As the Roads Turn Gray,
Ways to Make Driving Safer
Talking To A Senior Driver Who Should Stop Driving
As the Roads Turn Gray, Ways to Make Driving Safer
By TANYA MOHN
IT’S called the gray tsunami, the great wave of aging baby boomers nearing retirement, making older adults the fastest growing segment of the population. And by 2030, the roads will be full of them.
According to the Census Bureau, the number of people 65 and older is expected to double, growing from 35 million in 2000 to more than 71 million in 2030. The Insurance Institute for Highway Safety projected that by then one in four drivers will be 65 or older, statistics that have safety experts studying how cars and the drivers themselves will need to adapt as the roads turn gray.
At the AgeLab at M.I.T. in Cambridge, Mass., for example, there are at least 20 aging studies looking at such factors as driver fatigue, the impact of technology inside the vehicle and how emotions and medications affect driving. States are also redesigning intersections to make them less confusing for older drivers. And organizations like AAA and AARP are advising older drivers about how to measure their abilities and are evaluating their cars to determine what adjustments need to be made to counter a driver’s physical limitations.
Loren Staplin, a managing partner of TransAnalytics, a consulting firm specializing in transportation safety research and development, said that older people were usually superb drivers because of their lifetime of experience. But as a consequence of aging, vision, mental and physical abilities often decline, Dr. Staplin said, making it “more difficult for them to drive safely.”
Many of these factors are being studied at the AgeLab. Miss Rosie, a Volkswagen New Beetle, is a mobile lab used for research into how flexibility and strength affect driving performance. Miss Daisy, another New Beetle, and the AwareCar, a Volvo, are wired to track eye movements and to measure pulse, alertness and stress levels, as a measure of the kind of physical changes older people undergo while driving.
Joseph F. Coughlin, founder of the lab and director of the Department of Transportation’s New England University Transportation Center at M.I.T., said the findings could change how cars are designed. Cars of the future, he said, may have computerized dashboard displays where the driver could choose a type size and font that was easier to read, and could be customized to show only the information the driver found useful. There may also be collision notification systems and a way to route medical records ahead to the ambulance after a crash. A computer inside the car may someday adjust how it operates, depending on the physical weaknesses and range-of-motion limitations of the driver.
“The driving experience is about to become profoundly personal,” Dr. Coughlin said.
Anne McCartt, senior vice president for research at the Insurance Institute for Highway Safety, cautioned that not all technology is appropriate for older drivers. She said technologies like lane departure warning systems; cruise control that maintains a set distance from the vehicle ahead; and systems where the driver receives a warning from a flashing light or a vibrating steering wheel (like blind-spot warning systems) may not work well with older drivers.
“There is concern that if systems require a response or attention, it may cause cognitive overload or distraction,” she said.
What many experts do agree would help older drivers is changing the design of roads, especially intersections, where drivers often have problems judging speed and distance. So some states are redesigning them. They are installing left-turn lanes, left-turn signals, street signs well before the intersection and replacing eight-inch traffic lights with 12-inch ones.
The Road Improvement Demonstration Program, started by AAA Michigan and financed by state, county and local governments, made some of these changes at nearly 400 intersections. An analysis of the first 84 completed in the Detroit area showed the injury rate over a two-year period for older drivers was cut by more than half, compared with the rate for drivers 25 to 64 years old. And the rate of left-turn collisions involving seniors dropped 73 percent when a left-turn signal was installed.
Bella Dinh-Zarr, the North American director of Make Roads Safe, a nonprofit organization based in London, said making roads more senior-friendly had been “scientifically proven to save lives,” adding, “Many are simple, inexpensive things that can be done when updating.”
Of course, cars can change and roads can be improved, but older drivers also need to assess themselves and know when it’s time to stop, or limit, driving. Dr. Staplin of TransAnalytics said many older drivers self-regulate by reducing their driving at night, in bad weather or in heavy traffic.
To help older drivers assess their abilities, AAA offers the at-home “Roadwise Review” screening test. It’s a computer program that leads drivers through exercises that measure eight areas, such as memory and visual processing speed, said Dr. Staplin, whose company designed the program.
Merry Banks, manager of special projects for AAA of Northern California, Nevada and Utah, said one driver refused to give up his license, even after his family and doctor pleaded with him. “Nobody could convince him,” she said. But after doing poorly on the program, “He said ‘O.K., I’m not going to drive anymore.’ ”
Along with assessing the abilities of older drivers, AAA has joined with the AARP, American Society on Aging and American Occupational Therapy Association to develop a program called CarFit. It is a 15-minute free consultation that determines how well drivers fit their own vehicles and identifies ways to make the cars more functional and safe.
Volunteers go through a checklist to determine if the driver can adjust mirrors properly to reduce blind spots and whether they can see over the steering wheel.
Occupational therapists sometimes suggest installing devices like a steering wheel cover to improve grip for people with arthritis or pedal extenders for a person unable to reach the accelerator and brake.
Debbie Coplin, 80, and Bob Kent, 87, were among the about 50 residents of Carolina Meadows, a continuing care retirement center in Chapel Hill, N.C., who attended a CarFit clinic in March.
“I’m short, so I’m always worried about air bags,” Mrs. Coplin said. (A driver sitting too close to the steering wheel can be injured when an air bag deploys.) “After much measuring and discussion,” she said, her seat was adjusted slightly so she would be farther from the wheel.
Mr. Kent said the session confirmed what he already knew. “Probably my biggest weakness is neck flexibility. I can’t twist around as much as I’d like to. Mirrors become much more important.”
Frank Cardimen, president of the Traffic Improvement Association, a nonprofit traffic safety agency in Oakland County, Mich., said the association had recommended improvements at intersections to help the elderly. He said his inspiration to help older people stay mobile safely as long as possible comes from his father’s experience a few years ago when he stopped driving.
“My father died at 85, but he really died at 80,” Mr. Cardimen said. “He was the most active, funny, enthusiastic person, just a jewel. We tried everything possible to offset that loss of freedom, that quality of life, but there was nothing we could do,” he said. Seeing him “just watching TV and eating, waiting to check out, was heartbreaking.”
NY Times
When to Stop Driving (AARP)
We want to continue driving as long as we can do so safely. However, for many of us the time may come when we must limit or stop driving, either temporarily or permanently. The following advice may be able to assist you or someone you care about.
Warning Signs
What are the warning signs when someone should begin to limit driving or stop altogether?
1) Feeling uncomfortable and nervous or fearful while driving
2) Dents and scrapes on the car or on fences, mailboxes, garage doors, curbs etc.
3) Difficulty staying in the lane of travel
4) Getting lost
5) Trouble paying attention to signals, road signs and pavement markings
6) Slower response to unexpected situations
7) Medical conditions or medications that may be affecting the ability to handle the car safely
8) Frequent "close calls" (i.e. almost crashing)
9) Trouble judging gaps in traffics at intersections and on highway entrance/exit ramps
10) Other drivers honking at you and instances when you are angry at other drivers
11) Friends or relatives not wanting to drive with you
12) Difficulty seeing the sides of the road when looking straight ahead
13) Easily distracted or having a hard time concentrating while driving
14) Having a hard time turning around to check over your shoulder while backing up or changing lanes
15) Frequent traffic tickets or "warnings" by traffic or law enforcement officers in the last year or two
If you notice one or more of these warning signs you may want to have your driving assessed by a professional or attend a driver refresher class. You may also want to consult with your doctor if you are having unusual concentration or memory problems, or other physical symptoms that may be affecting your ability to drive.
How Can I Help Someone Else
Limit or Stop Driving?
Most drivers monitor themselves and gradually limit or stop driving when they feel that a certain driving situation or driving in general is not safe. However, some people fail to recognize declining abilities, or they fear stopping to drive because it will make them permanently dependent on others for the necessities of life, and it may reduce their social and leisure activities as well. Conditions such as dementia or early stages of Alzheimers' disease may make some drivers unable to evaluate their driving properly.
Step 1 – Assess the situation. See the 15 warning signs listed above. It will help to personally ride with the person and observe driving habits first hand.
Step 2 – Begin a process of having conversations about driving with the driver. As people age they tend to look first to family members (spouse and children) for candid advice concerning their well-being and health issues. Have conversations early and often. Start the conversation out of a sincere sense of caring for the person's well-being and base it on things you have observed.
Step 3 – Suggest various options, depending on the degree of impairment. One size does not fit all and while stopping driving may be the only answer in some cases, stopping driving too early can cause a person's overall health to decline prematurely. You may want to:
Take a classroom refresher course
such as the AARP Driver Safety Program
Order the AARP Driver Assessment Guide, "Older Driver Skill Assessment and Resource Guide: Creating Mobility Choices." (See ordering information below.)
Seek additional information from other Web sites on topics such as behind-the-wheel assessment, counseling from private or public sources, remedial training, and/or adaptive equipment from an occupational therapist. (See our Web Resources listing.)
Limit driving to certain times
of day or familiar areas.
Encourage the driver to consider and gradually begin using other methods of transportation such as rides from family and friends, public transportation, paratransit services, taxis or other public or private transportation options in your community. Accompany the person during initial trials of alternate forms of transportation.
Contact local motor vehicle office. Your state Department of Motor Vehicles may have programs to evaluate individual driving abilities or may offer special licensing alternatives. Remember, their goal is not to take licenses away, but to help people keep driving as long as they safely can. Contact the state for more information.
Step 4 – Seek additional help if necessary. If the person is not taking proper action in response to your concern and the impairment is increasingly obvious, it may be necessary to involve the driver's doctor. (In addition to family members, a family doctor is often the most trusted person for providing advice on health issues that may affect driving.) You may also consider resources on Alzheimer's Disease, dementia, and driving.
Web Resources
New help for older people who are shaky behind the wheel—and their children. (Time magazine)
You may find these links to other organizations' Web sites valuable as you decide when it's time to stop driving and explore other transportation options.
Talking to a senior driver
who should stop driving
(Many Resource Links Below)
If you feel that it is time to talk to a senior close to you about stopping driving, approach the issue with sensitivity. A driver’s license signifies more than the ability to drive a car; it is a symbol of:
- freedom
- independence and independent living
- self-sufficiency
- being employed
- fun and spontaneity
- involvement in social and religious activities
Understandably, driving is not a privilege that anyone—teenager or elder—wants to relinquish willingly. As important as it is to treat the senior driver with respect and not jump to unjust conclusions, it is also important to help the elderly driver retire from the road.
Start slowly and try to persuade the senior to give up the keys. Some approaches that may work:
Be understanding about resistance. The senior may dismiss you and refuse to listen to you. Emotion may get in the way of a rational decision.
Ask questions, rather than make demands. For example, “Would you consider not driving at night?” See Making the "Key" Decision.
Talk about safety considerations. Many senior drivers who shouldn’t be driving have already had an accident or some close calls. Remind the impaired driver of the danger of serious injuries and that the safety of others is also at risk.
Explain transportation options. Help the senior driver see that living without a car won’t make them permanently homebound. Acknowledge the lifestyle change, but also show them how to continue favorite activities and to remain mobile.
Emphasize monetary savings. The cost savings associated with giving up a car may be a selling point for some older drivers. Costs include insurance, gasoline, maintenance and repairs, and license and registration fees.
Offer rides and visits. Volunteer to come by once a week or to provide rides on a regular basis for things like grocery shopping, library visits, or doctors’ appointments.
Seek confirmation of the situation. Some elderly drivers may be aware of their faltering ability, but be reluctant to give up driving completely. Another person’s concerns may force the senior driver to act. They may even feel relieved to have someone else help make the decision to stop driving.
For more ideas on how to talk to a senior about stopping driving, see We need to talk...Family conversations with older drivers and other resources below.
When a senior driver refuses
to give up the keys
If the senior driver refuses to give up the keys, you may need to take stronger steps. Ideas for further action include:
Take away the car keys.
Disable the car or remove it from the senior driver’s residence.
Ask the elderly driver’s doctor to write a prescription stating “no driving.”
Enlist the help of a local police officer to explain the importance of safe driving and the legal implications of unsafe driving.
Some seniors may forget that they aren’t supposed to drive. If that is the case, it is even more important to remove the car or the keys to make it impossible to drive.
If High Risk Drivers Refuse to Stop provides information about dealing with a senior who won’t give up the keys.
Helping a senior adjust
to life without driving
Like any change, adjusting to life without a car will be tough at first. Some tips on helping a senior to make the transition include:
If possible, work with the senior to decide when to limit or stop driving. This sense of control is very important.
Help the senior find other ways to get around: research availability of transportation in their area, and schedules, routes, and costs.
Encourage the senior to reach out and connect to new people, many of whom may offer rides.
Make sure that the senior has rides to their usual activities. When a senior stops driving, continuing with other routines can be very soothing.
Help the senior to make a schedule. They can plan activities on a weekly basis and match up the best ride for the activity. Some activities, like doctor’s appointments, require punctuality, and others, like going to the grocery store, may be more flexible.
Investigate home delivery. Find out which services deliver and help the senior to learn to use the Internet for shopping.
Remind the senior to plan for fun. They must think beyond “needs” when planning their transportation schedule. Outings for church and social events are just as important.
Help develop or revive hobbies to do while riding, such as reading, knitting, or crossword puzzles. They may find that they enjoy the ride more when they don’t have to drive.
Encourage the senior to use positive language to describe their situation and to ask for assistance. Thinking about their transition as one that they can handle will help them to adjust quickly.
Offer rides and find others who can offer rides. Asking for rides is one of the hardest parts of not driving. For many non-driving seniors, asking for rides highlights the unwelcome truth of dependence.
Some seniors may adjust better if they can keep their own car, but have others drive them. Their own car may feel more comfortable and familiar, and the sense of loss from not driving may be lessened.
For a comprehensive article about seniors’ coping with not driving, see Coping, from the New York State Office for the Aging.
References and resources for helping an unsafe senior to stop driving
Risk factors of aging that can affect driving
Mature Drivers and Aging (PDF) – The facts about how aging affects driving. (BCAA Traffic Safety Foundation)
Evaluating senior driving
Tips for Older Drivers - Offers a series of articles on Vision Health, including information about all the possible vision impairements.
Driving Safely While Aging Gracefully – Helps seniors assess changes in vision, physical fitness, reaction time, and alternatives transportation options. Offers tips to counteract weaknesses in these areas so the senior can keep driving. (National Highway Traffic Safety Administration)
Drivers 55 Plus: Self-Rating Form – A driving self-awareness quiz. Helps the senior to pinpoint areas of driving weakness. (AAA Foundation for Traffic Safety)
Driving Decisions Workbook (PDF, rotate it) – A practical workbook for evaluating one’s own driving capabilities, with extensive suggestions for working around driving weaknesses. (University of Michigan Transportation Research Institute)
Making the "Key" Decision – Examines when an adult ought to think about giving up driving, including an assessment, checklist, and steps to consider before relinquishing the keys altogether. (AgeNet.com)
How's My Driving? Simple Tips for Maintaining Driving Skills (PDF) – A pamphlet describing risk factors of senior driving, a self-assessment quiz about safe driving, helpful features of newer cars, tips for safe driving, and flexibility exercises. (Meijer; Michigan State Police; and Michigan Academy of Family Physicians)
Test Your Driving IQ – Safe drivers are up to speed on the smart way to drive, regardless of age. Take this short quiz to see if your driving skills need a tune-up. (AARP)
Drowsiness and driving
Sleeping and Driving Don't Mix – Quiz and warning signs about excessive sleepiness while driving. (AAA Foundation for Traffic Safety)
Sleep – Discusses the dangers of sleepiness and driving, and how to take care of your sleepiness so you can drive. (SeniorDrivers.org)
Medications and driving
Drugs and the Older Driver – How medications can affect driving, tips for drivers on medications, and a table of medications that can affect driving. (Canada Safety Council)
Physical fitness and driving
Exercises – Exercises for seniors to increase flexibility for driving. (SeniorDrivers.org)
Alzheimer’s, brain impairment, dementia, and driving
A Practical Guide to Alzheimer's, Dementia and Driving (commercial site) – Discusses the ability of people in early stages of dementia to drive; includes warning signs and a family agreement form for the senior to sign. (TheHartford.com)
Dementia – Outlines the effects of dementia on driving (mild, moderate, and severe dementia). (California Department of Motor Vehicles)
Talking with the senior driver
We need to talk...Family conversations with older drivers (PDF download or web version) (commercial site) – Comprehensive coverage of how to talk to a senior about their driving. Includes risk factors of senior driving; who is the best one to have the conversation; how to prepare for and have the conversation; planning for alternative transportation; and a workbook for planning for the senior to stop driving. (TheHartford.com)
Helping Your Parents Stay Mobile – Tips for talking with elderly drivers about driving issues. (AARP)
When You Are Concerned (PDF) – Handbook for family members of senior drivers. Topics include: safety issues, monitoring driving, resources for help, and talking to the elderly driver. (New York State Office for the Aging)
Coping with life after driving
Coping – Comprehensive article about seniors coping with not driving: a senior’s reactions, how to cope with those emotions, how to help with practical matters. Focuses on the reality that family caregiving may become more time-consuming with the senior’s not driving anymore. Links to further information about transportation alternatives. (New York State Office for the Aging)
People With Vision Loss Share Insights on Driving – Insights on helping a senior to adjust to the transition to not driving. (Carol J. Sussman-Skalka , VisionConnection.org)
Complete article ---- Tina de Benedictis, Ph.D., Gina Kemp, M.A., Doug Russell, LCSW, and Monika White, Ph.D., contributed to this article. Last modified on: 01/14/08.