"There are many ways aging influences driving safety, primarily because of health problems that are typical as we grow older," says Moira Keller, LCSW, a clinical social worker at Piedmont Sixty Plus Services.

How aging affects driving ability

Keller says the following conditions can affect a person's driving ability:

• Arthritis may make it difficult to pivot quickly to look behind or out of the sides of the vehicle or even to reach to adjust mirrors.
• Visual impairments such as cataracts, glaucoma, or macular degeneration can make it more difficult to see well, especially at dusk or at night.
• Hearing loss may make a driver oblivious to emergency sirens passing by.
• Spine problems may make the driver lose height and become shorter behind the wheel, thus diminishing visual range.
• The onset of memory loss, which becomes more common the older we get, can result in a host of driving dangers, such as forgetting the rules of the road, getting lost (even in familiar locations), and confusion about how to operate the car.

"It’s important to note we all tend to take more medications as we age, and even if we are not developing dementia, such as Alzheimer’s disease, the medications we take can cause cognitive changes and confusion, which in turn can affect our driving abilities," she adds.

Warning signs an older adult may need to stop driving

If you are concerned about an older adult's driving ability, watch for these warning signs:

• Small fender-benders
• Getting lost during normal errands
• Poor driving judgment and "near miss" situations

"Family members can ask themselves if they are comfortable being a passenger in the older adult’s car," Keller says. "Are they comfortable having their children or grandchildren ride with the older adult? If the answer is no, then it’s time to have the conversation."

How to approach an older adult about driving safety

Approaching a loved one about your concerns requires sensitivity, as driving is often seen as a form of independence.

"Ideally, families will have addressed this issue in advance, asking their older adults – when they are healthy and functioning well – how they will want to handle life when they should no longer drive. It can be less traumatic when it actually has to happen, and older adults may be more likely to decide on their own to do it."

Unfortunately, in some families, a car accident or other crisis may occur before an older adult stops driving.

"This situation should prompt the family to kindly, but firmly, inform the older adult driving should stop, or at the very least, the driver should be tested by a formal driving assessment program," she says.

Maintaining independence

There are several ways older adults can maintain independence, even if they are no longer driving:

• Public transportation, such as bus or rail services.
• Transportation services for disabled adults who cannot utilize traditional public transportation. Atlanta's MARTA has Mobility Services that can be reserved for use. 
• Private transportation companies.
• Transportation offered by the older adult's retirement community.

Driving safety tips for older adults

Many older adults are safe drivers and can continue driving well into their later years. The following tips can help them maintain their driving skills:

• Every time a new medication is prescribed, check with the healthcare provider or pharmacist about possible side effects – specifically, anything that could interfere with safe driving.
• Be vigilant about when and if to use alcohol. Many people don’t realize that older bodies are more sensitive to alcohol’s effects – it takes less to get drunk.
• If their vision isn’t as good as it used to be, limit driving to daylight hours, on dry roads, and only in local neighborhoods. Avoid highway driving.
• Consider a formal driving evaluation. Specially trained occupational therapists will conduct several in-office tests for vision, knowledge of road signs, memory and other functional areas and provide a road test in a dual-controlled car. This is the best way to ensure that a driver is safe enough to be behind the wheel. Sixty Plus Services can refer to local testing programs.

Last-resort options

"Older adult drivers potentially are a big public health concern," Keller says. "A car can be a lethal weapon and anyone operating a car needs to know exactly what they are doing at all times. At Sixty Plus, we get calls every day from exasperated and worried family members who know it is dangerous for their parent, spouse, sibling, or other relative to be driving, but actually getting the person to stop seems impossible."

Many families do not realize there can be legal and financial ramifications if their loved one causes an injury or death while driving, particularly if the person has dementia.

"The family of the victim may be able to sue the driver and his or her family members in civil court," she says. "We have staff members at Sixty Plus who can help families resolve this difficult issue. Please let us know if you are concerned about a driver in your family."

To learn more about Sixty Plus Services, click here.

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