When should mom give up the car keys?
By Rhonda Mullen
When Rebecca Dillard arrived for a presentation on safe driving at a local senior center, she faced a tough crowd.
“Are you here to take away my license?” came the first question from the audience.
Dillard, assistant director of programs for the Emory Center for Health in Aging, had some explaining to do. No, she wasn’t there to strip anyone of a driver’s license. What she was there to do was to raise awareness in this group of older adults about decisions they all eventually will face about driving.
If and when an older person should stop driving, is a loaded question. Just as teens are excited to get their hands on the car keys for the first time, seniors are equally reluctant to let go of those keys—and for legitimate reasons. For most people in the United States, especially those who live in areas that lack public transportation, the car represents independence. It is a way for seniors to get to the volunteer job, church, the doctor, or the house of a friend. Furthermore, some studies have shown that retiring from driving in general causes decreased overall health and increased frailty.
Still, some facts can’t be ignored. With the U.S. population rapidly graying, one in five drivers will be older than 65 by 2030. With age comes a natural decline in motor, visual, and cognitive skills—explaining in part why seniors are involved in a disproportionate rate of motor vehicle crashes compared with other groups. In Georgia, the second leading cause of unintentional related injury deaths for those over the age of 65 is motor vehicle accidents. Conservative estimates put the annual costs of these accidents at more than $62 million, which doesn’t account for associated costs, such as time lost from work or related expenses such as rehabilitation, home health, or long-term care.
Those reasons are why the Georgia Governor’s Office of Highway Safety has funded an Older Driver Safety Program. Managed by the Office of Injury Prevention in the Georgia Department of Public Health, it brings together close to 60 key stakeholders. Emory’s Center for Health in Aging is an active member of the program and hosts the monthly meeting of the driving task force at its headquarters on Emory’s Wesley Woods campus. A longtime member of the task force, Emory gerontologist Herb Karp, now in his 90s, still attends most meetings.
The primary goal of the driver safety initiative is to maintain the mobility and safety of older drivers, while making the roadways safer for all road users. It also seeks to reduce the number of injuries and fatalities experienced by older drivers, and where possible, to enhance mobility options for older adults.
Collaborations are the cornerstone of the program, which draws in partners in transportation, health care, law enforcement, public health, senior advocates, and related areas. This type of comprehensive community planning is needed to bring the village to the challenge, says Dillard.
The Older Driver Safety Program has taken on a wide range of challenges, including educating physicians about how to broach comfortably the uncomfortable subject of safe driving with elderly patients, educating traffic engineers about how highway design can assist safety and mobility for older drivers, and teaching law enforcement to recognize a cognitive problem in an older driver.
On another front, the safe driving task force also considers the coordination of local public transportation routes to make them more convenient for seniors as well as transportation alternatives. In addition to official government options, these alternatives often exist informally in the community at churches, senior centers, or in naturally occurring retirement communities (NORCs). For example, the Toco Hill NORC—which abuts Emory and has one of the most concentrated populations of residents over the age of 65 in the metro Atlanta area—issues transportation vouchers for a driving service and helps coordinate carpools. The NORC frequently combines efforts with other partners, such as working with DeKalb County Senior Services to coordinate bus routes to serve NORC members’ needs or partially reimbursing members for a taxi ride, thanks to a New Freedom grant from the Atlanta Regional Commission.
“Some people reach 85 in very good physical and mental condition, while others have extensive cognitive and physical conditions by the age of 60,” says Dillard. “So a blanket approach to driving or not driving for seniors is not good.”
Instead she and other members of Georgia’s driving program for seniors want to raise awareness among older adults of the need to self-regulate driving behavior. “I tell them, if you haven’t driven in a while because you’ve been sick or in the hospital, maybe you should practice a little before getting back on the road.” Dillard uses herself as an example. When she returned to the United States from graduate school in Germany, where she relied solely on public transportation, she was rusty and had to practice before easing back into driving.
By the end of Dillard’s recent presentation to the skeptical seniors, she had covered the facts and nuances of driving as an older person, given them a list of resources for related agencies, and left them with informed ideas for how to evaluate their own driving. But did she make any headway in helping them think about the many issues around driving? “I think so,” she says. “I think they felt better as soon as they heard I wasn’t there to take away their licenses.”
