Statistically speaking, older adults are nine times more likely to be involved in fatal accidents than drivers aged 25 to 69, according to the U.S. Department of Transportation. Accidents involving older drivers can cause injury to both the older driver and other drivers and pedestrians. In 2000, older adults made up 9% of the resident population, but accounted for 13% of all traffic fatalities and 17% of all pedestrian fatalities.
 

The keys to reducing accidents and unsafe driving are for older adults and their family members to recognize signs of unsafe driving, intervene appropriately, and find alternative means of transportation before safety becomes an issue.

Recognizing Unsafe Driving

Many family members recognize unsafe driving among older relatives, particularly forgetfulness, confusion, bad judgment, failure to follow the rules of the road, inability of drivers to see where they are going, and aggressive driving. Family members may notice crashes; new dents and dings on the older driver's car; neighbors, friends, police, or others calling them about the driving problem; or observing unsafe driving firsthand.

Vision: Our eyes change as we get older, resulting in diminished ability to focus on objects (and shift our focus to other objects quickly), lessened ability to focus on fine details, reduced peripheral vision (i.e., the ability to see things out of the corner of our eyes), poor night vision and sensitivity to glare, and weakened depth perception.

While most of the changes are a normal part of aging, vision should be checked regularly by an eye care professional. Diminished vision does not necessarily mean that driving should be stopped altogether. In some cases, behavior and timing can be changed instead, such as by limiting night driving or wearing sunglasses during the day.
 

Hearing: Older adults may commonly experience some hearing loss, especially of high-pitched sounds. If hearing loss that leads one to be inattentive to their surroundings, they should consult an audiologist or doctor for a complete exam. If an older adult wears a hearing aid, make sure that it is properly maintained and placed correctly in the ear

Mental Functioning: The ability to react quickly and decisively to traffic conditions is critical to safe driving. Even though reaction time may slow with age, the driver can compensate by keeping a wider distance between other cars, for example. Family members should monitor the use of alcoholic beverages. If the driver is impaired due to the early stages of dementia, it is imperative to stop driving and discuss alternative transportation means with family members and friends.

Health and Medications: Numerous diseases, including arthritis and heart disease, can affect one’s driving ability. If the driver has limited mobility, such as the inability to tightly grip a steering wheel or to look completely over her shoulder, they should consider alternative transportation. Reduced physical strength, especially in women, may make it harder to control a vehicle. Certain medications may affect driving as well, especially those that cause drowsiness, blurred vision, dizziness, or muscle relaxation. Consult with your doctor or pharmacist for possible side effects and interactions, including common over-the-counter products.

Vehicle: Unexplained dents, dings, and scratches may be a sign that the driver has not been alert or has trouble negotiating parking lots or tight spaces. Small dents can be a sign of more serious accidents waiting to happen.

Strategies for Intervention

Older men with certain medical conditions, especially dementia or declining vision, who are not aware of or do not recognize their disabilities, and who have little contact with family members or friends, are most at–risk of engaging in unsafe driving behavior. The independence driving provides is more important to older men than older women who are more willing to modify or stop driving.

Family members and friends most likely to intervene to help the problem older driver modify or stop driving are those with strongest concern and caring for the older driver -- generally the same people who are likely to become caregivers or decision–makers for caregiving. Those who intervene are most likely to be a spouse, or an adult child of an older driver.

Sometimes family members recognize the older adult’s limitations before they do. Although they may try to intervene on their own - by removing keys, making the car impossible to start, or removing the car altogether - they may need the assistance of police or physicians. Traditional social agencies such as area agencies on aging, government, motor vehicle licensing agencies, or physicians may be able to provide family members with guidance on how to limit an unsafe adult’s driving.

According to a 2001 Department of Transportation study, barriers to intervention include social and cultural norms that favor individual independence over public safety; national policies, state regulations and practices including those related to reporting problem older drivers; lack of support from authority figures; lack of public education and information about public health risks; lack of customer–focused alternative transportation services; and an inability or unwillingness to recognize the problem and change to driving safely.

Families can help to persuade older drivers to limit or reduce their driving by:

Appealing to authority figures: Many older adults may respond to recommendations by healthcare professionals, law enforcement officials, and Department’s of Motor Vehicles when considering whether to limit driving due to impairment.
Focusing on cost savings: Family members can present various transportation options to the older adult while showing the costs and benefits of each. This may convince them to choose lower-cost alternatives such as car pooling, public transportation, or taxi service. Be sure to include the cost of insurance, gas, and repairs when calculating the cost of owning a car.
Helping plan for mobility changes: Families can help by researching various transportation options, exploring them, and gradually substitute them for private driving.
Getting an independent opinion: DMV examiners or healthcare professionals are the best authorities for assessing and examining a person’s ability to drive a car.
Improving existing skills: Families can encourage the older driver to voluntarily take a refresher course offered by AARP or their insurance company.
Maintaining Autonomy and Independence

Unless there is compelling evidence to the contrary, older adults should be encouraged to maintain their lifestyle and activities, including driving. However, we can expect that if a person lives long enough, at some point, age–related changes and declines in functional ability due to disease may alter the performance level of critical skills needed to drive.

If there is no other way for the person to get around, people are reluctant to "sentence" a family member to home confinement. Knowing when an older person's driving has become unsafe, or how to recognize the signs that the problems are reaching the point where intervention is required is critical.

There may be options for older adults to minimize their driving, rather than to stop altogether. For example, they may consider using public transportation, car pooling, or walking for certain trips. When weighing other options, keep in mind the reduced cost of gasoline, insurance, parking, and hassles when taking other forms of transportation; and the convenience of not having to drive, park, or pay attention to the road. Ideally, older adults will begin exploring the use of alternative transportation prior to completely stopping driving.

The type of transportation that is available in your community will vary depending upon where you live. Transportation for the elderly can include door-to-door service, the public bus that travels along a fixed route, or ridesharing in a carpool. Older adults and concerned family members should consult with their local Area Agency on Aging, the Eldercare Locator, or municipal and local social service providers for free and low-cost options (see Resources below).

Tips for Safe Driving

All drivers should be aware of safe driving habits, regardless of age. These habits are particularly helpful:

If you want to limit night driving, plan lengthy trips for daytime driving, leaving early in the morning if necessary.
Run errands in the morning when you are fresher and more alert.
Avoid driving on narrow, congested roads, especially at rush hour.
If you wear glasses or use a hearing aid, make sure that you use them when driving.
Sit comfortably in the seat without slouching or leaning, adjusting the seat each time or using a raised seat cushion if necessary.
Always wear your seatbelt, using a shoulder strap cushion if it is more comfortable.
Use extra caution when executing left turns or avoid them altogether.