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Older Drivers: The Car Key Decision

As the number of older drivers increases as the population ages, the question arises more often: When should the car keys be taken away to ensure the safety of older drivers -- and others on the road?

The Fix-It Approach continued...

But the good news, according to Cynthia Owsley, PhD, a professor of ophthalmology at the University of Alabama at Birmingham, is that surgery can put these drivers safely back behind the wheel. In her study of 288 drivers with cataracts, ages 55 to 85, some 187 had cataract surgery. After the surgery, the study subjects had a crash rate 50% lower than those who didn't have the surgery.

Decreased reaction times, common among seniors, also can be improved, according to Karlene Ball, PhD, director of the Center for Research on Applied Gerontology at the University of Alabama at Birmingham.

To evaluate reaction time and predict crash risk, Ball tested more than 3,000 seniors with driving problems who were referred to the Maryland Motor Vehicle Authority medical advisory board. She used a test called "useful field of view" in which a person reports whether they see a car or a truck coming down the road in the middle of a computer screen. At the same time, the subject must notice the location of a car on the periphery. "It starts off fairly slowly and gets faster and faster," says Ball.

Drivers who showed a 40% or greater impairment in their useful field of view were more than twice as likely to be involved in a crash within three years of testing, according to Ball's study. But after undergoing 10 computer training sessions on how to make quick decisions, people can improve their performance by as much as 300%, Ball says.

Other rehabilitation programs are available. For instance, the AARP Driver Safety Program helps older drivers sharpen their skills and develop safe defensive driving techniques. It covers the following topics:

  • Vision and hearing changes
  • Effects of medication
  • Reaction time changes
  • Left turns and other right-of-way situations
  • New laws and how they affect you
  • Hazardous driving situations

Classes are held nationwide.

When It's Time to Quit

If an older driver's declining skills are beyond help, the best solution is helping family and friends convince the drivers to hang up their keys for safety's sake. While some older drivers relinquish their driving privileges on their own, most need to be persuaded to stop driving by a relative or doctor.

To get a driver off the road, police officers, doctors, social workers, and family members can file a hazardous driver report (in some states, anonymously) with the state Department of Motor Vehicles. The DMV is then, in effect, the "bad guy." When they revoke a license, most people will comply, if bitterly, according to Nancy Wexler, MA, MFCC, a founding member of the National Association of Professional Geriatric Care Managers, which helps families arrange for long-term care and other services.

Doctors, for their part, would prefer to limit their involvement to patient counseling. Despite a proposal of its Council on Ethical and Judicial Affairs stating that the reporting of impaired drivers is an "ethical obligation" of a physician, representatives to the American Medical Association twice rejected that position at the urging of many medical societies, including the American Academy of Ophthalmology.

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