Today’s seniors came of age just as the American car culture was peaking - when every year each model had a new fresh look, drive-ins were a ubiquitous hangout, and walkability was the last thing on the mind of urban planners. For seniors, the automobile is not just a means of transport and a symbol of independence, but the physical embodiment of the carefree days of their youth. Naturally, the prospect of giving up driving is an emotional topic for older Americans.
But the issue of driving, and whether to stop, must be approached with reason and prudence instead of emotion and intuition, because the consequences of taking the wheel when you are not capable of driving safely can be dire. Aging, as we know, can impact mobility, reaction time, judgement, and memory – all elements of safe driving. But many seniors overestimate their driving skills or dismiss the accidents as incidents that only happen to others. In fact, seniors who drive when they shouldn’t not only jeopardize their own safety, but the lives of the motorists and pedestrians they share the road with. At our elder law practice, we assist seniors with legal matters that help them to maintain their independence and financial security as they age. But all the planning in the world cannot protect seniors from the potentially tragic and life changing consequences of driving when they are not fit to do so. Take for instance the tragic 2003 case of George Weller who, at age 86, became confused at the wheel and plowed his car through a crowded farmer’s market in Santa Monica, killing ten and injuring over sixty. No one thinks such an incident could happen to them, but neither did Mr. Weller. To learn more about this important issue, we connected with Tom Kalina, who has 26 years of experience assisting older drivers. As an occupational therapist and certified driver rehabilitation specialist at Bryn Maw Rehab Hospital (a Main Line Health provider), he helps to assess the driving ability of seniors and disabled people, and when appropriate, works to keep them safely on the road - sometimes with the help of adaptive devices ranging from hand controls to pedal modifications. “Plan for Not Driving” Kalina stressed that seniors should “plan for not driving”, just as they make plans for potential long-term care needs and the future of their estate. By recognizing that they will not drive forever, and planning for transportation when that time comes, the emotional and practical difficulties of giving up the keys will be lessened. He often reminds patients that they can always hire another driver, but they can never pay for a substitute dad or grandparent should the unthinkable happen on the road. One interesting planning strategy we heard of is to write a note to our older selves, firmly reminding yourself to listen to your loved ones when they tell you it’s time to stop driving. You write the letter reminding yourself that your loved ones have your best interest at heart and may have a better perspective than you in the years ahead, seal it, and give it to them to give back to you, still sealed, when 0they feel you can no longer drive. That way you are not hearing just from your children that it’s time to stop driving, you are hearing from yourself at a time when you were thinking most rationally and with your family’s best interest at heart. Kalina himself is living his advice to plan for not driving. At one time, he dreamed to retire off-the-grid in the peace of the remote countryside. But through his work, he came to the realization that as idyllic as that lifestyle sounds, the only thing that would be connecting him to the resources he’d need to thrive would be a motor vehicle. And when eventually he lost his own ability to drive, his rural home would become a prison. Today Kalina says that when he grows old he plans to move to a retirement community where transportation is provided. Maintaining a Realistic Outlook about Driving Seniors should not allow themselves to go into a state of denial about their own driving ability. The key is self-awareness. As put by National Highway Traffic Safety Administration document, “People who can accurately assess their fitness to drive can adjust their driving habits. With smart self-management, you can retain the personal mobility that comes with driving, while limiting the risks to yourself and others.” Of course, no one can drive forever, but by honestly appraising your own skill and being willing to admit deficits, you afford yourself the opportunity to drive longer through assistance provided by physicians and special resources like the Bryn Mawr Driver Rehab Program. Unsafe at Any Speed: The Warning Signs An essential part of the self-awareness is knowing and recognizing indications that driving skills may be impaired and need to be reassessed. It’s important for seniors and their loved ones to be mindful of physical and mental changes (including from medication side-effects) that could make driving dangerous. These changes can include (but aren’t limited to):
Decreased reaction time or coordination
Decreased or limited range of motion
Memory loss or cognitive impairment
Similarly, the loved ones of seniors should look for indications of unsafe driving that include:
Unexplained dents, scrapes, and dings on the car
Receiving more traffic citations or warnings than usual in the last year
Overlooking traffic signals, exits, or road markings
Getting lost in familiar places
Difficulty staying in the lane of travel, or having difficulty changing lanes
Kalina encourages seniors and their loved ones to seek the input of certified driver rehab specialists when these warning signs surface. In cases where a rehab specialist is not accessible, seniors (or their loved ones) should consult with their physicians as well as their state’s department of motor vehicles for guidance and possible retesting. When It’s Time to Give Up the Keys In many cases driver rehab specialists like Tom Kalina are able to provide seniors and disabled people the training and tools they need to adapt and drive safely, but sometimes giving up the keys is just the right thing to do. Of course, there are those that grieve when they can no longer drive. Kalina observed that the end of driving can feel like the loss of autonomy: “When you get your license, and the world opens up to you, you feel competent and can go where you want to go.” And then the day comes when this ability, which you had taken for granted for decades, is gone. But it’s important recognize that even without an automobile, the world can still be open to you. Mobility Without the Automobile Kalina related the story of an older man who sobbed when being told he needed to stop driving. The man’s refrain was, “But it’s the last thing I could do on my own.” While some seniors weep at the realization they can no longer drive, Kalina said “a lot of people become relieved when they stop.” Kalina said that for many people, moving away from the automobile is a practical and financially smart decision, observing that with the funds gained from selling a vehicle and no longer needing to pay for gas, insurance, and maintenance, often seniors can afford as much transport as they need. What’s more, giving up the keys does not mean resigning yourself to isolation. Citizens of the region are fortunate enough to be served by a generally robust network of transportation options for non-drivers. In addition to the standard public transportation options, many seniors arrange transportation through homecare agencies, the retirement home in which they reside, local government paratransit services, and the budding network of ride sharing services like Uber.