Dr. Cheryl Woodson

The Dilemma of Older Drivers: Independence vs Safety

Seniors A family health challenge will sideline my theme and guest blogs until spring. I will still weigh in on news items that affect aging and caregiving as they arise. Thanks for your support.

Yesterday, ABC news reported an older driver who became confused between the brake and gas pedals and thundered through a car wash, crashing into a wall on the other side. The rest of the report discussed ‘When to Say When?” and how adult children can initiate the discussion about giving up the car keys.

I agree with the report’s recommendation to discuss this possibility before there are problems, engaging the senior in decisions about timing and alternate transportation strategies. I also agree about their list of warning signs of problems with senior driving safety:

  • The start of any new medication
  • Unexplained dents and scratches on the vehicle
  • Seniors complain that other drivers yell and honk at them
  • Senior reports near misses.

I would also ask families to take it very seriously, if a senior get’s lost, or “turned around” in a formerly familiar neighborhood, or route.

Some state departments of motor vehicles require mandatory testing for license renewal after a certain age, but these programs are inadequate to insure safety on the road. They test vision, but not mobility, or brain function (cognition,)  which , after vision, is the most important determinant of driving safety. Neither do these state tests identify remediable problems, nor suggest strategies for to retain a senior’s driving independence.

However, as Maggie Kuhn, late founder of the Gray Panthers, said, ” Age is NOT a disease.” The problem is not aging; it is illness, whether acute or chronic. Yes, with normal aging come changes in vision, muscle coordination, joint mobility, and reaction time, but these changes do not offer significant functional problems unless there is some kind of illness. The key is to determine whether there is an illness, whether medical science can have enough impact to restore driving safety, or whether adaptations can improve driving skills ( extra mirrors, or special controls.)

Rehabilitation centers (like Ingalls Center for Outpatient Rehabilitation, or ICOR, in Calumet City, IL) offer comprehensive driving safety analyses that health insurance covers under occupational therapy codes. They test vision, mobility, reaction time, memory and other cognitive functions, judgment, defensive driving strategies, and visuospatial skills: the ability to see in three dimensions, understand the distance between objects, and know where each object is, relative to others. Seniors may be less threatened by comprehensive testing, if they understand that the goal is not to just yank someone’s license, but to look for ways to improve safety.  If you are in the Chicago area, contact

  •   ICOR at 708- 862-5500 or
  • The Rehabilitation Institute of Chicago, www.ric.org, 800-354-REHAB(7342), or      312-238-1000

Your local hospital’s rehabilitation and social service programs should be able to help you find a professional, comprehensive driving assessment in your area.

The AARP’s safe driving program, (www.aarpdriversafety.org  800-350-7025  ) is also a good way to refresh driving skills (and earn certification that can decrease your care insurance premiums,) but I recommend it only for healthy seniors who want to prevent driving issues. If you suspect that seniors’ driving puts them, or the community at risk, I recommend the comprehensive rehabilitation driving assessment first.

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