Driving Safely

The natural changes of aging

There is no denying that time causes our bodies to change, often in ways that make it more difficult to drive safely. Fortunately, we can compensate for these changes. And those who make adaptations are better drivers for it.

The first step is to acknowledge how aging affects key physical skills required to drive well.

• Vision. Most people over age 40 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 have more difficulty judging depth and speed, as well as driving at night. For instance, a 45-year-old requires four times as much light to see as a 19-year-old. A 60-year-old requires 10 times the light.
• Hearing. Nearly one third of adults over 65 have significant hearing loss. This can reduce the ability to hear a siren or horn, or to detect an oncoming car.
• Reaction time. There is no doubt that we are slower to react as we age. Still, 90% of older drivers who fail reaction tests at high speeds pass them if the speed is reduced by 10 mph.
• Strength and flexibility. Half of middle-aged adults and 80% of adults in their 70s 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.

There are mental changes that also come with aging:

• Processing time. Aging does not change intelligence. But as we age, it does take longer to think through an idea. And we need to concentrate more and do one thing at a time.
• 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, serious illness, or who are on medications, however, lose the extra edge of wisdom.
• Concentration. The ability to “multitask” diminishes with age. In fact, seniors find it much easier to get distracted. This can cause older adults to lose concentration and “accidentally” focus on something that is less important than their driving.

While adaptations can go a long way toward compensating for these changes, they cannot erase the years. Eventually, nearly everyone must consider “driving retirement.” (Put differently, very few people drive up until the day they die, unless, grimly, they are killed in a car accident.)

Talking with your parent

As a family member, you can best help by acknowledging the changes of aging and working with your loved one, sensitively, to plan ahead. Easier said than done! Although aging is inevitable, nobody likes to think about it.

Parents are notably resistant to hearing about driving concerns from their children. Even if you are middle-aged yourself, you are still their son or daughter. Certainly, if you are over 40, you can start by acknowledging changes you are experiencing personally. Perhaps your eyesight is not what it was. Or you notice it’s harder to turn and look over your shoulder when you back up. Joining with your parent rather than lecturing to them is more likely to bring out a cooperative response.
Here are some other tips to help:

• Treat driving retirement the same as we treat retirement from the work world. Both are stage-of-life events most everyone will experience. And both unfold best if we start planning years before we actually retire. So just as you might talk ahead of time with your loved one about his or her plans for job retirement, consider talking about plans for retiring from driving. For instance, if your loved one is thinking to downsize to a smaller home in the coming years, what are the transportation options in the desired neighborhood? It would be wise to think in terms of finding a place that has several convenient alternatives.
• Bring up the subject of driving retirement before it’s a critical problem. Experts say it is better to start talking early, when the issues are less threatening. Responses to diminished driving ability are most successful if you begin when the concerns are relatively minor and the solutions easy.
• Start small. Driving retirement occurs in stages. Avoid the tendency to think in terms of “all or nothing.” Just as aging is gradual, driving retirement can be gradual. Even with the work-world analogy, many people go from full-time employment to part-time work. They may even shift to freelance or consulting before they finally stop work altogether. The same is true for driving retirement.

For instance, one might begin by noticing if it seems hard for your loved one to turn and look over his or her shoulder. You can help by suggesting a wide-angle mirror to reduce blind spots that result from a stiff back and neck. Or flexibility exercises to help the back and shoulders stay limber. Next, you might suggest avoiding unprotected left-hand turns. Making a left without benefit of a traffic light is a high-risk situation for everyone, but seniors in particular. Perhaps you can share a route that you have discovered. (And remember, “three right-hand turns will make a left.” Depending on traffic, it may take more time. But three rights are much, much safer than trying to make a left without a stoplight for oncoming traffic.)

• Enlist the help of your loved one’s peers. If you are observing driving patterns that concern you, talk to your loved one’s friends. Describe your worries. Maybe the friend has had similar observations. Without prying, you might even ask if the friend might simply begin a conversation with your loved one. What has the friend noticed about others and driving retirement? Perhaps he or she could start by sharing his or her own experience of aging and driving. No one likes to feel singled out. But if others are admitting to their worries, such as poor night vision, it’s easier to reveal one’s own doubts or concerns. You don’t have to ask the friend to share anything personal with you. Just a suggestion of a chat among peers might be enough to get the ball rolling.
• Listen with compassion. Acknowledge concerns. If you do decide to bring up your worries directly, your family member may react with anger and denial. Driving is so central to our activities and sense of identity, seniors are understandably threatened by the idea of not being able to drive. Fears of loneliness, isolation, and dependence loom large. There is much more at stake than physical safety. At first just listen to your parent’s concerns. Show compassion and empathy.
• Emphasize that your goal is to find safe ways to preserve your family member’s independence. It’s a good idea if you can find a supportive way to help your parent make these changes. (See our article on the coach role, in Your Changing Role). Let your family member know you want to work together as a team. Together you hope to come up with a plan that will prolong his or her ability to drive safely for as long as possible.
• Consider bringing in a professional. Sometimes it is simply easier for seniors to hear about driving concerns from someone who is more objective. Studies show that seniors give more credibility to doctors and police than they do to their children. Other professionals to consider bringing in are Aging Life Care Managers, driving specialists, and occupational therapists. They can do an assessment and make recommendations specific to your family member’s current limitations.

Should Dad still be driving?

If you are concerned about your parent’s ability to drive safely, look for these signs of possible problems:

• Trouble with vision or hearing. Watch for problems seeing lane lines or pedestrians, overlooking stop signs, or judging the speed of oncoming traffic. 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. Talk to your loved one’s doctor about a driving skills evaluation.
• Two or more recent tickets. Consider tickets a yellow, warning light. Common infractions include poor parking, running a stop sign, or driving the wrong way on a one-way road.
• Two or more recent accidents. Parking lot and sideswipe accidents indicate driver error. Poor depth perception also causes seniors to have a very high rate of left-turn accidents.

Take regular ride-along outings. Notice your family member’s skill level and confidence level. Ask for input from friends and neighbors.

Assessments
You may want to explore a self-assessment your parent can take privately, at home. The American Automobile Association offers a Drivers 65 Plus: Self-Rating Tool with 15 multiple choice, text-based questions.

Or consider the offerings at the American Association of Retired Person’s AARP Driving Assessment webpage.  Among others, they offer a quiz about rules of the road, and a Fitness-To-Drive survey created by the University of Florida to help family members assess safety .

Helping Mom be a safer driver

Don’t be surprised if your parent reacts with some defensiveness when you raise the topic of driving skills. No one wants to have their independence snatched away! Make it obvious from the start that it’s a mutual goal to keep your family member safely on the road. And that it’s not an all-or-nothing situation.

Here are several options for supporting your parent’s continued safe driving:

• Mature driver refresher classes. These classes are often sponsored by the American Association of Retired Persons or a local chapter of the American Automobile Association. Classes offer practical information on easy ways to accommodate the natural changes of aging. They tend to be informal and include a lot of group discussion. Plus, persons over 55 may qualify for a discount on their car insurance! Online classes are inexpensive and are offered by both AARP and AAA. Or, contact a professional driving specialist for a personalized, behind-the-wheel evaluation.
• Staying physically flexible. Being able to turn to look behind you is critical to safe driving. Encourage your loved one to practice simple flexibility exercises.
• Maintaining car fitness. Make sure the car is properly adjusted for your parent. Especially important is the ability to see clearly in all directions. The addition of wide-angle mirrors, for instance, can help reduce blind spots. Be sure the wipers are in good shape. And maintain the car for road safety, too. Tires should be properly inflated and have adequate tread. And don’t forget to have the brakes checked regularly.
• Adjusting habits. A few simple changes can greatly reduce the chance of problems. Suggest Mom reduce or avoid driving at night or in bad weather. Stick to routes and times with less traffic. Make fewer left turns. (Three right turns are much safer!) And practice extra caution in parking lots and when changing lanes.

Alternatives to driving a car

Each town has its own transportation program. Possibilities include:
Public transportation options

• 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 companies can even arrange ahead of time for someone to accompany a first-time rider, share tips, and so forth.
• Paratransit service. 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. You must make reservations in advance.

Private organization options

• Taxicab service. Taxis provide convenient transportation by car or van. Simply call when you need one. Fares include a base charge plus a per-minute or a per-mile charge. Some companies accept transportation vouchers.
• Transportation vouchers. Some social service agencies offer travel vouchers for taxis and buses. The vouchers are used instead of paying a fare. Eligibility typically depends on financial resources and/or disability.
• Volunteer driver programs. A local nonprofit organization may manage a network of volunteer drivers. These programs tailor their services to a rider’s needs. For example, drop off only, or multiple stops. Fares are typically by donation.
• 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.

If you must take away the keys

Ideally, you’ve set the stage through candid discussion over the past months or years. Perhaps you’ve even talked about how others have handled this phase-of-life issue. Be aware of your own emotions when you talk with your parent. It’s better to acknowledge the sadness than avoid the conversation and risk an accident.

• Consider who should deliver the news. It’s typically best received from a trusted family member or a health professional. Choose someone who can be supportive and empathetic. If Mom is able, have her talk to Dad. Or vice versa. If it’s your role, go easy. Expect to have several conversations. Show your concern for maintaining your parent’s ability to get around and participate in life activities.
• Practice using alternatives. Unless there is an immediate safety risk, work gradually toward zero driving. Have family members and friends provide rides more often. Make it natural by saying, “Let’s go shopping together today.” Join Mom in trying public transportation. Perhaps you can arrange for home delivery of goods. Setting up automated bank deposits and payments is another way to reduce the need for a car.
• Work with resistance. If Dad doesn’t follow through with promised changes, you need to take further action. See if the doctor will set limits. Remind Dad his behavior puts others at risk. Impose family restrictions, if you must. For instance, it may be that he can no longer drive with the grandkids in the car.
• Be firm. Contact your state department of motor vehicles. They can tell you how to report an unsafe driver. This will trigger a driver evaluation. It’s not a small matter. But if you believe your parent is unsafe on the road, it is better to be cautious. An accident could be devastating for many people.
• In the case of dementia, it may be easier to tow the car away than to take away the keys. Many families disable the distributor and have the car towed and sold.  When dad asks about the car, you can just say “It’s at the shop.”