For anyone who’s had to ask an older adult to give up driving, or who has made the decision for herself, you know how agonizing and distressing it can be to lay down the keys and say goodbye to what is likely a vital part of everyday life. This is a challenge virtually every driver (or child of an older driver) must eventually face and the fact that so many of us deal with it doesn’t make it any easier. Driving is a distinctly unique skill that grants enormous freedom while also posing serious obligations and when the risks to the driver (or others) become too significant to ignore, the challenge becomes re-thinking life without the freedom that driving affords. For previous agebuzz posts on the challenges of senior driving, adjust your mirror and look here.

Of course, the ideal is not to make the difficult decision to end driving abruptly with threats or rash judgments. Ideally, you should first be able to explore ways to make driving for your older adult safer, perhaps with some limits. Whether it’s engaging an occupational therapist to help accommodate physical, cognitive, or motor skill limitations, or deploying new safety features in the car, there may be ways to extend the driving life of an older adult for at least a certain amount of time. There are a host of resources available to help older drivers determine their present level of skill, their need for additional training, or the need for creating an “advance plan for giving up driving.” For a sample “driving retirement plan,” check this out. To find an occupational therapist who can help you sift through the challenges, click here and to help you check your current level of driving skills and deficiencies, start your engine and click here. There’s also a not-for-profit that can help you determine if you have the right “fit” for your car. To find out more, read here. 

Of course, the nightmare scenario is that you or your loved one don’t stop driving until some catastrophe takes place- perhaps you cause a car accident or worse, hit a pedestrian. These sorts of incidents regularly happen with older drivers, many of whom likely didn’t even realize the risks they posed or the deficiencies they harbored. In fact, we have some new data that shows the potential for tragedies to happen when older drivers are at the wheel. While age alone should never be a disqualifier for driving, there’s no doubt that cognitive impairment is most prevalent among older adults, and it seems that the majority of older adults with cognitive impairment are still driving. According to a recent study of 600 older adults in South Texas, of those who were assessed to be cognitively impaired, over 60% of them were still on the road. While caregivers of many of these drivers expressed concern, this did not necessarily prevent impaired loved ones from continuing to drive.

So what preventive measures are in place, especially in situations where the driver is experiencing more than mild dementia symptoms? Internationally, Japan has been leading the way with driver restrictions, given that a substantial portion of its population is over 65. In Japan, drivers 75 and older who have some history of traffic offenses, such as running lights or speeding, are required to retake a driving test to renew their licenses. This came after a gradual increase in fatal car accidents involving older drivers. Japan also requires adults 75 and older who apply for a new license to take a cognitive test which could lead to a loss of license if they are found to have dementia. A study of the impact of this new law found that as a result, there was a decrease in motor vehicle accidents involving older males, but this was also accompanied by an increase in pedestrian and bicycle accidents among older adults. This suggests that testing older drivers may decrease the potential for accidents, but if provisions are not made to provide alternative transportation for those no longer driving, they may take other risks to continue to be out and about. 

In the United States, 32 states have medical boards that can review a driver’s fitness to drive and 6 states have laws making it a crime not to report driver impairment if such impairment could affect driving safety. Experts suggest that if a driver is no longer able to handle his finances or manage his medications, he’s likely unable to safely drive. Furthermore, there are data to correlate several medical conditions common among older adults with driving impairment, including stroke, diabetes, obstructive sleep apnea, vision loss, and dementia. Each state has its own set of reporting and driving restriction requirements. For example, in California, anyone over age 70 has to take a new knowledge test and eye exam in person at a Department of Motor Vehicles office. While there may be many complaints that the knowledge test has little to do with actual driver safety, it is a good opportunity for older drivers to take stock of their competence so as to keep themselves and those they share the road with safe and secure. Bottom line for older drivers? Age alone should not prevent you from driving- but it should make you wise enough to consider whether your skills and abilities allow you to be a safe driver, or whether you need to rethink transportation alternatives for the days to come.