Elderly Drivers *

David A. Gershaw, Ph.D.

With cooler weather in Arizona, there is an increased concern about elderly drivers. With the influx of retired people into our community each winter, older drivers intensify our traffic problems. People want older drivers off the road completely, especially if someone has just been injured or killed by an elderly driver.

In the last 20 years, the number of drivers ages 65 and over has more than doubled, numbering about 13 million. By 2020, there will be 30 million. In relation to miles traveled, drivers over 65 have more crashes – and more fatal crashes – than other age groups. With this mileage criterion, only drivers under 20 have higher accident rates.

However, with the number of drivers, drivers 65-74 years of age have as few or fewer accidents than drivers at other ages. Even those 75 and over have fewer accidents than drivers under 30. In other words, the elderly drive less, but they are a higher risk when they do drive.

This does not mean everyone over 65 is at risk in traffic. According to one researcher, "There is a small subset of impaired older people, under 20 percent, that brings the group’s average down. They have multiple accidents. The goal is to find some way of identifying them."

Restrictions made according to age – rather than driving ability – express the prejudice of ageism. In addition, the traditional eye tests and "rules-of-the-road" examinations are not effective in weeding out high-risk elderly drivers.

The main pressure for better control of older drivers comes from those who have lost loved ones in accidents. An organization – CARD (Concerned Americans for Responsible Driving) – was founded in Missouri by the family of a 21-year-old college student. He was killed swerving to avoid a 91-year-old, senile driver in a pickup going the wrong way. With this organization’s urging, legislation was introduced for increased testing of older drivers. It required exams every three years after age 74 and annually after the age of 80.

According to the State Senator who introduced the bill, "I had such pressure from senior citizens, you wouldn’t believe." An amended version of the bill – supported by CARD – calls for the same exams for all drivers every six years. AARP (American Association of Retired Persons) also favors bills that relate to performance rather than just age.

Another option is being considered in New York State. When patients have ailments that make them unsafe as drivers, physicians should urge them to report their condition to the DMV (Department of Motor vehicles). If the patient fails to report this to the DMV, the physician will be obligated to do so. Some licenses may restrict driving to various times and areas.

The AARP offers refresher courses for drivers. In 32 states, attending these courses leads to lower insurance rates. Each year, almost a million older people take the course.

Whether they take the courses or not, most older people recognize their limitations. They restrict their driving accordingly. However, some oldsters don’t recognize their limitations or adapt to their infirmities. How can these drivers be identified?

In Kentucky, research is centering on an automated test of visual processing. It measures a driver’s useful field of vision and the ability to ignore visual distractions. Those who lost over 40% of their visual field were 16 times more likely to be involved in an accident.

In Connecticut, drivers – ages 72-92 – were asked questions and given medical exams. When interviewed a year later, 13% had been in an accident or moving traffic violation. The best indicator of risk was the inability to copy a simple pattern of two overlapping pentagons.

Even though the tests can help to identify risky drivers, they are far from perfect. John W. Eberhard, a psychologist at the Department of Transportation in Washington, indicates that most tests are related to vision, but visual acuity is a poor predictor of accidents. Eberhard believes more effort should go into making families and physicians identify at-risk drivers. Then they need to be willing to report these drivers to the DMV.

Older people see driving tests as threatening. In Eberhard’s words, "I’m against tests if they unnecessarily stop people from driving. That leads to people being institutionalized." Many oldsters live in smaller communities that do not have public transportation. If they cannot drive, they lose their mobility. Their quality of life is diminished. The oldsters themselves think it is "criminal" to let at-risk oldsters behind the wheel. Even so, they would feel crushed if their licenses were taken away. They would lose most of their independence. In one person’s words, "If I didn’t have the means to go somewhere when I wanted to go, I couldn’t live that way."

Significant others of impaired older drivers
are caught in a dilemma.

This puts the children and spouses of impaired oldsters into a conflict. We may want report unsafe drivers, because they are a danger to themselves and others. We don’t want them to cause an accident – especially one leading to injury or death. However, this will severely restrict their independence. At that point, others will have to chauffeur those ex-drivers, or the oldsters may need to be placed in an institution where their needs can be met without the demands of driving.

It is a very difficult decision to make. You are "damned" if you have the license taken away, but you may be "damned" if you don’t. I can empathize with this dilemma, since my wife and I may soon be in it.

* Adapted from Robert W. Stock, "Balancing the Needs and Risks of Older Drivers," Themes of the Times: Abnormal Psychology, Prentice Hall, Fall, 1996, page 11. Originally printed in The New York Times, March 28, 1995.

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