We’ve all seen it – the little old lady who can barely see over the steering wheel, the old man who drives 5 miles down the highway with his blinker on, or the headlines proclaiming another senior citizen has confused gas pedal and brake pedal, and has driven into a building.
First, the facts
The Insurance Institute for Highway Safety, in its Fatality Facts 2014 article on Older Drivers, states that fatal crash rates increase starting at age 75 and increase markedly after age 80, measured by miles traveled. The Centers for Disease Control, in its article New Data on Older Drivers, states that on average, 15 seniors die every day in vehicular accidents. There are more than 20 million drivers age 70 and older on the roads today according to the Insurance Institute for Highway Safety. Because of frailty, seniors are more likely to die of injuries sustained in a vehicle crash. Miles traveled decreases, but fatalities per miles increases. And the only age group that has worse driving statistics remains young drivers, whose abilities will improve, given the chance, while seniors’ abilities will deteriorate.
What are the warning signs?
One way to determine if your senior driver should stop driving is to go for a ride with him/her. That can sound pretty scary, so first, casually check out the mailbox, garage doorway, and garage interior for new paint. Has something been painted recently to cover a minor collision? Also check bumpers and fenders for ‘resculpting’ – changes in their configuration that resulted from bumps, dents and dings. Look at the tires – are they scuffed from rubbing against or from bouncing off curbs? While riding with the senior driver, try to be patient, calm, and quiet. Note for later discussion the stop sign that your senior driver ran, the number of times your driver cruised along the white line separating the road from the shoulder, and the horns honking behind you, but don’t confront your driver while he or she is driving. (Unless, of course, safety is truly at risk.) Is your senior driver nervous? Is a lack of confidence obvious? Or is he/she showing off to prove that there is no need for this test, flying around corners and changing lanes without benefit of blinkers? The AARP list of ten top indicators that it’s time to stop driving (http://www.aarp.org/home-garden/transportation/info-05-2010/Warning_Signs_Stopping.html – también en español) will help you make the correct assessment.
Other factors that affect driving safety
Decisions to stop driving may be based on medications that interfere with safe operation of heavy machinery (and a car is heavy machinery!), physical changes (can’t turn to back up or check blind spots), memory issues (gets lost or forgets to use blinkers), reduced cognitive abilities (cannot take appropriate defensive precautions when the other guy swerves toward him/her), slower reaction rate, or vision problems (cannot see signs, or peripheral vision is poor and glare interferes). Sometimes we need to request that they limit their driving to daytime and dry roads. Sometimes we need to ask that they not drive on certain heavily traveled roads, but given the traffic density in New Jersey, trying to limit driving to lightly traveled roads is virtually impossible. And don’t forget parking lots. Some shopping area parking lots may be too busy for senior drivers to navigate safely.
How to approach the conversation
When the time comes to address the situation with your own parent (or other loved one), you need to be prepared. It is one of the hardest subjects to broach; many people say it is harder than making funeral plans or selling the family home. Experts suggest using reflexive and open-ended questions, a calm voice, and lots of patience. One positive statement is “I want you to drive as long as you want to and can do so safely.” Several experts suggested that this is best done as a kitchen table discussion. If you are concerned about your loved one’s driving and would like additional resources to plan these conversations, visit www.aarp.org/weneedtotalk. The subject may need to be introduced and dropped, then picked up again on another day. If it is possible, have your senior driver make the decision; demanding that the person stop driving will lead to anger and resentment.
If Action is needed NOW!
Involve the physician. If you feel that your words have had no impact and that your senior driver really needs to stop driving immediately, you can contact his/her primary care physician or specialist. Although the doctor may not discuss the patient without his permission, the doctor is allowed to listen to your concerns. The doctor may then review the senior’s history. A retest of abilities will allow the physician to determine if he/she should advise the patient to stop driving.
Involve the Motor Vehicle Commission. If you cannot make headway with your loved one, and he or she is still driving even though you have tried to get him or her to stop, and you feel they are a danger to themselves or others on the road, you can report them to the New Jersey Motor Vehicle Commission (MVC). This cannot be done anonymously; however, the MVC will not tell the driver who requested the investigation. There are three types of forms that MVC offers: one for police, one for physicians, and one for friends and families. Documentation of need for assessment is required. The MVC test is generally a pass/fail exam that determines a driver’s current state of readiness to drive. It does not evaluate the driver’s potential to drive safely after modifications in equipment or rehabilitation of the driver.
Get an In-Depth Driving Evaluation. This type of evaluation has been around for decades and has been conducted by occupational therapists for persons with disabilities. In recent years, occupational therapists or other professionals with specialized credentials to train older drivers, have begun to expand their practice, conducting comprehensive evaluations for older drivers. The evaluation usually takes a few hours and includes a clinical assessment, which may involve using a driving simulator, an on-the-road test, and a feedback session. This evaluation is very different from the evaluation offered by the Motor Vehicle Commission.
Hit ‘em where it hurts. Hit ‘em in the wallet. Money talks. Calculate the cost of driving one’s own car, including gas, maintenance, insurance, tolls, parking, On-Star or AAA membership fees, tires, repairs, inspection fees, registration and licensing. Then, calculate how much taxi fare might be for typical daily or weekly travel. If the car is owned outright, calculate the original cost amortized over the age of the car, as well as the present value of the car, which could be recovered by selling it. Owning and operating a vehicle can be much more expensive than your senior driver may think. By writing down the actual expenses, the driver can get an idea of how much money could be available for alternative transportation if he or she stopped driving.
Alternatives to driving
Here is a partial list of alternatives to driving. Fortunately, alternatives are increasing as baby boomers retire and enter the “older driver” population. The American Automobile Association (AAA) estimates that by 2020, over 40 million drivers over 65 will be on the road – double the estimate for 2010.
Some alternatives are:
Call a cab. Taxicabs take people where they want to go, for a fee. The costs of driving far surpass what most people would need to spend on cab fare.
Ask a friend. This provides companionship along the route, and can be re-paid in pet-sitting services, a batch of cookies, gas money, or an occasional Jersey diner lunch.
Ask a relative. Add babysitting service to the list in “Ask a friend.”
You can make it easier to call a friend: Make a list of potential drivers with their phone numbers. Make it more useful by listing when these drivers are available.
Check out your local Paratransit. The ADA has a clause that requires all communities to have alternatives to public transit for disabled and elderly who cannot ride a bus independently. Check with your county Office on Aging or with your municipal government for information on your loved-one’s community services.
Seek out the Independent Transportation Network of America. It is a network that provides a community-based quality transportation system for seniors and adults with visual impairments. It currently operates in Bergen county and has plans to expand in to other north Jersey counties in the near future. Riders pay a small fee to ride, or may donate their car and use the value of it as their savings account for future rides.
Watch out for the downside
With all these positive aspects of giving up driving, there are some downsides. Knowing them can help to avoid them or reduce them. According to data released by the Independent Transportation Network of America (ITNAmerica), the transition from the driver’s seat to the passenger’s seat can make it difficult for older adults to keep their doctors’ appointments. It can also decrease the number of trips to shopping centers, restaurants, and movies, activities that reduce the risk of social isolation and help to prevent depression.
Help schedule trips to the doctor. Offer the non-driving senior a ride and take him/her to the family gathering. (Or designate a niece, nephew, or grandchild to be the chauffeur.) Find out if the senior’s church has a program to pick up shut-ins for church services. Help them sign up with shop-from-home services. Watch for signs of depression. And expect anger – lots of anger. You may be vilified to your siblings. You may be shut out of your senior loved-one’s world while he/she calms down and learns to accept the change.
We realize that these are difficult decisions with life-changing results. When they are made, they must be made out of love and concern, and our senior drivers must be convinced that what we are suggesting is the right thing to do.
In a 1994 Newsweek article, Max Israelite, one of the founding members of ITN America wrote, Undeniably, I will suffer a loss of mobility when I give up driving. I will give up a measure of my cherished independence when there is no longer a car parked in my driveway, available for instant use. But I would rather stop driving five years too soon than one millisecond too late. Me, too.
The author is a retired member of the Senior Ministries Commission of the Diocese of Newark