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Home >> Solve a Problem >> Dangerous Driving
 

Dangerous Driving and Seniors

Picture of heavy traffic on a freeway

bullet Warning Signs of Unsafe Driving
This Section is Published Through the Courtesy of Vicki L. Schmall, Ph.D.

Behavior that may indicate a person's driving threatens personal safety and that of others includes:

bulletHas difficulty following instructions and directions.
bulletCoasts to a near stop in the midst of moving traffic.
bulletDrifts into other lanes of traffic.
bulletStops abruptly without cause.
bulletPresses simultaneously on the brake and accelerator while driving.
bulletDelays changing lanes when an obstacle appears in the lane in which s/he is driving.
bulletFails to appreciate the frustration, exasperation, or irritation exhibited by other drivers toward his or her driving.
bulletDoes not signal when turning or changing lanes.
bulletHas accidents, near misses, or "fender benders."
bulletGets lost in familiar places.
bulletFails to obey traffic laws, road signs, or signals.
bulletDrives against traffic, on the wrong side of the road (definite danger).
bulletMakes errors in signal use, steering, braking, speed, and accelerator use.
bulletHas difficulty seeing pedestrians, objects, and other vehicles.
bulletIs increasingly nervous when driving.
bulletBecomes increasingly flustered in traffic or by more aggressive drivers.
bulletFails to yield the right-of-way or yields the right-of-way inappropriately.
bulletDrives significantly slower than the posted speed or general speed of other vehicles.
bulletTurns from an improper lane or at an improper time or pace at intersections (especially when turning left).
bulletStraddles lanes.
bulletIgnores or coasts through stop signs.
bulletBacks up after missing an exit (definite danger).
bulletFalls asleep while driving or gets drowsy.
bulletDoes not pay attention to other drivers or road hazards.
bulletDoes not react to emergency situations.

When any of these signs appear, it is time to assess the situation. Don't wait for an accident. Also if a person is having problems related to daily living - such as hygiene, grooming and paying bills - he or she may be having difficulties with driving. Up arrow to top of page

bulletReduction in Skills Needed for Safe Driving

Physical and mental changes associated with the aging processes often lead to reductions in the skills needed for safe driving.

bullet

Effects of medications
The use of multiple prescription drugs may cause drowsiness or anxiety, thus impairing driving skills.
bullet

The Older Adult Driver (American Family Physician)
includes a list of medication that may impair driving skills.

bullet

Common medications can impair driving (WebMD)

bullet

Drugs and human performance fact sheets (from NHTSA)

bullet

Brain impairments
bullet

Incidence and prevalence of the major causes of adult-onset brain impairment in the U.S. (Caregiver.org)

bullet

How dementia affects driving (CA DMV)

bullet

Alzheimer's, Dementia & Driving (The Hartford)

bullet

Vision conditions
The eyes become slower to adapt to light and darkness, which can create sensitivity to bright sunlight and glare. The eyes also lose some ability to process light, which makes seeing at night harder. Depth perception and judging the speed of oncoming traffic also weaken.
bullet

How is your vision? (from NHTSA)

bullet

How vision conditions affect driving (CA DMV)

bullet

Loss of hearing
bullet

Should I be concerned about hearing loss? (AARP 55 Alive Driver Safety Program)

bullet

Physical fitness
Common health problems, like arthritis, can make it harder to drive by limiting people's ability to turn the head easily or move a foot from the accelerator to the brake.
bullet

How is your physical fitness? (from NHTSA)

bullet

Flexibility allows you to see what is happening on the road. Exercise can help to improve your range of motions. (SeniorDrivers.org)

bullet

Sleepiness
The use of multiple prescription drugs may cause drowsiness.
bullet

Sleeping and driving don't mix. (SeniorDrivers.org)

bullet

Drowsy driving and automobile crashes (from NHTSA)

bullet

Danger Signals: How sleepy are you? (from AAA Foundation for Traffic Safety)

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Attention and reaction time
Older drivers often find it difficult to react quickly as they process multiple images or sounds, such as when they're looking for street signs while monitoring traffic and talking with a passenger.
bullet

How is your attention and reaction time? (from NHTSA) Up arrow to top of page

bullet Losing the Right to Drive is a Traumatic Event

Driving is viewed as a necessity. When a disability occurs, it can affect the skills necessary for independent living.

The Community Transportation Web site includes a comprehensive Web page on "Mobility and Independence: Changes and Challenges for Older Drivers" addressing the consequences of mobility changes and the impact that loss of driving has on personal independence.

In the research paper "The Mobility Consequences of the Reduction or the Cessation of Driving by Older Women" (PDF format), the authors study the consequences of driving cessation with a focus on older women. Up arrow to top of page

bullet Ethical and Moral Concerns

bullet

Senior
Few seniors plan for the time when they will be unable to drive, yet many will eventually face this decision. Most believe they will know when it is time to stop driving. However most seniors also know friends who continue driving and can no longer operate a vehicle safely.
Giving up the car keys is viewed by elders and those around them as a major event with significant implications regarding independence, self-sufficiency (especially in Los Angeles), and social responsibilities.
Many seniors face this dilemma:
"Do I continue to drive even when driving begins to pose real safety risks for myself and others?" 

Faced with this dilemma, some individuals stop driving, while others continue to drive. Up arrow to top of page

bullet

Family
Giving up driving is a major event for an older person and a senior's loss of independence also has significant implications for his or her family.
Children are reluctant to discuss this emotional issue and may be concerned about hurting the senior's feeling. Some family members may also be afraid of losing the senior's affection or of retaliation.
Family members may be unprepared to provide the additional level of care and support needed by an increasingly dependent elder.
Many family members must face this decision:
"Do I continue to let a senior drive even when driving begins to pose real safety risks for him or her, other family members and the public?"

Some family members refuse to intervene but would not let their own young children ride with the senior driver. Up arrow to top of page

bullet

Physicians
Physicians must balance their ethical responsibilities to patients and to the public. Their dilemma is illustrated in this Web page:
Medical Crossfire Debate: Should physicians report patients with medical conditions that make them unsafe drivers?
In December, 1999, the American Medical Association changed its ethical guidelines to let doctors notify the motor vehicle department in their states about patients with medical conditions that could make them unsafe drivers. This policy makes public safety a priority over the confidentiality of patients and does not have universal support among physicians. Up arrow to top of page

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Organizations
Most organizations providing services to seniors are aware of elders who can no longer drive safely but continue to do so and are placing themselves and the public at risk.
Like physicians, social workers attempt to balance their ethical responsibilities to clients and to the public. They are also very concerned that their organization not get a reputation for "turning in" seniors to the Department of Motor Vehicles, thus discouraging elders from seeking their services. Up arrow to top of page

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Elected Representatives
Elected representatives are caught between constituents clamoring for public safety through increased screenings of older drivers, and pressure from seniors and advocacy organizations fighting against age discrimination.
In several states, legislative attempts to add to the testing requirements for older drivers have met with successful opposition from senior groups (such as AARP and the Congress of California Seniors). Additional driving tests for the elderly continues to be a highly controversial topic.
An interesting comparison of the Driver Licensing Renewal Procedures for Older Drivers in the U.S. as of May 2004 can be found on the Insurance Institute for Highway Safety Web site.
Many renewal requirements now focus on health, not age, in determining whether people should be retested. Up arrow to top of page

bullet Department of Motor Vehicles (DMV) Process in California

Senior driver information
Topics include renewing your driver's license, preparing for exams, and driving tests. Up arrow to top of page

Medical Conditions and Traffic Safety
The DMV provides guidelines for physical and mental conditions such as dementia, diabetes, loss of consciousness and vision problems.

Another DMV Web page addresses these questions:
* What can DMV do about a person who may be unable to drive safely due to a physical or mental condition or disorder?
* What types of medical conditions can affect a person's ability to drive safely?
* How does DMV find out about persons who may be unsafe to drive due to a physical or mental condition or disorder?
* How do I let DMV know about a family member, relative or acquaintance whom I believe may no longer be a safe driver?
* What types of conditions must a physician report to DMV?
Up arrow to top of page

How to Refer an Unsafe Driver
If you are concerned for the safety of a family member, friend, or other person who can no longer drive safely, you may write to your local Driver Safety Office or the address given below. You should provide the person's name as shown on the license, birth date, driver license number (if known) and current address, and explain what you observed that led you to believe the person is an unsafe driver. The letter must be signed; however, you may request that your name be kept confidential.
Write your letter to:
Department of Motor Vehicles
Driver Safety Actions Unit M/S J234
P.O. Box 942890
Sacramento, CA 94290-0001

DMV will contact the person for a reexamination and, if necessary, administer a driving test to determine whether or not the person is safe to drive. The person may be issued a restricted license. It is possible that the person's driving privilege may be revoked as a safety measure, not only for the safety of that individual but also for the safety of the rest of the driving public.
For more details, please see the DMV Web page.
The list of DMV Driver Safety Offices in California can also be found on the DMV Web site.
Up arrow to top of page

Confidentiality of Reporter
Anonymous reports will not be considered. However, you can ask to keep your name confidential and DMV will not tell the person who made the report. 
According to Vehicle Code 1808.5, all records received by DMV, which report a physical or mental condition are confidential and cannot be made public:
"Except as provided in Section 22511.58, all records of the department relating to the physical or mental condition of any person, and convictions of any offense involving the use or possession of controlled substances under Division 10 (commencing with Section 11000) of the Health and Safety Code not arising from circumstances involving a motor vehicle, are confidential and not open to public inspection."
Up arrow to top of page

Reexamination Process
The reexamination process may include an interview, a written test and a driving test.
DMV may send the person a form (DS 326: Driver Medical Evaluation) and a notice to call a Driver Safety office for a DMV reexamination. The physician treating the person must complete the medical form. It is important for the person to come in for his or her DMV appointment and bring the completed medical form, otherwise his or her driving privilege will be suspended.
A detailed description and a copy of the Driver Medical Evaluation Form can be obtained on-line.
Starting January 2001, a driving test will be given to any person when a:
*Physician reports the person has lapses of consciousness.
*Traffic officer
requests a DMV review and the officer believes the driver is incapable of operating a vehicle safely.
*Relative makes a good-faith report to DMV stating the driver cannot safely operate a vehicle.
Up arrow to top of page

DMV Guidelines for Taking Action
This DMV Web page provides comprehensive guidelines for evaluating and taking action against the driving privilege of drivers with physical or mental conditions or disabilities that may impair the ability to drive.
Some of the requirements considered are:
* Physical requirements
* Sensory functions
* Mental requirements
* Emotional stability
* Knowledge requirements
* Physical limitations/restrictions
* Physical or mental condition and history
* Aggravating factors
* Treatment
* Nexus of physical or mental condition to driving
* Determination of compensating factors
* Driver understanding and awareness

This Web page also reviews DMV options and your hearing rights. 
Up arrow to top of page

DMV Options
A determination may be made that no condition exists which warrants an action against the driving privilege. The department may also find that a condition exists which warrants:
*Reexamination on a specified date (Calendar Reexamination)
*Medical Probation I: driver must comply with medical regimen and report any changes to the department
*Medical Probation II: annual medical reports required to be submitted to the department on specified dates
*Limited Term Licenses: license issued by the field office for one to two years which requires the driver to return to the department for reevaluation and/or testing
*Restrictions
*Suspension
*Revocation: The hearing officer may revoke the person's driving privilege if he or she does not do well on the written test or it is clear that the person does not have the skills needed for safe driving. For this reason, DMV suggests that someone accompany the person to the interview. The loss of license will be a traumatic event. Support and resources should be made immediately available to help the senior during this crisis. Up arrow to top of page

No-Fee Identification Card
The driver license is often a person's primary means of identification. Its loss often means the person will not have a handy form of photo identification for check cashing purposes, qualifications for services, etc. DMV understands that a person needs some form of identification. So If a senior's driving privilege has been revoked because he or she is no longer able to drive safely, or he or she develops a physical or mental condition which interferes with his or her driving performance and voluntarily surrenders the driver license, then DMV will exchange a valid driver license for an identification card (ID) free of charge, as long as the license has not expired. Up arrow to top of page

bullet Options to Keep Driving Safely

bulletAssessment
bullet

A Self-Assessment Form: Driver 55 Plus
can help drivers discover their limitations and help them prepare for the day when they may no longer be able to drive safely. A self-assessment may also help your mature driver understand your concern about his or her driving skills.
You can download the very large file in pdf format from the AAA Foundation Website.

The self-assessment form, Drivers 55 Plus: Test your Own Performance, is also available from the following organizations by enclosing a check or money order for $2:

Automobile Club of Southern California
Public Safety Dept. H206
2601 S. Figueroa St.
Los Angeles, CA 90007

California State Automobile Association
Traffic Safety Dept.
150 Van Ness Ave.
San Francisco, CA 94101

AAA Foundation for Traffic Safety
1440 New York Avenue, Suite 201
Washington, DC 20005

bullet

Test your driving IQ and
Close Call Quiz

From AARP 55 Alive.

bullet

Keep alert to changes: Has this happened to you?
From the National Highway Traffic Safety Administration.

bullet

Safer Driving for Mature Drivers
From the State of California Department of Insurance

bullet

Arrange for a private driver evaluation
If you, or those who drive with you, are concerned about your safety, you may chose to have a private driver evaluation.
A driver rehabilitation specialist can provide a comprehensive evaluation to determine your ability to drive.
This assessment should include:
bulletVision Perception
bulletFunctional Ability
bulletReaction Time
bulletBehind-the-wheel evaluation. Up arrow to top of page

bullet

Prevention, Choosing Safe Alternatives, Rehabilitation and Assistive Devices
bullet

AARP 55 Alive Driver Safety Program
The nation's first and largest classroom driver improvement course specially designed for motorists age 50 and older. It is intended to help older drivers improve their skills while teaching them to avoid accidents and traffic violations.
Find a class near you!

bullet

Driving Safely
From California DMV

bullet

Safety tips on a variety of subjects
From the AAA Foundation for traffic safety

bullet

The Association for Driver Rehabilitation Specialists
offers helpful fact sheets covering several types of disabilities, how they affect driving skills and possible remedies including assistive devices:
bullet

Aging and driving

bullet

Driving after a limb amputation

bullet

Driving after a spinal cord injury

bullet

Driving after a stroke

bullet

Driving after a traumatic brain injury

bullet

Driving and Alzheimer's / Dementia

bullet

Driving and cerebral palsy

bullet

Driving with multiple sclerosis

bullet

Driving with rheumatoid arthritis

The Association Web site Directory can help you find a specialist near you.  Up arrow to top of page

bullet Support and Resources to Help After the Loss of a Driver's License

The loss of his or her Driver's License will be a traumatic event for the senior. The sudden loss of transportation may mean the loss of:

Independence and self-esteem

Access to family and friends

Employment and income

Access to trusted medical care

Ability to shop including grocery shopping and prescriptions

Access to personal care

Social and cultural activities

Religious expression.

Support and resources should be made immediately available to help the senior during this crisis.

bullet

The local Multipurpose Senior Center (MSC)
is the primary source of assistance for seniors and their families. Our "Find a Senior Center Web page" can help you find an MSC near you.
The MSC Care Manager can help you with:
bullet

Local transportation and transit programs for seniors,

bullet

Applying for the various benefits, which a senior may be entitled to receive,

bullet

Social activities, trips, classes, fitness, grocery shopping, assistance/escort for medical appointments, nutrition sites near you, meals-on-wheels and much more...

bullet

Professional advice and support for the senior's family.

bullet

Specialized Resources
are available to help a senior remain independent in his or her own home. 

bullet

Local clergy
Seniors who are actively involved with a religious institution can find support from the congregation to keep this important component in their life.

bullet

Delivery Services
Increasingly groceries and prescriptions can be delivered to a senior's home and you can explore this option. Up arrow to top of page

bullet When Your Family Member Who Shouldn't Drive Insists on Doing So
This Section is Published Through the Courtesy of Vicki L. Schmall, Ph.D.

It is important to involve older family members in decisions about driving. However, when a person has a dementia, such as Alzheimer's disease, family members need to take an active role in making and carrying out decisions.

People with Alzheimer's disease or a related disorder simply may not remember that they can no longer drive. Arguing or giving explanations about why the person no longer can drive usually does not work. You will likely only get more frustrated, and so will your family member. Families have found many of the following actions - which are also suggested by the Alzheimer's Association - worked for them.

bullet

Get a prescription from the doctor that states "no driving"
Show this to your relative when s/he insists on getting behind the wheel.

bullet

Distract the person
When your family member insists on driving, try to get his or her attention focused on something else. For example, one wife would say to her husband, "I was just fixing a bowl of your favorite ice cream. Let's eat it first." Another wife would say, "We can't drive now. The car needs to be repaired."

bullet

Control access to car keys
Do not leave car keys in view of your family member. Give him or her a different, but similar-looking set of keys or have a locksmith file the part of the key that turns the ignition. The person can still enter the car, but will not be able to start it. Some people, however, may become frustrated and angry when "the keys won't work."

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Disable the car
A car mechanic can show you how to quickly disable a car - remove the distributor cap or battery or unplug the starter wire - so it won't run and what to do to get it to operate again. Another option is to have a "kill wire" installed. It prevents the car from starting unless a switch is thrown. If your family member lives alone, this may not be a good option. As one family said:
"We knew how important Dad's car was to him. I had never seen him cry so hard as the day we told him he could no longer drive. He finally agreed not to drive, but wanted to keep his car in his driveway. Since we did not know if he would remember that he was not to drive, as a precaution, we made his car inoperable. What we did not count on is that a week later he would call a mechanic to repair the car."

bullet

Move the car
For some people, seeing the car is what triggers the desire to drive. Try parking the car where your family member does not see it but where you can get easy access.

bulletSell the car
You might use the excuse that the car cannot be repaired or that the car was no longer safe to drive. Up arrow to top of page

In addressing driving concerns, it is important to remember that:

Driving is not a right; it is a privilege, which the state may grant or withhold.
An older driver does not automatically equal an unsafe driver. Do not hassle the older family member who is driving safely. Age is not the most important criterion for determining an unsafe driver.
When asking a person to give up driving, we are asking a great deal.
Driving and owning a car have a symbolic meaning as well as practical significance.
It is important to work with your family member, so that it is his or her decision.
If your family member is putting others at risk by driving, or is cognitively impaired, you will need to take an active role in the decision.
Public safety is a high priority. How well a person drives affects the lives of everyone else on the road. Act if you must! Up arrow to top of page

Updated on 08/19/2004

 

Inside This Page

bullet Warning signs of unsafe
  driving
bullet
Reductions in skills
  needed for safe driving
bullet
Losing the right to drive
  is a traumatic event
bullet
Ethical & moral concerns
bullet
DMV process in California
bullet
Options, assessment
  prevention, rehabilitation
  & assistive devices
bullet
Support and resources
  to help after the loss of
  a driver's license
bullet
When your family
  member who shouldn't
  drive insists on doing so

Useful Links

bullet NHTSA - Driving safely
  while aging gracefully
bullet
Administration on Aging
  Mobility & independence,
  changes and challenges
  for older drivers.

bullet
AARP 55 Alive
  Driver Safety Program
bullet
Association for Driver
  Rehabilitation Specialists
bullet
California DMV
bullet
AAA Foundation for
  Traffic Safety - Seniors

Related Stories

bullet Medical Crossfire Debate
  Should physicians report
  patients with medical
  conditions that make
  them unsafe drivers?

bullet
NHTSA
bullet
Older Driver Safety  
bullet
DOT: Driving is more
  dangerous for older
  drivers
bullet
NHTSA: Older drivers
  cues for law enforcement
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This site was first published in April, 2001.

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