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Elderly
drivers a concern
WASHINGTON
- First, the
elderly woman tried to drive between a delivery van and two people walking
on a narrow Florida street. Then, busy chatting, she didn't notice a car
stopping in front of her. At a stop sign, she pulled out in front of a
truck. This
was a test to see if it was time for the 75-year-old to give up her keys
-- and when driving specialist Susan Pierce emerged from the car, it was
to break bad news. "She
stood up and literally pounded her fist on the table and said, 'I am not
giving up my driver's license and not giving up my home,'" before
storming out, recalls Pierce, an occupational therapist certified to
assess driving skills. "That's
probably the toughest part of my job, when I know I have to say
'no.'" Losing
the ability to drive can be a traumatic experience of aging -- and knowing
when it's time to quit can be immensely difficult. Tests
in doctors' offices aren't completely reliable. And nationwide there are
only 300 specialists like Pierce certified to perform road tests and offer
techniques to help some seniors stay behind the wheel a few more years. Now
medical and traffic groups are beginning some major programs to address
the issue: • The American Medical Association will issue guidelines in July to
help doctors tell when older patients' driving is questionable and get
them help to stay on the road as long as it is safe. This fall, the AMA
also will run a program to train doctors about medical fitness to drive. • The government recently earmarked $1.6 million to start a National
Older Drivers Research Center. Run by the University of Florida and the
American Occupational Therapy Association, it will train more
"certified driving rehabilitation specialists" like Pierce, and
create better off-road tests to screen drivers for problems. As
the baby boomers age, one in four drivers is expected to be over age 65 by
2030. Some 600,000 people age 70 or older give up their keys each year,
estimates the National Institute on Aging. Problems
with vision, perception and motor skills increase with age. Some
are obvious, such as severe dementia. But many aren't. Diabetes can numb
the legs and feet, making it hard to know if you're properly pumping the
brake. Arthritis can hinder turning and checking for traffic. Then
there are problems like Pierce's student had: diminished reaction time,
ability to judge spatial relations and juggle more than one task. As
for eyesight, the tests administered to get a driver's license only check
visual sharpness. Yet seniors can lose peripheral vision; have blind spots
from cataracts, strokes or eye diseases, or lack contrast sensitivity --
making it hard to see a dark car at dusk. Seniors
often deny problems, because losing their license is a giant blow, says
NIA's Dr. Stanley Slater. It's
not just demeaning: Having no easy, reliable way to get to the grocery
store or doctor's office can mean an end to elderly independence. Recall
Pierce's student: She wound up having to move in with the daughter who'd
insisted on the driving test. The
question is how to spot a problem before a crash, something that usually
falls to worried relatives. Few states require more frequent license
renewals or eye exams for the elderly. The
AMA guide will urge doctors to ask patients and their relatives about
driving problems, watch for possible red flags and hunt medical treatments
to help them drive as long as possible. Occupational
therapists increasingly are assessing driving skills with memory and other
tests, and offering rehabilitation services to strengthen driving skills. But
ultimately, driving tests are the best tool, says Dennis McCarthy,
co-director of the new National Older Drivers Research Center. They're
more complex than those parking-and-steering tests offered at driving
schools, says Pierce, who performs them in Orlando, Fla. Nor is it always
pass-or-fail: She often finds ways to keep people driving longer. For
example, unprotected left turns -- those without a turn-only light -- and
unfamiliar roads can be big challenges. Some drivers merely need to
restrict driving to close to home and avoid risky intersections. Avoiding
night driving also helps. So can adaptive technology -- special mirrors or
hand controls. The cost for driving evaluations varies widely, from $250 to $800. Elder advocates are lobbying for Medicare coverage, today available in only a few states, Pierce says. Copyright
© 2002 Global Action on Aging |
