Step 1: Collecting Information
The first step requires family and friends to collect information about what is happening with the older driver. This takes time and may require gathering information from a variety of people who have opportunities to observe the older person’s driving.
The more information you collect, the better and more complete a picture of the driver you will have, and the more informed your discussions can be. The information can help you, other family members, health care professionals, and the older driver decide what needs to be done.
A word of caution: It is not uncommon for families, caregivers, and friends to be wrong in their judgment of a driver’s risk or driving ability. A person’s driving performance – not age – is what determines fitness to drive. Collecting a variety of information can give you more confidence in the accuracy of the determination that something needs to be done.
Even collecting the best information and planning ahead does not mean the decision about what to do with an at-risk or unsafe driver will be easy. But the information and planning can give all concerned more assurance that the best interest of the older driver is at the center of the decision making process.
Your concern about the driving behavior of a family member or friend may stem from your observations of the person driving, stories about the driver, or both. It’s important to turn that concern to action. Be deliberate and careful about recording your own observations and observations of other people about the driver. Are there trends that signal the person may be at increased risk while driving? Be sure to date the written notes on your observations. If the driver’s physician becomes involved in the driving decision at a later time, the dated notes will become helpful.
To get the most complete picture, collect information not only about their driving but also about other personal indicators (described below) because these may signal the person is at risk while driving.
Ideally, you will have a conversation about your interest in ensuring that the driver remains safe on the road. Explain that riding with the driver is the best, most practical way to make observations about his or her driving. Another option may be to follow the driver in your own vehicle.
You should watch the person drive at different times of the day, in different types of traffic, and in different road conditions and weather. Over time, a picture will emerge of things the driver can do well and things the driver may not do as well.
You should be paying attention to make sure that the driver:
- stops at all stop signs and looks both ways to check for cross traffic;
- stops at red lights;
- appropriately yields the right-of-way;
- responds properly to other vehicles, motorcyclists, bicyclists, pedestrians, and road hazards;
- merges and changes lanes safely; and
- stays in the lane when turning and driving straight.
In addition, you want to observe whether the person is:
- slowing or stopping inappropriately, such as at green lights or in intersections;
- driving too fast for road conditions;
- driving so slowly as to impede the safe flow of traffic;
- driving aggressively; or
- getting lost routinely on routes that should be familiar for the driver.
Obviously, some of these driving behaviors pose an immediate concern. Drivers must stop at red lights and stop signs, and yield to other cars as the traffic laws require. Failure to do these things puts the driver and others at extreme risk and requires immediate action to stop the driver.
Even when older people are not in the car, their actions, statements, or even the way they look may cause you concern or may indicate a problem that could threaten their safety when they are driving. Some of these things you see and hear may be triggered by major events happening in the person’s life. These could include the loss of a spouse or a close friend. But an illness or changes in one’s medications can also make it hard for the person to drive safely.
No single sign can be taken as a warning that the person is at risk or is an unsafe driver. But if you observe several of the warning signs, you should strongly consider taking action to help.
Such danger signals may include:
- forgetfulness (frequent and combined with other signs);
- unusual or excessive agitation;
- confusion and disorientation;
- loss of coordination and trouble with stiffness in joints;
- trouble walking, swallowing, hearing, or following verbal instructions;
- dizziness when changing positions, tripping, and falling;
- shortness of breath and general fatigue; and
- difficulty following verbal instructions, and/or giving inappropriate responses to those instructions.
At some time or another, many of us may have difficulty with some of the items above. But if you frequently observe these behaviors or signs in a family member or friend, they likely signal the need for you or a health professional to take action. These behaviors can indicate the person is at risk if he or she continues to drive.
In addition to your own and others’ observations about the older driver, encourage the person to evaluate his or her own driving performance. Several organizations have free self-assessment guides that a person can use. A self-assessment cannot solely determine whether or not the person is a safe driver. But an assessment may prompt the person to be more open to a conversation with you and other concerned individuals about driving.
- AAA clubs have an assessment tool called “Roadwise Review” that people can use on their computers at home. Roadwise Review takes users through a series of brief tasks that examine a person’s vision, reaction time, and other measures related to driving safety. It also directs users to sources of more information about driving safety. Some AAA clubs charge for the screening tool, while others give it away free to members.
- AARP’s Driver Safety Program offers its “Test Your Driving IQ” self-assessment quiz, which asks drivers to answer ten questions about today’s driving environment and how they react to driving on today’s roads. Go to www.aarp.org/families/driver_safety and click on the link in the “Test Your Driver Safety IQ” box.
- The AAA Foundation for Traffic Safety has a quiz (http://seniordrivers.org/quiz/driver55.cfm) that asks a person to respond to 15 statements about driving situations and gives suggestions based on the person’s answer.
Again, the value of these screening tools listed above is to prompt a person to talk with family and friends and health care professionals, and, if needed, to seek a more formal assessment of driving skills.
Observations of others in your community
Friends and professionals in the community often stand ready to help you get a more complete picture of the person whose safety may be at risk. In developing a complete picture of the older driver, however, it is crucial that you respect that driver’s dignity, privacy, and personal autonomy.
If you live in the same city or town, keeping tabs on how well a family member or friend is driving is easier than if you don’t live nearby. But either way, you need to build a network of helpers. They may be able to give you information to help determine whether action is needed to keep the older adult driver safe and sound.
Some members of the network – health care professionals including eye care specialists, pharmacists and physicians – cannot speak with you unless and until they have a signed release form from the driver.
Collecting information helps you develop an action plan, if one is needed, to enhance the safety and mobility of the older person. It can also help you to determine if actions need to be taken to reduce a person’s driving risk.
Physicians and law enforcement officers are often the first people families and friends go to when they seek outside help for a person they believe to an at-risk or unsafe driver.
Other community resources also exist to help you build a better action plan. These include your local:
- Area Agency on Aging;
- Driving Rehabilitation Specialist
- Department of Motor Vehicles office
- AAA (American Automobile Association) and AARP Driver Safety Programs
- Alzheimer’s Association Chapter
Area Agencies on Aging
A network of more than 650 Area Agencies on Aging has been established nationwide to provide information about virtually all programs and services that are helpful to older people, their families, and caregivers. In many cases, Area Agencies can provide information about transportation choices available in the community. An agency may provide some of those programs and services directly or may arrange for them through contracts with other community service organizations. Call the Eldercare Locator at 800-677-1116 and ask for your local Office on Aging, or go to the web site at www.eldercare.gov.
Driver Rehabilitation Specialist
A driver rehabilitation specialist can provide an in-depth evaluation of a person’s driving. The specialist can determine if and how a particular disease or condition such as Parkinson’s, stroke, or diabetes is affecting a person’s driving. The specialist, who is often an occupational therapist, may offer interventions such as training to improve the person’s driving safety. The specialist also may suggest installing specialized equipment in the vehicle to keep a person driving safely longer, as well as provide the training on how to use that equipment.
To find a driving rehabilitation specialist near you, go to the American Occupational Therapy Association’s Older Driver Resource Center at www.aota.org/driver_search/index.aspx, or call the Association of Driver Rehabilitation Specialists at 800-290-2344, or go to its Web site at www.aded.net. You also can call hospitals and rehabilitation facilities in your area to find an occupational therapist to help with the driving skills assessment and intervention.
Department of Motor Vehicles
If, based on your personal observations or knowledge, you are concerned that a family member or friend has a medical condition or has experienced a mental decline that would lead to unsafe driving, contact the State’s Department of Motor Vehicles (DMV) where the older driver lives.
In almost every State, a family member can report a driver to the DMV by writing a letter. Your letter should describe specific examples of what you consider to be unsafe driving behavior and/or medical conditions that you believe place the driver at risk. The DMV is required to carefully examine your claims to ensure the driver is not being harassed unfairly. Depending on your State, the letter you write may or may not be confidential, meaning the older driver could find out you have written the letter.
Even if the driver is re-examined and passes the required tests, the DMV may still require future periodic reviews. The DMV may require the driver’s physician to submit a report every so often. This would most frequently occur in cases involving an individual who has had seizures, for example. The DMV also might require periodic road tests, such as for people with progressive medical conditions or some forms of dementia. Finally, the DMV may require the driver to submit a report from an eye care specialist if the person has a progressive eye disease such as macular degeneration.
Before contacting the DMV about the person’s driving behavior, a family member or friend should carefully consider sitting down with the driver first to discuss the concerns and possible plans of action that best meet everyone’s needs and concerns.
AAA/AARP Driver Safety Programs
Several national organizations offer educational programs for older adult drivers. These “refresher” courses present participants with up to 10 hours of classroom tips and reminders about driving safely on today’s roads.
AARP’s Driver Safety Program is the largest national program that educates older adults on driving safely, self-assessment, and finding transportation alternatives. Go to www.aarp.org/families/driver_safety and click on the link in the “Find a Class Near You” box.
The AAA and the National Safety Council also offer courses through many of their local offices. Insurers in most States offer a car insurance discount for individuals who complete these classroom “refresher” courses. Sometimes the discount applies for several years after the course is taken. At that time, however, the individual must re-take the course to renew the insurance discount.
Alzheimer’s Association Chapter
For someone who has been diagnosed with Alzheimer’s disease or other dementia, the issue is not whether the person will have to stop driving, it is when that must happen. There are some early and clear warning signs that Alzheimer’s is affecting a person’s ability to drive safely. These signs include, but are not limited to, when the driver:
- drifts out of the lane;
- becomes confused when exiting or entering a highway;
- has trouble making turns, especially left turns;
- gets lost in familiar places; or
- stops inappropriately – such as at green lights or in the middle of an intersection when not turning.
Local Alzheimer’s Association chapters or local Alzheimer’s support groups have caring people with expertise in helping families and caregivers deal with the driving issue. To find your local Alzheimer’s support group:
- contact your local Area Agency on Aging
Call the Eldercare Locator at 800-677-1116
Monday through Friday, 9 a.m. to 8 p.m. (ET),
or go on-line to www.eldercare.gov.
- Go on-line or call the Alzheimer’s Disease Education and Referral Center: