Elderly Driving

Elderly Driving and AAA's Missouri Fitness to Drive

An interesting report done by AAA regarding Missouri’s Fitness to Drive and Voluntary Reporting Law results, http://www.aaafoundation.org/pdf/MedicalFitnesstoDriveFS.pdf

Starting in 1999, Missouri has a legal process whereby law enforcement, doctors, and family members could report an unsafe driver.

The study looked at the 4100 individuals reported under this program from the years 2001 to 2005:

Approximately half voluntarily surrendered their license or did not see their physician and thus their license was quickly revoked. Of the half that did see their physician, most were deemed unsafe to drive. Only 3.5% continued to hold a license to drive. That’s worth repeating, only 3.5% of the individuals reported unsafe to drive, continued to hold valid licenses to drive after going through any required medical review and on-road driving test. The report presents the program as a bit of a failure, not in the sense that it isn’t taking elderly drivers who are unsafe off the road. Rather the program was intended to give medical personnel and family the tool for having their elderly driver evaluated and if necessary, removing of driving privileges. So it’s looked on as somewhat of a failure when police and licensing personnel are the ones who do the majority of the reporting of elderly drivers under the system.

Some inferences from the report:

· A lot of elderly people hold licenses that really shouldn’t be, they are unsafe.

· A lot of family members and doctors either aren’t thinking about the elderly person’s ability to drive safely or are ignoring the warning signs and aren’t doing anything about it.

o Of those reported, 30% were by police, 27% by licensing personnel, 20% by physicians, and 16% by family members

o 7 out of every 8 reports by police were made following a crash or safety violation.

· Reported drivers have an average age of 80. Half were involved in at least one crash in the past 13 years and 2/3 of these crashes happened within 6 months of being reported.

· Almost half have an indication of dementia in their medical history.

Key Facts About Elderly Driving:

Motor vehicle injuries are the leading cause of injury related deaths among 65-74 year old.
After falls, motor vehicle injuries are the second leading cause of injury-related deaths among 75-84 year olds.
Every year over 65, the chances of being involved in a left turn crash go up 8%.

Older drivers are driving longer distances.

By the year 2020 there will be approximately 53 million persons over age 65 and approximately 40 million (76%) of those will be licensed drivers.
By the year 2030, the number of adults 65 years and older, will more than double from its current size to approximately 70 million, approximately 20 percent of the total U.S. population.
In some states in the U.S., the population of those 65 an over may reach 20 percent of the state’s total population in this decade.
Adults 80 years and older is the fastest growing segment of the U.S. population. This group is projected to increase from about 3 million to 8-10 million over the next 30 years.

Some older adults will need to stop driving.

For most adults in the U.S., including the elderly, driving is their usual mode of transportation. Although the percentage decreases with age, approximately 60 percent of those 85 and older still use driving as the usual mode of transportation.
Most Americans will spend many years of their later lives without the functional ability to drive a car.

Driving behavior is self-regulated by many older drivers.

Both older men and women tend to drive significantly less as they get into their old age.
Many Americans know someone who is older who has problems with their driving but is still behind the wheel.

Age and disease related physical and/or mental changes contribute to the crash rate for older drivers

Over 27 million people aged 70 and older, approximately 20 million are licensed to drive.

Physicians and family members have a large influence on the older person’s decision to modify or stop driving. They can also help the person maintain their ability to drive safely.

Medical conditions that may affect someone’s ability to safely operate a motor vehicle.

Seizures

Neurologic disorders ( Parkinson, dementia, alcoholic dementia, various other neurodegenerative

disorders)

Vision

Cardiovascular Disorder

Diabetes

Cognitive impairments (stroke, head injury, dementia, etc.)

Impairments of limbs, back or neck (CP, stroke, injury, etc.)

Psychiatric disorders

Substance disorders

If you have any of the above medical conditions, this does not mean that you should not and cannot drive. However, if someone does have these conditions, they may have progressed to a stage where the person would not be safe to operate a motor vehicle OR would require the condition to be properly controlled along with adaptive equipment, license restrictions and/or additional training to continue to drive safely.

The DMV will look to the treating physician to make a recommendation as to their client’s ability to safely drive.

Restrictions that are commonly placed on a driver’s license to allow a person to continue to drive:

Corrective lenses
Daylight only driving
Reduced speed/No interstate travel
A limited distance from their home
List any adaptive equipment that allows a person to continue driving safely

The following should be looked at and assessed with regard to the older person’s ability to drive safely:

Vision: Difficulty seeing things, bumping into objects as they walk.
Leg weakness: Difficulty walking, unsteady balance, falls often, difficulty getting into and out of chairs.
Hand/arm weakness: Poor grasp, objects fall when being held
Cognitive: Poor attention, unfocused, poor memory, repeating conversations, not speaking clearly or understanding simple questions. Related to this is Poor personal care: Not taking showers/baths, wearing the same clothes when others are available, uncombed hair, disheveled appearance, untidy house, lots of clutter, dirty dishes.
The most common medical conditions in older adults are arthritis, cataracts, diabetes, dizziness, heart disease, hearing impairments, high blood pressure, and pain or difficulty with walking. All of these can affect the older person’s ability to continue driving safely if unchecked.
Many prescription and nonprescription drugs, either by themselves or in combination with other drugs, can potentially impair the user’s ability to drive safely. It is usually left up to the user to self assess the affects of medication on their driving ability. However, people tend not to be very good at self assessments.

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