Elderly Drivers: When To Have The ‘Key’ Conversation
“Life is a highway.” To most drivers, there is more to this Tom Cochrane tune than meets the ear; being behind the wheel is essential to living an independent, self-sufficient and adventurous lifestyle. However, as we age and especially as we move into our ‘elder’ years, safe driving begins to take on new challenges.
Accidents on the road happen at any age. However, according to the Insurance Institute for Highway Safety, elderly drivers experience higher rates of fatal accidents based on miles driven, more than any other group with the exception for of young drivers. In large measure, the result for this high fatality rate is that elderly drivers tend to be more frail and generally do not survive severe auto accidents. Coupled with diminishing eyesight, reflexes, hearing and judgment, many elderly drivers are primed for a major incident on the roadways if they do not modify their driving habits. Some do. But what about the others who refuse to make a change? How do families approach this delicate subject with an elderly driver…is it time to ask for the keys?
Elderly driving statistics.
Recent studies have challenged the notion that elderly drivers are more likely to be involved in auto accidents. In 2014, the Insurance Institute for Highway Safety’s Highway Loss Data Institute issued a report showing that between 1995 and 2012, older drivers were less likely to be involved in a fatal crash. Safer vehicles and improved senior health were cited as key factors in the decline. While the trend is significant, the sobering fact remains that older drivers continue to have higher rates of fatal crashes than any other age group.
When viewed by miles traveled, the risk of fatality caused by an auto accident increases at 70 to 74 years of age according to the IIHS. The statistics also show that elderly drivers are more likely to be involved in certain types of accidents and less likely in others. For example, elderly drivers are less prone to be involved in drunk driving or bad weather accidents but more likely in situations involving left-hand turns while crossing oncoming traffic. This may be attributed to weakened eyesight, slower reaction time and reflexes needed to gauge the timing of oncoming vehicles.
The statistics and research are of little consolation to families who are worried that their elderly loved one may cause or be involved in an auto accident due to diminishing abilities. The concern grows exponentially; the U.S. Census Bureau estimates that the population 65 years of age and older is expected to exceed 82 million by 2050, nearly twice that of the 2012 level. Thus, more families will be faced with similar dilemmas.
It is important to note that driving requires a set of skills, clarity of mind and judgment in order to safely get from point A to point B. As we grow older, the physical and mental changes that often accompany aging can impact these capabilities. Such changes include:
- Diminished vision and hearing
- Reduction in response time
- Loss of muscle strength and dexterity
- Loss of capacity to concentrate
- Reduced alertness due to medications
Taken individually, none of these equates to removing the keys but each capability needs to be carefully monitored as it pertains to the elderly driver’s ability to remain safely behind the wheel.
How do we stop elderly driving accidents?
So what practical steps can families take now and into the future to reduce the risk of their elderly loved ones causing or experiencing an auto accident?
Many experts believe one of the best things families can do when they suspect diminishing driving abilities is to take short periodic drives trips with the elderly driver to gain a first-hand experience with their driving habits and/or abilities. Some of the tell-tale clues to reduced capacity in driving include:
- Difficulty with traffic signs or signals; difficulty reading them
- Driving at inappropriate speeds
- Difficulty in using brake or gas pedals or confusing the two
- Close calls with other traffic; near misses
- Frequently getting lost or confused on roads
- Slow responses to traffic situations, pedestrians or cyclists
- Drifting across lanes
- Difficulty concentrating or becoming easily distracted
- Scratches, dents noticed on the vehicle or garage
- Difficulty using rearview or side mirrors or simply not using them
- Multiple traffic citations
Suppose you observe one or more of these cautionary signs with an elderly driver.What do you do?
Your checklist should start with these questions:
- When was their last physical examination by their physician? Were their reflexes tested and were conditions discussed that might impede driving?
- Were there any falls in recent months? Any difficulty walking or climbing stairs?
- Is the elderly driver on any medication or set of medications that might cause drowsiness or fatigue?
- When was the last time their vision and hearing were tested?
Answers to the questions above may point to issues that if resolved medically, might contribute to stabilizing driving habits and capacity. Once these are addressed, return to your observations during the ride-along trip and address them promptly, do not procrastinate. Given the consequences, it is worth your time and the safety of your elderly driver as well as others to sit down and gently begin reviewing what you observed.
How to talk with elderly drivers.
It is important to plan how you will discuss your observations or issues involving the elderly driver. A word of caution, it will take several discussions, not one, as this issue is an emotionally-charged matter and one the elderly driver may not immediately grasp or agree with. David Solie, a recognized thought leader on the psychology of aging, author of “How To Say It To Seniors: Closing The Communication Gap With Our Elders” notes that elders will fight for control since at this stage of their lives they are losing control over many other facets of life. Depression, isolation, and loneliness are likely to be brought up. To them, giving up driving means changing where and when they go, who they see, and possibly where they live in addition to other significant lifestyle changes.
Broaching the matter requires tact, an appropriate space and time, and respect for the elder and their right to make decisions. Asking questions such as, ‘Are you experiencing any difficulties while driving?’ or ‘I noticed you are having some problem seeing well at night, how is your driving after dark?’ These will help open up the discussion without putting the elderly driver in an uncomfortable position or causing them to become defensive. As the discussion moves forward, your best approach is to help the elder express their concerns. Acknowledge that they are probably concerned about what giving up driving would mean but perhaps there are measures to be taken to reduce the current risk. Some families have suggested the following:
- Drive during day hours only and on familiar routes
- Don’t drive alone
- Don’t drive on freeways; take local streets
- Take a safe driving course; AARP, automobile clubs and commercial driving schools offer courses
- Set up a schedule for taking public transportation
- Arrange with family and friends to transport the elder on specific days
- Exchange old interests for new ones that do not require driving
- Show the positive financial results of not driving -no car insurance, maintenance costs, etc.
- Suggest relocation to an assisted living community where most needs including transportation are met; hire in-home care and access other resources to provide the services usually obtained out of the home.
For many families, a genuine, frank discussion with multiple alternatives to self-driving works very well. There are, of course, elderly drivers who will refuse any alternative and refuse to give up the keys. If the person is a danger to themselves and others on the road, the process will be more difficult. States allow for ways to report individuals to the Department of Motor Vehicles which may result in retesting or a formal communication with the elderly driver. Family physicians have been asked to talk with the elder about driving. Family interventions have been initiated that force the senior to drill into the denial. Taking the keys, disabling the vehicle, relocating the vehicle, and other measures have all been used as efforts to eliminate the risk on the road.
It can be a complicated and wrenching process, but one that must be taken to protect lives and the life of the elder. If done responsibly, the elder can adapt to changes with the support and firm resolve of the family.
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