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.