The vast majority of older Americans have grown up in a culture that strongly depends on automotive transportation for mobility. Driving occupies a central role in the lives of many older adults, so it is not surprising that no longer being able to drive can be a major life crisis for many older individuals. The aging of the baby-boom generation will result in a 50 percent increase in the number of older drivers by 2015, with most of them being women and all dependent on their personal vehicles for mobility.
Transportation mobility is a critical link between older people and their social and community activities, as well as to goods and services. Seniors use their automobiles for appointments with doctors, for shopping, to visit relatives, to volunteer in a variety of programs and services and a variety of other uses. In addition, driving is an important part of many older individuals’ self-concept in much the same way that driving is a right of passage for younger people. To older people, driving symbolizes freedom, independence and competence.
In a survey taken of families and caregivers in the state of New York concerned about the safety of an older driver, nearly 80 percent said that taking away a person’s independence was what concerned them most. Over 75 percent felt that elderly drivers had some kind of physical or medical condition that impaired their ability to drive safely. Vision, hearing and restricted movement problems were identified by half of the respondents. When asked what would be helpful for their situation, alternative transportation was identified by 79 percent of respondents.
Based on current rates, the number of elderly involved in traffic fatalities will more than triple by the year 2030. If this expected increase occurs, the number of traffic fatalities in the elderly population in 2030 will be 35
percent greater than the total number of alcohol-related traffic fatalities in 1995 – a fatality number that is viewed by policymakers and the public as cause for serious concern.
The aging process frequently leads to medical conditions that may impair a person’s ability to operate a motor vehicle safely by affecting their level of consciousness or perception, judgmental processes or motor abilities. Individuals (particularly the elderly) respond in different ways to similar conditions, so it is important to focus not on the specific conditions but on the functional impairments that may result from these conditions. Simply because a person has certain medical conditions does not mean that he or she should not be driving. Determining just when or under what conditions a person is at risk for poor driving behavior is a question that challenges experienced health-care professionals and family members alike.
Some older drivers are able to recognize functional changes on their own and take adaptive or self-restricting measures that moderate their declines as safe drivers. Other individuals will lack this level of self-awareness and will continue to drive. People who drive at reduced skill levels will be at increased risk for accidents, with potentially serious consequences for themselves and others.
There are many ways to adapt to functional changes. These include improving health and physical functioning, identifying problem drivers, retraining older drivers, re-engineering the auto, re-engineering the driving environment and teaching non-elderly drivers to accommodate their elders. Many elders support driver testing because they believe that there are many poor drivers on the roads today. Additional travel options and more information about these options would take the fear out of the retesting and re-licensing process by offering transportation alternatives. With more travel choices, higher standards of driving skills could be enforced, and everyone’s safety would improve. Graduated licenses also are supported by elders as a means of easing the transition from driver to non-driver.
There is a nearly universal lack of planning, by those now elderly or those of us who hope to be older one day, concerning travel options once driving is no longer viable. Many people can look forward to 25 years of active life after retirement. We need to educate people to consider how they will get around if and when they don’t drive and to encourage financial and residential decisions be made with mobility issues in mind. The counterpart of such planning, of course, is that our society also must recognize a social responsibility to ensure that transportation options are available when and where needed.
Additional articles on Healthy Aging are available on the Colorado State University Cooperative Extension Web site. Go to www.ext.colostate.edu then click on the Consumer/Family link under Information Online.