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A Checklist for When to Put the Brakes On Elderly Drivers
Reprinted with the permission of Aging Parents and Elder Care

Are elderly drivers safe? Yes ... for the most part. The same can be said for teen drivers.

Do driving skills of elderly drivers decline with age? Yes, but just like other age groups, driving skills vary from one elderly person to another. Telling elderly drivers that it may be time to stop driving can be one of the most difficult milestones for caregivers. Driving represents freedom and independence for the elderly ... the ability to visit friends, go to the movies and shop ... without relying on anyone else.

Revoking an elderly person's drivers license over a certain age is not an acceptable solution. Elderly driving skills vary widely at all ages. It is unfair to punish most elderly drivers for problems caused by only a few drivers.

When the question of declining driving abilities becomes personal, the issues involved with elderly driving are very emotional. Elderly drivers might get defensive ... even angry ... when the subject of their driving abilities is raised. Thus, include the elderly person in the decision-making process if at all possible, rather than dictate a decision to them. It can also be very helpful if both you and your elderly loved one discuss the matter together with family members, doctors, and other people they respect, such as clergy and friends. But, despite your best efforts, you may still have to make the decision to stop for them for their own safety and the safety of other drivers and pedestrians.

How does aging affect the abilities of elderly drivers?

Safe elderly drivers require the complex coordination of many different skills. The physical and mental changes that accompany aging can diminish the abilities of elderly drivers.

These include:

::A slowdown in response time
::A loss of clarity in vision and hearing
::A loss of muscle strength and flexibility
::Drowsiness due to medications
::A reduction in the ability to focus or concentrate
::Lower tolerance for alcohol

Taken separately, none of these changes automatically means that elderly drivers should stop. But caregivers need to regularly evaluate the elderly person's driving skills to determine if they need to alter driving habits or stop driving altogether.

A checklist on safe elderly driving...

Watch for telltale signs of decline in the elderly person's driving abilities. Do they:

::Drive at inappropriate speeds, either too fast or too slow?
::Ask passengers to help check if it is clear to pass or turn?
::Respond slowly to or not notice pedestrians, bicyclists and other drivers?
::Ignore, disobey or misinterpret street signs and traffic lights?
::Fail to yield to other cars or pedestrians who have the right-of-way?
::Fail to judge distances between cars correctly?
::Become easily frustrated and angry?
::Appear drowsy, confused or frightened?
::Have one or more near accidents or near misses?
::Drift across lane markings or bump into curbs?
::Forget to turn on headlights after dusk?
::Have difficulty with glare from oncoming headlights, streetlights, or other bright or shiny objects, especially at dawn, dusk and at night?
::Have difficulty turning their head, neck, shoulders or body while driving or parking?
::Ignore signs of mechanical problems, including underinflated tires? (one in 4 cars has at least one tire that is underinflated by 8 pounds or more; low tire pressure is a major cause of accidents.)
::Have too little strength to turn the wheel quickly in an emergency such as a tire failure, a child darting into traffic, etc.?
::Gets lost repeatedly, even in familiar areas?

If the answer to one or more of these questions is "yes," you should explore whether medical issues are affecting their driving skills.

Medical issues to consider...

Caregivers need to know if the elderly person:

::Has had their vision and hearing tested recently?
::Has had a physical examination within the past year to test reflexes and make sure they don't have illnesses that would impact their driving?
::Is taking medications or combinations of medications that might make them drowsy or confused while driving?
::Has reduced or eliminated their intake of alcohol to compensate for lower tolerance?
::Has difficulty climbing a flight of stairs or walking more than one block?
::Has fallen - not counting a trip or stumble - once or more in the last year?
::Has had a physician told them that they should stop driving?

Adapting to changes...

Driving is not necessarily an all-or-nothing activity. Some programs exist to help elderly drivers adjust their driving to changes in their physical condition:

AARP (the American Association of Retired Persons) sponsors the 55-Alive Mature Driver Program, which helps older people deal with issues such as how to compensate for vision problems associated with aging. And, the Association for Driver Rehabilitation offers referrals to specialists who teach people with disabilities, including those associated with aging, how to improve their driving.

There are many ways for elderly drivers to adjust so they are not a danger to themselves or others. Among them are:

::Avoid driving at night and, if possible, at dawn or dusk
::Drive only to familiar locations
::Avoid driving to places far away from home
::Avoid expressways (freeways) and rush hour traffic
::Leave plenty of time to get where they are going
::Don't drive alone

Other forms of transportation...

Encourage your loved one to rely more on public transportation. This will reduce their time behind the wheel and help prepare them for the day when they can no longer drive. Many cities offer special discounts for seniors on buses and trains, and senior centers and community service agencies often provide special transportation alternatives.

How to get them to stop...

If you feel strongly that your parent cannot drive safely, you have little choice but to get them to stop driving. If they agree without an argument, wonderful. If not, you have several options:

::Stage an intervention. This approach, commonly used with substance abusers, involves confronting the elderly driver as a group of concerned caregivers. The group should include family members, health care workers and anyone else respected by the senior. The intervention needs to be handled firmly but with compassion in order to break through the senior's denial of the issue.
::Contact the local Department of Motor Vehicles and report your concerns. Depending upon state regulations and your senior's disabilities, it may be illegal for them to continue to drive. The DMV may do nothing more than send a letter, but this might help convince your parent to stop.
::Take the keys, disable the car or move it to a location beyond the elderly person's control. Leave the headlights on all night or disconnect the battery to disable the car. But if your loved one is likely to call AAA or a mechanic, you have no choice but to eliminate all access to the car. While this may seem extreme, it can save the lives of seniors, other drivers and pedestrians.


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