Health & Medicine

October 11, 2012

At what age should one turn in the car keys?

Esther Carl is confident in her driving abilities, not only in her Ford Taurus but also in the pickup truck she uses when she and her sister go camping and the van that her late husband, Albert, used to haul music equipment around to the seniors' facilities where the couple sang.

Esther Carl is confident in her driving abilities, not only in her Ford Taurus but also in the pickup truck she uses when she and her sister go camping and the van that her late husband, Albert, used to haul music equipment around to the seniors' facilities where the couple sang.

But she has enough concern about a few older acquaintances' competence behind the wheel that she won't get in the car with them any more.

"I see what they do," said Carl, a 74-year-old retired teacher who lives in Fair Oaks. "They go too fast and then slam on the brakes at stops. I don't feel like they're paying attention to lights that are about to turn. Some are too busy talking, so they miss their turns.

"I notice it, and I think I would give up my license if I thought I was dangerous."

When should older adults stop driving?

The answer depends on the older driver in question, according to driving experts including the California Department of Motor Vehicles.

The issue isn't age, strictly speaking; it's unsafe driving, a problem that came into renewed focus at the end of August, when a 100-year-old Southern California driver backed onto a sidewalk filled with schoolchildren, hitting 11 people.

With a tsunami of seniors hitting the road, it's important to take into account older adults' sense of independence as well as the need for public safety.

Already, almost 14 percent of California's 24 million licensed drivers are ages 65 or older, according to DMV statistics. Within two decades, one-quarter of the nation's drivers will be in that age group, up from one in seven today, the AARP Public Policy Institute says.

By no means are all older adults reckless and unsafe drivers: Only 2.5 percent of drivers 75 and older are involved in collisions in an average year, the National Highway Safety Administration says, compared with 13.3 percent of teenage drivers.

But coordination and reaction time can suffer with age. Powerful medications can take a toll on older drivers' abilities. And physical limitations – impaired hearing and eyesight, perhaps, or neck arthritis that makes it painful to turn the head – can limit drivers' competence, too.

It was in the last year of his life that Michelle Johnston's father, David, agreed with his concerned wife and children that he should stop driving. He had Parkinson's disease, which eventually led to his death in 2011 at age 79, and his physical and cognitive problems made him unsafe on the road.

When he was briefly hospitalized, the family lent his car to his grandson and then made the loan permanent.

"The basic opportunity for driving, we just didn't provide any more," said Johnston, Sacramento regional director for the Alzheimer's Association. "My dad signed on to that, but he'd occasionally talk about 'when I can drive again?'

"It was hard for him not to have the freedom to go where he wanted to go."

But what happens when the elderly relatives in question aren't so compliant and agreeable about giving up the keys? How can families intervene?

The DMV's four senior ombudsman offices around the state each receive dozens of calls every week from relatives frantic to figure out how to get their older loved ones to stop driving because of safety concerns.

"They love Mom and Dad and don't want them to hurt themselves or somebody else," said John Locher, DMV senior driver ombudsman in Sacramento. "Some notice medical conditions and confusion. They're really concerned."

A confidential – but not anonymous – form allows people to report their elders' driving problems to the DMV, giving the agency legal authority to ask the older adult to come in for a re-examination.

"We want specifics," said Locher. "We want actual concerns. Unexplained dings and dents in the car, that's big. Getting lost in a familiar place. Near-accidents. Frustration at driving or fear of driving. Those are red flags.

" 'Dad is 86' isn't enough."

To drive past the age of 70, California requires older adults to take a written test and undergo a vision exam every five years. In some cases, said Locher, restricted licenses – curtailing night or freeway driving, for example, or requiring the use of panoramic mirrors or pedal extensions – can help older adults remain independent and mobile.

Sometimes, that's not enough to ensure safe driving, which is why state law mandates that doctors report diagnoses of dementia, Alzheimer's disease, lapses of consciousness and other medical conditions to the DMV.

That's how Lou Bordisso Jr. got his license revoked not long ago. The 58-year-old retired psychotherapist was diagnosed with early- onset Alzheimer's disease in early 2010.

Over time, he found that driving in bad weather confused him, and freeway driving had begun to frighten him. He'd already given up night driving, and he noticed that his judgment in traffic was decreasing.

"My neurologist told me that driving home from the office that day would be my last day driving," said Bordisso. "He was very nice about it.

"Driving puts me at risk, and worse, it puts other people at risk."

For many older adults, a driving refresher course is all it takes for them to brush up on skills and learn new strategies. And – bonus! – completing a refresher class can bring them car insurance discounts, as well.

"You do have more things that affect your driving when you get older, but there are things you can do," said Liz McClatchy, executive director of the Safety Center, which offers senior driving classes.

"For instance, we teach seniors to leave a longer following distance between themselves and the car ahead of them, because it takes them longer to stop than when they were 17."

No one had to tell Harry Mall to give up his car keys. After seven decades of driving, he turned in his driver's license on his 90th birthday in 2010.

The retired insurance agent's driving skills weren't the problem. It was other drivers' skills that bothered him.

"I decided I'd had enough of driving," said Mall, now 92 and a resident of Carmichael Oaks Senior Living.

"The way I see traffic today, it's too fast and not courteous. You've got people riding on your bumper.

"Why can't they just slow down a couple of seconds? One day, I told myself, 'I'm done.' "

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