Driving While Aging

Susan A. Martin, MS, OTR/L

The first week in December has been designated as Older Driver Safety Awareness Week, and with good reason. The National Highway Transportation Safety Administration (NHTSA) says there were 40.1 million licensed drivers in the U.S. who were 65 or older in 2015—a 50% increase since 1999.

Going through changes

It’s clear that as we age, most of us want to maintain our ability to drive for as long as possible. But as we grow older, natural changes will begin to affect our physical, mental, and sensory abilities.

The physical changes include:

  • Joint stiffness. Approximately 80% of seniors over age 70 have arthritis. That can make it harder to turn one’s head to check the road prior to changing lanes or reversing. Arthritis can also make it hard to grip the steering wheel adequately, turn the steering wheel quickly, or reach the seatbelt to secure it.
  • Decreased reaction times. A slower reaction time can complicate braking quickly or turning fast to avoid obstacles or debris in the road.
  • Decreased strength. Limited strength can mean a more difficult time gripping the steering wheel or managing the gas and brake pedals.

Mental changes that could affect driving ability include:

  • Decreased processing speed. When the mind doesn’t process things as quickly, decision making and physical reactions are also slower, which increase the risk of a crash.
  • Confusion. Mistaking the gas pedal for the brake, or forgetting where one is traveling to, are both common results of confusion in older drivers.

Changes in sensory organs include:

  • Decreased hearing. Loss of hearing reduces the vital ability to hear other cars, sirens, or safety warning sounds from your own car.
  • Vision problems. Visual “acuity,” or the sharpness of our vision, begins to decrease when we enter our 40s. This can make driving at night particularly challenging as many develop a lower tolerance for the glare of oncoming headlights. Some also develop cataracts, glaucoma, or macular degeneration, which make it harder to see out car windows.

Signs of trouble

Do you have concerns about your own driving abilities or those of a family member or friend? Here are signs to look for:

  • Multiple crashes, minor fender benders or near misses
  • More than two tickets or warnings in the past two years
  • Anxiety about driving
  • Health issues that could also affect driving
  • Multiple complaints about other drivers’ speed, sudden lane changes or actions
  • Increased honking from other drivers
  • Needing to think more about how to get places

If you notice any of these signs, it could be time to seek advice.

Next steps

Driving is a privilege that requires multiple simultaneous skills. As life expectancy grows, we need to plan for our future transportation needs much like we plan for other life events, such as retirement. Just as we retire from employment, we may also need to retire from driving.

Losing one’s ability to drive doesn’t have to mean losing one’s independence. Occupational therapy (OT) professionals can help patients and families plan ahead. The goal of occupational therapists is to assist clients in maintaining both their safety and independence as long as possible.

OTs can:

  • Evaluate the physical, sensory, and mental abilities that can impact driving ability
  • Prescribe therapeutic interventions to help clients adjust their abilities and continue to drive safely
  • Arrange for a clinical or road assessment with someone who specializes in driving
  • Make equipment recommendations that can help a client drive better, such as additional mirrors, seat belt pulls, pedal extenders, swivel seats, or even hand controls

When the time comes to retire from driving, OTs can help patients and their families develop transportation plans that support their continued independence. Our goal is to make sure patients can still access the places and activities that are important to them.

Rhode Island Hospital also offers a pre-driving evaluation, a helpful clinical tool used to evaluate the various skills needed for safe driving. This evaluation:

  • Assesses range of motion, strength, sensation, and coordination of the arms and legs
  • Records reaction times using a gas-brake device
  • Monitors cognitive and perceptual skills, including attention, memory, speed of mental processing, problem-solving, and judgment

These skills are assessed using a combination of computer programs, paper and pencil tests, and a video depicting various driving situations. In this simulation, the client must interpret information to make safe driving decisions without delay.

The pre-driving evaluation takes approximately two hours. Clients will be given a thorough, written evaluation that will recommend a return to driving, completing an on-road evaluation or, in some cases, retiring from driving.

We all hope for healthy, independent senior years. Hopefully, safe driving will continue to be part of them.

If you or a loved one has had problems driving, please contact us for additional information or to schedule an appointment.

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