Driving Safety for Seniors
Are you worried about an older family member who's still driving?
When you see an older person behind the wheel, what is your reaction? Are you happy they can still get around? Or concerned for them and everyone else on the road? It’s a big question. For example, there are more than 5.5 million drivers over the age of 55 in California, and more than 2.5 million are 70 or older.
The topic of older adult driver safety has raised the attention of organizations such as the National Highway Traffic Safety Administration and the American Medical Association. Concerned parties are asking questions such as, "At what age should a person stop driving? At what age should the Department of Motor Vehicles (DMV) re-test an older driver?"
Questions lead to debates and position statements by national senior organizations. For instance, AARP says "It's not age, it's ability!" It's true, chronological age does not indicate a person's functional abilities, including driving skills. People experience the signs and symptoms of aging at different rates and in different ways.
The situation becomes more personal when a wife is worried because her husband was recently rear-ended by another vehicle. Or a son discovers several scrapes and dents on his mother's car. Concern is heightened by news stories of a senior parked in front of a store, failing to put the car in reverse, and crashing through a plate-glass window. Even worse are the stories of fatalities when an older driver becomes confused and accelerates in a crowded public area.
Older driver perspective
For most people, driving seems necessary for normal life. When an older driver becomes concerned about "not being able to drive any longer", their concern is not just about transportation, but about a loss of autonomy, independence, social connections, and life-time roles.
Many seniors still work part-time or as community volunteers. Others have a major family role, such as caring for grandchildren, and providing after-school pick-up and transportation to activities.
Many older drivers are the "designated driver" for a peer group -- "I'm the one who drives my three friends to our local service-club lunch meetings and YMCA fitness program."
Many people expect their senior years will involve lots of travel, including long-distance leisure driving, and even piloting RVs and motor homes.
Almost everyone has a lifestyle in which driving is fundamental, and being "stuck" is a scary thought. Even so, many seniors are aware that driving limitations are on the horizon. When older drivers contact driving safety programs, they have these concerns:
- They have had one or more minor driving accidents and are worried about driving skills
- They question how much longer they will be able to drive, and wonder when to move to a senior community that provides transportation
- They are concerned that a driver's license won't be renewed following serious illness and/or surgery, and want to learn more
- They want to keep helping driving family and friends, but is it safe?
Driving programs for older adults
There are resources to help seniors continue to drive, safely. For instance, San Diego's Sharp HealthCare offers the Sharp Rehabilitation Adaptive Driving Program (SRADP), which has been helping adult drivers since the 1970s. The oldest driver referred to the program was 92 years old. SRADP provides evaluation, behind-the-wheel training, and recommendations for adaptive driving equipment and vehicles to help a driver stay mobile. For other parts of California and in other states, call your local DMV or AAA office, or ask your healthcare provider for programs near you.
The Sharp Rehabilitation Adaptive Driving Program offers:
- Telephone consultation with driving program staff before evaluation. This may include counseling for family members, information on DMV procedures, and consultation with physicians.
- Evaluation by two driving program staff members, an occupational therapist clinical evaluator, and a California licensed driving instructor who is trained in occupational or physical therapy.
- Driving evaluation is typically three and a half hours, including:
Tests before driving for vision, visual-perceptual skills, eye-hand coordination, thinking and memory, arm and leg strength, coordination, and reaction time.
- Behind-the-wheel evaluation using a training car which has an additional driving instructor safety brake and accelerator. The vehicle is equipped with adaptive equipment for drivers with physical limitations, such as a left-foot accelerator and hand controls.
- During the evaluation, the driving instructor in the passenger seat provides feedback on driving skills, while the clinical evaluator in the back seat watches for good and bad driving skills and behavior. The evaluation includes a standardized route that requires driving skills known to challenge older drivers, including situations with higher risk of accidents, such as turning left at intersections that don't have stop signs or traffic lights.
Driver training for seniors
Older drivers and anyone with cognitive deficits can benefit from professional, behind-the-wheel driver training to improve defensive driving skills.
Drivers with visual limitations might need training with adaptive driving equipment. For instance, a stroke can lead to visual field loss, where vision narrows and it is difficult to notice what's happening to the sides. This may be helped by learning compensatory strategies, or by using wide-angle, panoramic mirrors. A driver who has lost strength and coordination of the right leg can be trained to drive using a left-foot accelerator. A driver who has lost the function of both legs can learn to drive with a hand control for brake/acceleration and a one-hand steering aide.
An older driver does best in a personal car on familiar roads to local destinations. Driving program personnel know it might not be fair to evaluate a driver who is worried or nervous about driving a different vehicle in an unfamiliar area. Therefore, it can be helpful to do a short-series of behind-the-wheel lessons in the driver's own vehicle and neighborhood. After this custom training, the driving program staff and physician review progress with the driver and provide an objective opinion.
Ask the doctor
The experts at Sharp Rehabilitation Adaptive Driving Program suggest discussing "driving" with a physician. Drivers should tell their doctors, "My goal is to drive as long as possible," and ask, "What do I need to do medically to stay on the road as a safe driver?" Show the doctor a list of all medications, both prescription and non-prescription, in case they might affect driving. People who see several medical specialists, and take a number of medications, can unknowingly encounter interactions or side-effects of medications, such as drowsiness, decreased attention, or difficulty concentrating. Drivers of all ages should see an eye doctor regularly, too.
Check out your options
Whether living in Southern California, or another part of the U.S., chances are there are senior driving programs to take advantage of. It's better to prepare ahead of time for safety, than to wait for something unfortunate to happen first.
National Highway Traffic Safety Administration
California Department of Motor Vehicles
American Occupational Therapy Association
Car Fit -- 12-point check list to ensure senior drivers are sitting properly in their own vehicle and that seat, seat belt, mirrors, steering wheel, head rest, gas/brake pedals, and other controls are positioned properly.
American Automobile Association AAA
Association for Driver Rehabilitation Specialists
Senior Drivers Organization
AARP American Association for Retired Persons
Driver Safety Program
Sharp Rehabilitation Adaptive Driving Program
Sharp Rehabilitation Center is part of Sharp Memorial Hospital, Sharp HealthCare
Patient Representation Driving Program Lisa Wyatt 858-939-6942