Ask the Expert: How to Help Older Drivers Stay Safe on the Road

Barbara Resnick

Barbara Resnick, PhD, RN, CRNP, FAAN, FAANP
Professor, Organizational Systems and Adult Health
Sonya Ziporkin Gershowitz Chair in Gerontology
American Geriatrics Society Past President

 

For many older adults, being able to drive is a ticket to freedom. What’s more, driving helps promote the well-being that comes with maintaining your independence, says Barbara Resnick, PhD. “However, older individuals and their caregivers both have different perspectives when it comes to evaluating driving safety,” she notes. Here are some of the most frequent questions Dr. Resnick has addressed during her decades of practice taking care of older adults.

Q. How does an older adult know when it’s time to stop driving?

A.  I have a set of questions I pose when dealing with this serious issue. First, I ask a general question: “How comfortable do you feel when you’re behind the wheel?” No one wants to be unsafe or to hurt anyone, even though some people may be in denial about their abilities. Then, I follow up with these questions:

  • Do you feel comfortable driving at night, or on a busy highway?
  • Are you comfortable driving along an unfamiliar route?
  • Can you clearly see road signs?
  • Do you clearly hear sounds while you’re driving, such as honking horns?
  • Have you been free from bumps and crashes while driving?

If the answer is, “I feel fine driving as long as I know where I’m going, and as long as I don’t drive on busy highways,” then that’s a sign to me that they’re OK driving in their neighborhoods along familiar routes. But I’m still going to suggest that their caregivers monitor their driving behaviors.

On the other hand, if the answers to these questions are negative, then it’s time to come up with plans to keep the older driver mobile—but not behind the wheel.

Q. Can being more careful or taking certain safety steps lengthen the time an older driver can safely stay on the road?

A. The most important safety step an older driver can take is to schedule a driver evaluation exam. These are typically conducted by occupational therapists who specialize in evaluating drivers, called driving rehabilitation specialists. According to the Automobile Association of America, a driving skill evaluation includes an in-car evaluation of your driving abilities and a recommendation as to whether you might need further specialized driver training or equipment. Driving assessments are used to identify underlying medical causes of driving performance issues. Therapists who conduct the tests can offer ways to address many of the issues that might arise, so that driving remains a safe option.

Contact your local rehabilitation hospital’s occupational therapy department to help find an evaluation service near you. You can also use the American Occupational Therapy Association’s Find a Driving Specialist website.

Q. When should a relative or caregiver step in to tell an older driver that they may no longer be safe on the road?

A. I always recommend calling the older driver’s healthcare provider first. Share your concerns with them. I think it’s best when the older adult’s provider acts as the voice of reason in these cases, even if it means them becoming “the bad guy.” The healthcare provider will frame the discussion in terms of the older driver’s medical issues—and it’s easier for the older adult to swallow any bad news when it comes from their healthcare professional, rather than from you. The provider can say things like, “Your arthritis doesn’t allow you to turn your head enough to be a safe driver,” or “your vision and hearing are not clear enough for you to drive safely,” for example.

Q. What if the evaluation or the healthcare provider determines it’s time for the older adult to stop driving?

A. You need to develop a “Plan B” so that the older adult can easily stay mobile. This could mean researching all the public transportation options in their neighborhood and making sure that these cover any destinations to which they may need or want to travel. Some communities even have free local ride services provided by volunteers; other communities have effective rideshare options like Uber or Lyft that are reasonably priced options.

These days, many drug and grocery stores deliver, allowing people to shop online, order, and have their purchases sent hours later.

Another option that I’ve found helpful is to suggest to the older driver that they donate their car to a beloved grandchild. Very often, making their grandchildren happy is a great incentive! In a perfect world, the grandchild would then offer to drive their grandparent to destinations from time to time. Win-win!

Q. My older relative is not safe behind the wheel, yet he refuses to recognize this and insists he’s not giving up the keys. What should I do?

A. This is, of course, the most difficult situation of all. It happens in a relatively small percentage of the time, thankfully. In these cases when all else fails, we have to get the local Motor Vehicles bureau involved by reporting the unsafe driver to them.   Again, it’s best when the older adult’s doctor/provider reports, even if it means them becoming “the bad guy.” I can think of a few lawyer-patients in my career who’ve failed their driving evaluation and threatened to sue me! But in the end, we have to protect the patients from themselves in addition to protecting the public.  

Updated May 2019