Is Your Elder Driving Safely?

Diane Carbo

When should you take steps to encourage a senior to stop driving?

Posted April 26, 2010

By Diane Carbo

Remember when you couldn’t wait until you were old enough to drive? Getting a driver’s license gave us an opportunity to experience a new freedom we did not have before. For those of us with two parents working, driving meant taking ourselves and our siblings to after-school activities and work. Driving took us to a level of independence that we had not experienced before. In an aging society of drivers, those very same feelings exist in many today. Driving gives us a sense of independence and freedom, the ability to go out and socialize, go to work or to church. Safety issues are a concern as many move into the golden years. The life expectancy of seniors is increasing. There are more active senior citizens out on the road today than ever before. Since we all age differently, many aging adults can drive into their seventies and eighties. As we age, the risk for having a serious car accident that requires hospitalization rises. Statistics show that fatal car accidents rise after the age of seventy.

If you know an aging adult driver who is experiencing difficulty with driving, it is important to carefully monitor the situation. This article can help you determine whether you should take steps to encourage the senior to stop driving.

An aging society and risk

Some key risk factors that affect our aging society are:

• Vision declines, affecting depth perception and the ability to judge the speed of oncoming traffic. Night vision becomes a problem as our eyes lose the ability to process light. By age 60, you need three times the amount of light that you did at age 20 in order to drive safely after nightfall. We also become more sensitive to bright light and glare. Signs and road markings can be difficult to see.

• With age, flexibility may decrease as response time increases. A full range of motion is crucial on the road. Turning your head both ways to see oncoming traffic, moving both hands and feet can be difficult for those with chronic conditions such a rheumatoid arthritis, or Parkinson’s disease, heart disease and diabetes.

• Older adults in an aging society will often need to begin to take medications. Certain medications, as well as a combination of medications and alcohol, can increase driving risk. Be aware and careful about medication side-effects and interactions between medications. It is important to talk to your pharmacist to be aware of interactions that could affect your driving safely. Some medications cause drowsiness.

• Aging affects our quality of sleep, resulting in daytime sleepiness. Falling asleep at the wheel is a major concern for those that doze off during the day.

• The beginning of dementia or mental impairment can make driving more dangerous. A decreased mental capacity or decreased tolerance to stressful driving situations such as complex and confusing intersections may cause delayed reactions to sudden or confusing situations on the road. Aging brains and bodies don’t have the same response times as younger ones.

Look for warning signs

There are multiple warning signs that an aging adult is becoming, or already is, an unsafe driver. Some of them are small; but if there are multiple concerns, it may be time to talk about your concerns with the aging driver. Warning signs of an unsafe driver include:

• Abrupt lane changes, braking, or acceleration.
• Increase in the dents and scrapes on the car or on fences, mailboxes, garage doors, curbs, etc.
• Trouble reading signs or navigating directions to get somewhere.
• Range-of-motion issues (looking over the shoulder, moving the hands or feet, etc.).
• Becoming anxious or fearful while driving, or feeling exhausted after driving.
• Experiencing more conflict on the road: other drivers honking; frustration or anger at other drivers. Oblivious to the frustration of other drivers towards them.
• Getting lost more often.
• Trouble paying attention to signals, road signs, pavement markings, or pedestrians.
• Slow reaction to changes in the driving environment.
• Increased traffic tickets or “warnings” by traffic or law enforcement officers.
• Forgetting to put on a safety belt.

If you are concerned about an aging adult driver, closely monitor their driving before deciding whether they need a refresher coarse on their driving skills, or approaching them to give up their driver’s license altogether. Ongoing and open communication is important to addressing the issue of driving. Studies conducted by Harvard and MIT show that while most drivers preferred to discuss the issue with their spouse, doctor, or adult children (in that order), this is not the case for everyone. The right person may not necessarily be the most forceful or outspoken one, but rather someone whose judgment and empathy are especially trusted by the driver.

Talk with other family members, your doctor, and close friends to determine the best person for “the conversation.” Remember: to active senior citizens, driving signifies independence, freedom, and self-sufficiency. Realize you may meet with resistance, and the aging driver may become defensive. Emotion may get in the way of a rational conversation. Express your concerns and give specific reasons for those concerns. The goal is to get the aging driver be part of the decision-making process.

You may begin by asking your loved one to make some concessions because of your concerns.

• Taking a driver refresher course.
• Not driving at night.
• Suggest they not drive on busy thoroughfares or during rush hour.
• Taking shorter trips.
• Not driving under adverse weather conditions.

Encourage a visit to their primary care physician or pharmacist to go over medications that may affect driving skills. Your physician may be able to recommend a Driver Rehabilitation Specialist. This individual can assess driving safety by an office exam and driving test, and make recommendations regarding special equipment or techniques that can improve the driver’s safety. Consider ways to decrease the need to drive. Check out alternatives to shopping by car, including:

• Arrange for home deliveries of groceries and other goods, and try to arrange for home visits by clergy, medical and personal care providers, and government service providers.
• Use financial services that don’t require bank visits, like automatic bill paying, direct deposit, and bank-by-phone or online banking services.

Fears of those living in an aging society

Fear of isolation and decrease in socializing is a real concern for the aging driver. It is important to keep spirits high as the aging driver makes the adjustments to becoming a non-driver. Be in tune to their need for fun, volunteering, work and religious activities. Create a transportation plan that can make it easier for the aging driver to give up driving. You can create a list of friends and family that are willing to drive, or contact the church and the local Area Agency on Aging in regards to transportation programs in the area.

Some seniors may adjust better if they can keep their own car, but have others drive them. Being in their own car may make them feel more comfortable and familiar, and the sense of loss from not driving may be lessened. Remember, baby boomers have grown up walking out the door and being able to go where they want to go.

Diane Carbo, RN has over 35 years’ experience in a variety of nursing settings, including orthopedics/rehabilitation nursing, home care, discharge planning, case management, oncology, hospice, senior behavior health, assisted living, and long term care. Her passion is to help people plan for long-term care needs, and to that end started AgingHomeHealthCare.com. Her goal is to assist aging seniors and their families to develop plans that allow individuals to remain home, safely and comfortably, in the least restrictive environment, regardless of age, income or ability level.