When Should the Elderly Stop Driving?

Sometime in her late eighties, my mother-in-law announced that she would no longer drive her car. She explained simply that she’d been driving for decades without an accident and she didn’t want to break her safe driving record. So, she just quit.

My mother, on the other hand, terrified the officer who took her out for a driving test after she had inadvertently let her license expire when she was about 80. My mother said that the official yelled at her so often and so loudly that she was mortified. The official said that she’d never been on the road with such a bad driver.

Needless to say, my mother did not get a new license.

The first way is the best way, I think.

But many elders don’t want to give up their licenses, even when family and friends know they should. Who should decide? It’s often an emotionally charged issue for the drivers, who fear loss of mobility or don’t realize their shortcomings. But, it’s a safety issue for the rest of us.

"Driving in Massachusetts: When to Stop and Who Should Decide," a study by the U Mass Boston Gerontology Institute and Center, reports that older drivers are likely to experience an increased accident rate per mile (though they ddrive fewer miles) and are at a greater risk of dying in that automobile accident.

Moreover, the report continued, "Data also suggest that older drivers are at fault a disproportionately high percentage of the time when they are involved in accidents."

About three years ago, the American Medical Association suggested that doctors notify their state department of motor vehicles if patients have medical conditions that could adversely affect their driving abilities. And the Academy of Neurology suggested that doctors assess their Alzheimer’s patients every six months.

Surveying doctors, law enforcement officers, and people over 50, the Gerontology Institute found that all three groups agreed there should be periodic tests of skills as people age, that there should be driving reassessment in Massachusetts and that an age for that reassessment should be determined.

That was the easy part. When it got down to details about how often reassessments should take place and in what form, or at what age they should begin, there was less agreement.

Vision tests, road tests, and mental health assessments were most often suggested. Other criteria noted as being important included alertness, flexibility, hearing, memory, history of moving violations, and medications taken.

But, different groups placed the bulk of the responsibility on others.

For example, everyone agreed the drivers, their families, the Registry, physicians and law enforcement officers should share the responsibility for deciding when the elderly should stop driving.

The general public and law enforcement groups rated physicians as more responsible for the decision than did the physicians. Law enforcement officers and physicians rated adult children significantly higher in responsibility than did the general public.

Right now, only 11 states have age-based license renewal requirements and Massachusetts isn’t among them. Age alone, of course, isn’t the sole way to determine competence behind the wheel.

Consider vision. (Massachusetts does mandate a vision test when renewing a license.) Driving record. Medical history.

Someone has to take responsibility.

The driver? Many do take responsibility by driving less, not driving at night or in bad weather, not driving on highways.

Law officers? Many are reluctant to issue tickets or warnings to older drivers. The Institute suggested that they receive more training about complications that can arise because of failure to ticket, thus inadvertently condoning unsafe driving.

Doctors? Many are not aware that the AMA allows them to put public safety over confidentiality.

The Registry? With which tests, at what age, and how often? The study suggested vision, alertness, reaction time, number of moving violations and hearing.

Respondents to the study had several answers to the question about who should take responsibility. The consensus, in this order: self, Registry, spouse, physician, law officers, adult children.

Remember: one out of every three drivers today is over 55, some 7,000 older drivers are killed in automobiles accidents each year. There’s been a 39 percent increase in the number of drivers 70 and older killed in crashes in the past 10 years.

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