Older Drivers

Older Drivers--Deciding When to Give Up the Car Keys

by Sally Bowman, Ph.D. Extension family development specialist and Vicki L. Schmall, Ph.D. Extension gerontology specialist emeritus, OSU

The proportion of older drivers is increasing dramatically as older persons rely on driving more and more as their major means of transportation. While the record of older drivers is good based on the number of accidents per driver, the record is poor when based on the number of accidents per mile driven annually. The most common problems of older drivers are failure to yield right-of-way, incorrect lane changes, and improper turning, particularly left-hand turns and turning from the wrong lane.

This does NOT mean that an older driver is an unsafe driver. Age or medical condition alone are unreliable criteria for assessing driving ability. Age-related changes, however, may affect driving performance. These include decreased vision, impaired hearing, decreased ability for dual task performance, and reduced muscle strength and flexibility. Many older drivers compensate by voluntarily restricting their driving to avoid riskier conditions, such as night driving or rush hour traffic.

Some medical conditions are linked to decline in driving ability. These include strokes--especially people with right hemisphere brain damage--and dementia. Studies show that people with Alzheimer's disease are likely to rate themselves as highly capable of driving when they are not. Cognitive impairment requires regular assessment, because at some point, an individual with dementia should stop driving. Certain classes of medications can also interfere with good driving practices.

Warning signs that indicate a person's driving threatens public safety include turning from an improper lane, driving against traffic on the wrong side of the road, and backing up after missing an exit.

Studies find that immobility, isolation, and loneliness are major consequences of the decision to no longer drive. This holds true for older adults living in both rural and urban areas. Public transportation may not be available; when available, many older adults find it is unreliable, inconvenient, or distasteful. The symbolic importance of driving in an individual's life in maintaining independence and dignity is evident when you ask people to "give up the car keys." Consider the comment of one 94-year old man:

"The day the doctor told me I had to give up driving because of my poor vision was the most difficult day of my life. I felt as though my world was coming to an end. I had always been independent and took care of myself. I felt as though the doctor had just given me a life sentence in prison."

Family and friends, as well as health care professionals, play a significant role in an older person's decisions about driving. For some people, a doctor's advice is the most influential. It's important that discussions about driving are approached in a caring and supportive manner to preserve the older person's self-esteem and dignity. When a person has dementia, family members often need to take an active role in making and carrying out decisions.

The role of family, friends and others who are concerned about the driving practices of an older adult is the focus of the OSU Extension Service publication, Driving Decisions in Later Life. This publication offers strategies for assessing an older person's driving capabilities and for dealing with the dilemmas families and others face when concerned about someone's driving performance.

Preserving the independence and pride of drivers is important, but it must be balanced with the need to protect the safety of others. In addressing driving problems, it is important to remember that driving is not a right; it is a privilege.

Public policy related to driving safety includes regulations about screening, assessment, remediation, and the removal of privileges. Making driving safer for all drivers by improving traffic signs, traffic control devices, and motor vehicles are other useful strategies. The lettering, color, size, and location of traffic signs, the use of speed bumps, traffic signs at intersections to show who goes first, and wide-angle rearview mirrors on motor vehicles would improve public safety on the road for everyone.

Driving Decisions in Later Life (PNW #510, 1998) Publication Orders, Extension & Station Communications, OSU, 422 Kerr Administration, Corvallis, OR 97331-2119. FAX: 541 737-0817, Email: puborders@orst.edu. See it at http://eesc.orst.edu/agcomwebfile/edmat/PNW510.pdf.