if you complete the program-is that it's taught by peers, people who have experienced the same things the people taking the course are going through."
Eileen Beal, MA, is a freelance healthcare writer specializing in geriatric issues. Successful Aging is a sservice provided by Benjamin Rose (www.benrose.org), a nonprofit social service agency for older adults.
Sources and Resources for information on senior driver programs: (websites have been verified)
AAA's Foundation for Traffic Safety/Senior Drivers (factsheets, tipsheets, self-assessment quiz)
AARP's Safe Driver Program
www.aarp.org/55alive or 888-227-7669
Family Caregiver Alliance (factsheets)
www.caregiver.org/factsheet.html or 800-445-8106
Insurance Information Institute (factsheets)
Lighthouse International's "Vision Changes and the Aging Driver: A range of issues"
National Highway Traffic Safety Administration's "Driving Safely While Aging Gracefully"