Most of us obtain our driving license as young adults, which is a "rite of passage" in some ways. Driving gives us independence and flexibility, with fuel and vehicle maintenance costs being the main barrier. But, did it ever enter our minds that we wouldn't be driving forever? Of course, when we are younger and in our best health, we wouldn't think of that. However, as our body and mind age, is there a point that one should consider retirement from driving?
Driving is a privilege and the ability to operate a vehicle safely is a condition of that privilege.
Physical and medical conditions associated with aging may directly affect the ability to drive safely.
Be alert to vehicle damage or unsafe operation signs indicating your loved one may not be safe to operate a vehicle.
Driving statistics for older adults
The population over age 65 in the U.S. increased by 35% between 2011 and 2020. In 2020 17% of all traffic fatalities involved adults 65 years of age and older. The number of fatalities increase in adults over 75 and even more after age 85.
Older adults are more likely to be seriously hurt in a motor vehicle accident and require hospitalization. Some states require older adults to renew their license in person after age 75 to 80 by a written test, sometimes accompanied by a road test.
Driving and age-related limitations
While we can't stop the process of aging, we can educate ourselves to be more aware of limitations that could affect the safe operation of a vehicle. For example, while we often consider having a driver's license a right to drive, it is more appropriate to view our state license as a privilege to drive. However, with every privilege, responsibilities are required to maintain that benefit.
As we age, our vision may deteriorate, or we may develop age-related eye conditions such as cataracts, macular degeneration, and glaucoma. Some people will self-restrict by driving only during the daylight hours, in good weather, or avoiding the freeway. Aging may also cause decreased peripheral vision, which is problematic for an adequate visual field. A comprehensive visual assessment by an eye care professional should occur every year after age 65 for early detection of any subtle changes.
A decrease in hearing ability may also cause challenges with driving, although people who are hearing impaired can also drive safely with modifications. In addition, as we age and hearing acuity declines, the capacity to hear sirens and horns can affect the ability to respond safely to an emergency. Therefore, after age 50, an audiology professional should assess your hearing every three years. This assessment will provide early detection of hearing impairment. In addition, hearing aids can be an effective treatment for hearing loss, and recent data suggests improvement in hearing may reduce the risk of dementia.
As we age, our reaction time and reflexes may decline. This impairment can risk the safe and prompt reaction to an emergency.
Some medications may affect alertness and the ability to drive safely. If one is tired or lightheaded, it could be a side effect of medication. Contact your medical practitioner or pharmacist for a medication review. Do not drive if you feel these effects.
Many people with mobility restrictions can drive safely. Some may require modifications to their vehicle, such as hand controls. As we age, inflammatory conditions such as osteoarthritis and rheumatoid arthritis can affect our range of motion to change position. Mobility challenges may also impair our physical ability to operate a vehicle. For example, conditions in the upper spine and neck can cause you to be unable to look over your shoulder to check your "blind spot" efficiently. If you have flexibility limitations in your legs, promptly moving your foot from the gas pedal to the brake may be more challenging.
Cognitive decline, dementia, and driving
People with mild cognitive impairment or even in the early stages of dementia may be able to drive safely. Because dementia is a progressive disease, it is necessary to monitor the driving of your loved one with cognitive impairment. Maneuvers requiring a prompt "reaction time" can be affected by a decline in cognition. A medical practitioner must, by law in most U.S. states, report a diagnosis of dementia or Alzheimer's to the State Department of Motor Vehicles and any other medical condition that can pose a safety risk.
Assessment by a registered Occupational Therapist or a lesson with a certified driving instructor can also aid in the evaluation. People with cognitive impairment may not have the insight or awareness to realize their driving ability is problematic; family and friends need to have heightened attentiveness to their loved one's driving capability. Dementia can also cause issues with someone's visuospatial capacity, meaning it is more difficult to judge the distance between them and another vehicle when driving or parking.
People with cognitive impairment may have the ability to get into a car, turn on the key, and appear to be able to drive, but this could be an example of procedural memory. Procedural memory is the ability to carry out a task that is so habitual and repetitive that it is ingrained in your brain pathways. A person's ability to manage this initial task can make it difficult for them or their family to recognize they have a problem driving. While the action of starting the car is not in question, when driving, the person with a cognitive impairment may not be able to react quickly if an animal or small child runs out into the vehicle's path. Often when you explain it this way to family, they have a better understanding of the possible safety risk.
Should your loved one retire from driving?
Here are 10 warning questions to help you decide if your loved one needs to retire from driving:
- Are there unexplained scratches or dents on the vehicle?
- Are they accumulating more traffic tickets for unsafe maneuvers?
- Are they driving over curbs or going through stop signs or traffic lights?
- Are they driving too fast or too slowly?
- Are neighbors making comments about their poor driving?
- Are they getting lost driving in previously familiar areas?
- Are they confusing the gas and brake pedals?
- Are they missing exits or taking wrong turns more often?
- Are there unexplained dents and damage on their garage door or house?
- Do they have increased irritability and/or anxiety when driving?
Driving is a privilege
We often take our ability to drive for granted. However, to maintain a driver's license, you must ensure you can drive in a capacity that does not put others at risk. If you have any previously mentioned concerns about your loved one operating a vehicle, it may be time for them to consider retiring from driving. Please feel free to talk about these concerns with your medical practitioner for the treatment of any possible medical issues. In addition, you may need to explore alternate transportation methods, such as ride-share programs, taxis, public transportation, or friends and family.
Whether your loved one decides to retire from driving or they have lost their license, it can be a very stressful time as the freedom to drive can be part of one's identity. You may wish to consider reaching out to your local Alzheimer's Association or a private counselor for support and direction. The safety of your loved one and others on the road is paramount to everyone arriving at their destination.