Safe Driving for Older Adults

Health Conditions, Medications Could Increase Risk
To add to the problem, there are a variety of medical conditions that may be associated with aging that make driving a more risky venture. The presence of dementia, some forms of depression, Parkinsonism, stroke, hearing loss, arthritis, diabetes, and all types of visual impairment can make good driving more difficult to accomplish. Medications, both by prescription and over-the-counter, can impair driving skills. Antidepressants, anti-anxiety medications, sleeping pills and antihistamines are just a few of the drugs that can measurably affect concentration and wakefulness. Alcohol use remains an important risk factor for motor vehicle crashes and its use in older adults is probably underestimated.

Build a Plan Around the Facts
Conducting an assessment of driving habits and skills is one way to assemble some objective data regarding driving safety:

• Look at the individual’s driving history as measured through citations, crashes, loss of orientation, etc.
• Make an inventory of the kinds of trips most often taken and the destinations of the older driver. Can these trips be scheduled and then rehearsed to maximize safety and as well mutual awareness of one’s whereabouts?
• As a family member, would you be comfortable driving with the individual in question?
• Assemble a list of medications and review them for possible driving related side effects. Ask to be present when the older adult is making a physician visit to determine if there are medical conditions such as a stroke, dementia, or severe depression that may impair driving, as well as to report adverse events to the physician that might otherwise not come to light.
• Are there other caregivers who can drive?

Some careful planning can maintain independence when appropriate and lead to the construction of alternatives when driving needs to be either temporarily or permanently suspended. If it is apparent that the older individual is an unsafe driver, ask them to surrender the car keys while making alternate plans for transportation. This surrender could be temporary if restorative steps can be taken such as physical therapy, re-fitting of glasses, and medication adjustments. If the individual is deemed safe for the highways, encourage them to drive only during daylight hours, to avoid adverse weather conditions, to drive during off peak times, to avoid congested thoroughfares, and to follow rehearsed routes to and from key destinations.

Preventing Harm
If an individual persists in unsafe driving, the physician should document this in the patient’s medical record along with the recommendation to cease the activity. Some departments of physical therapy have the ability to conduct a comprehensive driving safety evaluation that can be an additional source of documentation of driving ability. Some states require that physicians report cases of illness such as dementia to the state health department and department of motor vehicles. In Wisconsin, there is no mandatory reporting, but the physician can write a letter to the Department of Transportation or the local police department requesting re-testing and can complete a driver behavior report. Call your local police department if you have any questions. In rare circumstances, filing down the ignition key, removing the key or car from the premises, or disabling the battery may be necessary.