when to stop driving

Discussing Driving Cessation With Elderly Patients

A growing population of baby boomers means there are considerably more elderly drivers on the road, but when should these drivers hand over the car keys and relinquish the independence of driving?

Statistics show, on average, there are about 33 million individuals over the age of 65 regularly operating a motor vehicle in the US. Nearly 500 adults in this age group are injured daily from a driving-related accident; 15 killed. Notably, across all age groups, males have substantially higher death rates than females.

The risk of vehicular fatality increases significantly as we age, especially after 75, largely due to a heightened susceptibility to injury, medical complications and disabilities, age-related decline in vision and cognitive functioning, and other physical changes that naturally come with age.

The aforementioned issues can result in an impaired ability to negotiate turns, remain in operating lanes, failing to determine proper distance and speed, and gas pedal versus brake confusion. But suggesting someone consider retiring from driving is an especially difficult discussion to have for loved ones and physicians.

According to a new study, published in the Journal of General Internal Medicine, from the University of Colorado School of Medicine and the CU College of Nursing, clinicians often wait too long before talking to elderly patients about giving up driving.

Doctors will often wait until they see a blatant medical red flag that could mean an increased possibility of an accident before having the “unpleasant” driving discussion with older patients. But based on interviews performed in a focus group of 33 drivers, 65 and older – along with eight health care providers including physicians, nurses, and physician assistants – researchers found most of the older operators were open to being approached earlier with driving retirement.

The study, led by Dr. Marian Betz, was performed at three clinics at the CU School of Medicine, and drivers were recruited from a local senior center and senior living community.

Telling someone they can’t drive anymore often results in a disagreeable emotional response. As unpleasant as physicians presumed the talk could be elderly drivers, meanwhile, said they were open to these discussions and generally saw their medical providers as fair minded.

At the same time, however, the majority of respondents said they didn’t believe their providers were aware of their driving status or ability. The elderly also tended to see a smaller role for family members in conversations about whether they should stop driving.

Several states have considered instituting an elderly driving law, requiring individuals to be retested behind the wheel after a certain age.

Study researchers suggest that doctors begin addressing driving issues earlier on before red flag health factors appear – referred to as anticipatory guidance – allowing patients ample time to process and prepare in the event they become driving incapable or impaired.

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