Deciding when seniors should give up driving

Driving can become a challenge as people age. Jan Crye, an occupational therapist and certified driving rehabilitation specialist at the Driving Evaluation and Training Program at Sinai Hospital, called it a delicate balance between the need for independence and the need for safety. She pointed to an 83-year-old man who recently drove the wrong way on a California freeway, causing a pileup. There are many factors that should be considered before elders get behind the wheel, she said.

Question: Is there a specific age at which people should have their driving skills tested?

Answer: As we age, there are certainly varied functional driving skills that can change, such as vision, reaction time, physical changes in sensation, range of motion of our limbs and thinking skills. Everyone ages differently. If there are changes in your medical condition, or you seem to be having more difficulty performing daily tasks, it may be time to have a driving evaluation.

Q: What are the signs that someone may need to have their driving evaluated?

A: In addition to medical changes, some of the warning signs are: decreased confidence or change in comfort level while driving; finding it difficult to think through traffic situations; frequent stopping or having to go slow to figure out how to handle road situations; physical changes where it is more difficult to move legs for pedal operation, turn the steering wheel or rotate the head to see adequately while backing up or lane changing; people honking their horn at you; striking curbs, grazing objects, seeing an increase in scrapes/dents on vehicle; having near-misses while driving; getting lost in familiar locations; discovering that people are no longer wanting to be a passenger or ride with you when you are driving; and having friends or family comment about your driving skills.

Q: What medical assessments can be done to test a person's ability to drive safely?

A: Certainly, a physician may be able to perform varied medical screening procedures in the office to identify potential issues and concerns. In most cases, a medical driving assessment, performed by a certified driving rehabilitation specialist, is the only evaluation that can fairly and objectively determine specific driving skills and problems. The initial part of the screening involves dividing the driving task into different parts. A thorough vision screening is completed. Physical movement and sensation is evaluated. Memory, concentration, distractibility tests are performed. Emergency brake reaction is measured by a machine. Information on driving history, routes, type of traffic needed to drive, as well as a medical history is also obtained. Following the clinical assessment, an actual on-the-road driving evaluation is done. Following this assessment, varied recommendations or training needs will be suggested.

Q: What are some specific strategies that people can use to help decrease risks on the road?

A: Make sure your seated position in the car optimizes your safety and visibility. Eye level should be 4 inches over the steering wheel. There should be 10 inches clearance between the steering wheel and your chest. The wheel should be positioned at a level where, if the airbag deploys, it is aimed at your chest instead of towards your face. Small round blind spot mirrors, which can be obtained at any auto parts store can be placed on both side mirrors, to enable a driver to see a vehicle that would normally not be seen next to their car when attempting a lane change or merge.

When completing turns, always double check the side where you are turning away from, with the last glance occurring just before moving the car and initiating the turn.

Use traffic lights to complete turns onto or off of busy roadways.

Whenever you slow or stop your car, always look into the rear view mirror to assess what is happening behind you and always leave a one-car-length space between you and the car in front of you as a safety cushion.

Use a three-second space gap when behind other vehicles — start counting seconds between the time the car in front passes an object and when you pass it. If you are closer than three seconds, you will most likely hit that car if it stops suddenly.

Minimize all distractions while driving.

Q: Where can someone go to have a professional driving evaluation completed?

A: There is an organization which certifies professionals to perform medical driving evaluations. The website that lists qualified individuals by state is aded.net.



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