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Older Drivers Pose Greater Risks?

The deadly incident in California Wednesday involving an elderly driver losing control of his vehicle raises the difficult question of how to determine when a person is too old to drive.

Geriatric medicine specialist Dr. Robert Wang visited The Early Show Friday with tips to determine whether an older person's ability to drive has been compromised. He discussed the difficulties involved in addressing the problem.

By the year 2030, the National Institute on Aging estimates, 25 percent of all drivers will be older than 65, and the Insurance Institute for Highway Safety says that 25 percent of all fatal traffic crashes will involve drivers 65 or older by that same year.

Wang says traffic safety is important for seniors themselves as well as others because studies have shown when older drivers do get into accidents, they are more easily hurt and less likely to survive their injuries. Road accidents are leading cause of injury-related deaths in the population over 65. The fatality rate for drivers over 85 is nine times higher than the rate for drivers 25-69 years old.

Wang explains that problems with vision, perception, hearing, joint mobility, response time, dementia and motor skills increase with age. These factors all may cause driving problems.

Diabetes can numb the legs and feet, making it difficult to know if you're braking or accelerating properly, he says. Also, arthritis can hamper turns and traffic checks. Seniors may have trouble judging spatial relations and juggling more than one task.

Wang says the issue of road-testing seniors differently from other age groups is very controversial. Many states do have age-based rules such as requiring those older than 65 or 70 to renew licenses in person, renew them more often or pass road and vision tests.

Laws typically require a minimum vision requirement for a driver's license and some states impose behind-the-wheel testing if doctors or others report concerns about a driver's physical or mental limitations. If necessary, restrictions can be placed on people's licenses. The restrictions include measures such as annual testing, limiting driving to daylight hours or in-town driving only.

The American Medical Association (AMA) says help can come for seniors in many forms, some of which may increase the ability to drive if problems can be isolated. Reviewing tips for driving safely and brushing up on the rules of the road can also help. Wang says a senior can identify problems in a self-examination by asking questions such as:

  • Do I have trouble turning the steering wheel or trouble looking over the shoulder when backing up?
  • Do I avoid driving at night?
  • Do other drivers honk at me?
  • Do other drivers drive too fast or do other cars appear out of nowhere?
  • Do I have trouble seeing signs in time to respond?

    Wang says family and friends are very important in spotting a senior's driving problems, and can help arrange alternate transportation or convince a reluctant parent or other relative to give up the car keys. Family members can watch out for signs of driving impairment by being vigilant for signs that their loved one is experiencing problems in the areas of perception, reaction time and decision-making.

    Wang suggests family members ask themselves the following questions about elderly relatives:

  • Do they forget to buckle up?"
  • Do they fail to obey lights and signs?
  • Do they drive too slowly or too fast?"
  • Do they get lost often, even on familiar roads?
  • Do they stop at green lights?"
  • Do they fail to stay in their lane?"

    Any of these questions answered with a yes may be warning signs. But, Wang says, even normal driving may disguise problems that won't surface until an emergency arises.

    Losing the ability to drive can be a traumatic experience and knowing when it's time to quit can be difficult. It can be a very emotional and divisive issue. Having a car and a car key represents independence. People often become angry when they cannot renew their licenses or remove restrictions. It's difficult to legislate because of discrimination issues. Seniors have widely differing driving abilities, and bad drivers come in all ages.

    The AMA advises concerned family members to talk to their driving-impaired loved ones, bring up concerns (but never in the car), explain their concern with examples, help make plans for transportation, make a formal agreement about driving, encourage a doctor visit and encourage a driving test or seeing a driver rehab specialist.

    Doctors play an important role in the safe mobility of their older patients, says Wang. And the AMA is encouraging physicians to make driver safety a routine part of their geriatric medical services.

    The AMA plans to issue guidelines in July that will help physicians know when their older patients have become risky drivers. The idea is not just to persuade these drivers to get off the road, but to get them help and training so they can continue to drive safely if possible.

    The AMA will also offer training for doctors in determining medical fitness to drive. Another government-sponsored program will train rehabilitation specialists to screen older drivers and help sharpen their skills or persuade them to quit.