Driving represents freedom, independence, and adulthood. Being able to get where you need to go when you need to is critical to quality of life. It’s not something to be given up lightly. An older adult’s need for autonomy is extremely important! Also important, however, is the issue of safety. Not only for the driver, but for passengers and others on the road.
We are all individuals
Some people are unsafe drivers and have been since their youth! Others are quite safe well into their very elder years. Each person’s driving journey is unique. That said, the aging body does change over time, often in ways that negatively affect the basic skills of driving.
Adjustments to driving patterns can be made along the way as required by the changes of aging. They can often add many more years of safe driving.
This collection of articles is designed to foster wise and safe driving. It can also help you decide when it’s time for a partial, and then eventually a full, “retirement” from driving. The articles may also help you determine when to bring in a professional, such as an Aging Life Care Manager, to assist with this evolving process.
The demands of driving
Driving is not a simple activity. It requires the ability to visually scan for potential threats and then to quickly evaluate options and make a corrective action when a dangerous situation is identified. Left-hand turns, congested intersections, and fast speeds on the highway are examples of situations that require greater attention and fast reaction times. This can prove very challenging for older adults.
From one perspective, older adults are actually some of the safest drivers. They wear their seat belts consistently. They don’t tend to speed. They are less likely to drive under the influence of alcohol. And they have half the number of crashes that teenagers do each year.
But some of these statistics are simply because they do not drive as much. When measured mile for mile, seniors are actually involved in more collisions than are most other age groups. Only teenagers rank higher in the number of crashes per miles driven. And the consequences of a crash are much more extreme for older drivers. A person over age sixty-five is seventeen times more likely to die when involved in a car accident than is someone between ages twenty-five to sixty-four.
Are all older drivers a safety hazard? Absolutely not!
We are each individuals with our own strengths and difficulties. Some experience difficulty with vision yet retain superb reflexes. Others have fine vision but difficulty turning to look over their shoulder. No matter what, the years eventually take their toll. The trick is to be aware of the changes and compensate as needed.
There is no denying that time causes our bodies to change, often in ways that make it more difficult to drive safely. Between 83 percent and 95 percent of unsafe driving in older adults is a result of visual or cognitive (thinking) impairments.
Fortunately, we can compensate for these changes in many ways. Those who acknowledge their deficits and make adaptations will wind up as better drivers for it.
The first step is to recognize how the normal process of aging affects some of the key physical skills we need to drive well.
Vision. Most people over age forty begin to notice a change in their eyesight. We cannot focus as quickly. This makes it harder to observe critical objects when we are in motion, such as brake lights or stop signs. We also have more difficulty judging depth and speed, as well as adjusting to alternating dark and light conditions while driving at night.
Hearing. Nearly one-third of adults age sixty-five to seventy-four has hearing loss. That number rises to nearly 50 percent among those age seventy-five and older. This change can reduce the ability to hear a siren or horn, or to detect a problem with one’s own car.
Strength and flexibility.Half of middle-aged adults and 80 percent of adults in their seventies report problems with arthritis. Stiff joints can result in an inability to grasp the wheel and make quick or sharp movements. Turning to check for traffic in the next lane can be painful. And stiff knees or weak legs can result in not being able to hit the brake strongly enough to prevent a crash.
Some mental changes also come with aging.
Processing time.Aging does not change intelligence. But as we age, it does take longer to think an idea through and then respond with action.
Judgment. As a general rule, experience, maturity, and the natural caution of older drivers compensate for their reduced ability to process information quickly. Elders with dementia or serious illness, or those who are on medications, however, lose the extra edge of wisdom.
Concentration. The ability to multitask diminishes with age. In addition, older adults find it harder to filter out irrelevant input, meaning it’s much easier to get distracted. Conversations, listening to the news, or watching events occurring on the sidewalk can take attention away from important driving cues.
And then there are specific conditions that occur more frequently the older we get. For instance, cataracts, glaucoma, dementia, and Parkinson’s. While not everyone will get them, those that do can be profoundly limited in their ability to drive safely.
Adaptations can go a long way toward compensating for the changes of aging, but they cannot erase the years. According to the American Automobile Association, because we are living so long, on average we outlive our ability to drive safely by seven to ten years. Eventually, nearly everyone must at least consider “driving retirement.”
Just as we plan to retire from our jobs, it’s wise to plan for the time when we retire from driving. On average, we outlive our ability to drive safely by seven to ten years. That’s a long time to be homebound if you don’t plan for driving alternatives!
Retirement from driving tends to be a gradual phasing out, much like moving from full-time work to part-time. Then to a less demanding position. Perhaps then on to volunteer work. And then eventually we stop work altogether.
Gradual adjustments for safe driving Simple changes in driving habits can go a long way in reducing accidents. This goes for younger drivers as well. In fact, everyone drives more safely if they follow these recommendations:
Avoid rush hour.
Avoid routes with congested intersections.
Turn off the radio when driving and limit conversations when traffic is heavy.
Make a left turn only at intersections with a protected left arrow. (Otherwise, remember that “three rights make a left.”)
Drive only during daylight hours.
Prepare well in advance You wouldn’t start planning for retirement six months before you plan to quit work. Too many parts of your life would be affected with too little time to get ready. You need to prepare and structure your life to accommodate the change.
Driving retirement is similar. If you can accept that one day you will probably not drive, then you might look at big decisions in a different way. For instance, if you are planning to move at some point, what are the transportation options at your new location? Will there be a bus or shuttle? Access to ride-sharing such as Lyft or Uber? Perhaps you’d want to move someplace within easy walking distance of groceries and a pharmacy. These are all important things to consider.
If you are concerned about a loved one’s driving safety, consider riding as a passenger to get a real understanding of their abilities and possible difficulties. Here are some direct warning signs:
Straddling lanes or weaving
Missing stop signs or traffic signals
Driving too slow compared to others
Speeding or making impulsive, unwise decisions
Confusing the gas and brake pedals
Not turning to check behind before changing lanes
Having other drivers honk or pass regularly
Situations to look out for:
Trouble with vision or hearing. Problems seeing lane lines or pedestrians, overlooking stop signs, or misjudging the speed of oncoming traffic are signs of vision or hearing concerns. Other signs include discomfort with glare or driving at night.
Inability to twist or turn easily. Arthritis and stiff muscles can make it painful to turn and look when needed. This can lead to trouble when backing up, changing lanes, or merging with traffic.
Medication use. Many medicines can slow thinking and response time. Drugs for depression and anxiety can have these effects, as can sleeping pills and medicines for heart conditions, colds, and allergies.
Dementia. At “early” stages, many individuals can still drive safely. Ask the doctor about a driving skills evaluation by an occupational therapist.
Relying upon a passenger for help. If your relative requires assistance to drive safely—for example, to see if anyone is in the adjacent lane before changing lanes—they should not be driving.
Two or more tickets in the last two years. Consider tickets a yellow warning light. Common infractions include poor parking, running a stop sign, or driving the wrong way on a one-way street.
Two or more accidents in the past two years. Parking lot and sideswipe accidents indicate driver error. Poor depth perception also causes older adults to have a very high rate of left-turn accidents.
If you are an older adult with concerns, or family or friends who are expressing concerns, you may want to download the American Automobile Association’s “Drivers 65 Plus” self-assessment.
Aging undeniably brings changes that can impair driving abilities. These changes arrive earlier for some than for others. If you have concerns about a loved one’s driving, there are many ways they can compensate. Rather than stop driving altogether, here are some things they can do to become a better and safer driver:
Take a refresher course. Classes are available online. They teach everything from the latest changes in the law, to things you can do to reduce distractions, take advantage of new safety technology, and driving tips to avoid the most dangerous situations for senior drivers. As an added benefit, your relative may even earn discounts on their car insurance for taking these classes. Check out:
American Automobile Association’s “Roadwise Driver”
AARP’s “Smart DriverTM“
Or get an in-person assessment with an occupational therapist or a licensed driving instructor.
Modify driving habits. Many simple changes can greatly reduce the chance of an accident. For example:
Avoid rush hour.
Drive only during the day if nighttime glare is a problem.
Turn off the radio to improve concentration.
Plan your route ahead of time so you aren’t navigating on the fly.
Do stretching exercises. Keeping the neck and trunk flexible is important for looking back to verify it’s safe to change lanes. Or when parking the car.
Adjust the car to fit. Every time the driver gets in the car, they should check that the rear-view and side-view mirrors are positioned for maximum visibility. The seat of the car should be high enough that the driver’s eyes are at least three inches over the steering wheel. The seat belt should fit tight across the chest and lap.
Learn to use safety features. Adaptive cruise control monitors the speed of the vehicle relative to the car in front. This increases the chance of responding in time to avoid a “rear-ender.” Back-up cameras and parking assistants are immensely helpful for reducing parking lot accidents caused by reduced ability to turn and look behind.
Address vision and hearing loss. Wear glasses as needed. Consider cataract surgery if nighttime driving is a problem. Similarly, wear hearing aids if hearing is a problem so safety cues about traffic and car difficulties are not missed.
Check medications. The American Automobile Association has an online “Roadwise Rx” program. Go there to look up medication side effects that might affect safe driving, such as dizziness or drowsiness. Or ask the pharmacist for a medication review and to suggest alternative medicines.
After they stop driving, most people will rely first and foremost on friends and family to help. But depending on the goodwill of others can be wearing. Concerns about reciprocity are common. There might be distress over whether the drivers will be available when needed.
Compared to prepandemic times, there are many new options that are available for those who decide it’s time to let go of driving.
Many towns have their own transportation program. Consider these possibilities:
Public or mass transit
This service is bus or rail travel on a preset route. It usually has a preset schedule. Seniors often pay a reduced fare. Some services can even arrange ahead of time for someone to accompany a first-time rider, share tips, and so forth.
This service is for individuals with physical or mental disabilities. It provides door-to-door or curb-to-curb travel. Most paratransit vehicles can handle wheelchairs. Timing is based on the rider’s schedule. Passengers must make reservations in advance and may need to go through an initial qualification process to document disability.
Private organization options
Transportation vouchers.Some social service agencies offer vouchers for taxis and buses. The vouchers are used instead of paying a fare. Eligibility typically depends on financial resources and/or disability.
Taxicab service.Not every location will have the option of Uber or Lyft. And not all older adults feel comfortable with a smartphone app. Taxis provide convenient transportation by car or van that can be summoned by telephone. Simply call when you need a ride. Fares include a base charge plus a per-minute or a per-mile charge. Some companies accept transportation vouchers. Ask if they can send a vehicle that can accommodate a walker or wheelchair if necessary.
Door-through-door service.Some private transportation companies do more than drive. They physically help the rider get safely out the door of one location and through the door of another. This could be important for persons with dementia, those who use a wheelchair, or persons who are especially frail. Clarify with the services if they are just door-to-door drop-offs or can actually ensure the passenger gets assistance at both ends of the trip.
Ride-sharing services. Uber and Lyft are becoming increasingly popular with older adults who are comfortable using mobile apps. Both companies, however, are exploring ways to make their services more accessible for those who do not feel comfortable with smartphone technology. Check out their options. Be sure to request “door-through-door assistance” if your loved one needs help going up the elevator to go to an appointment. (Or similarly, to be met in the doctor’s office when returning home rather than out on the street.)Another option involves concierge telephone services such as GoGoGrandparent.com. Their service allows subscribers to call in requests for popular app services such as ride-sharing, DoorDash for restaurant food deliveries, or Instacart for groceries. No apps or smartphone needed.
Volunteer driver programs.A local nonprofit organization may manage a network of volunteer drivers with services tailored to a rider’s needs. For example, you can choose drop-off only, or to make multiple stops. Usually, you need to call several days in advance to arrange for going to the doctor’s or making a weekly grocery run. Fares are typically by donation. Check out the local senior center for a transportation program.
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