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Family Health Online / Pharmacy at Safeway
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Family Health Magazine - growing older

Safe Driving for Seniors
Knowing when it’s time to quit

Without a doubt, driving offers seniors both mobility and independence and today’s seniors are driving more and longer than in the past. Although many older drivers are safe drivers, in the past 20 years, crash rates have increased by 50 per cent for senior drivers (and decreased 10 per cent for drivers under 65).

graph - increased at-fault crash riskIt is not age alone that puts seniors at risk. Medical conditions and medications can affect both mind and body, and so influence driving ability. Some conditions also affect insight, making a senior unaware of driving dangerously.

As a senior driver, you must think about whether you can still drive safely. Understanding the facts about seniors and driving may help. If you have doubts, consider having your driving skills evaluated. Part of driving responsibly involves knowing when to stop. The following questions may help you or your family decide.

I only drive during the day and in excellent road conditions. Should I be concerned?

Crashes involving seniors are often due to medical conditions that reduce safe driving skills. Conditions of the environment or the road are not the issue. Most of these accidents happen during the day, on good roads, in familiar locations close to home.

If I live in a rural area, am I less likely to get into an accident?

Compared to senior drivers living in the city, those in rural communities are more likely to die in crashes. Rural drivers travel at higher speeds on the highway. In addition, crashes where a senior is at fault most often involve more than one vehicle. This means that continuing to drive when you are unsafe puts other road users at risk. Remember, traveling at a slower speed will not lessen your risk of a crash. In fact, you may risk a crash by going slower than the expected speed limit.

What medical conditions(illnesses) increase my risk of unsafe driving?

Many illnesses can affect your ability to drive safely. Some of these conditions include dementia (e.g., Alzheimer disease, vascular dementia), chronic heart disease, strokes, diabetes, chronic lung disease, and Parkinson’s disease.

The chart below shows the increased risk for a collision for people with various conditions or illnesses.

  • The risk of having a crash is one and a half times greater for drivers with visual impairments.
  • Drivers with conditions that affect the musculoskeletal system (such as arthritis) have almost double the risk of an at-fault crash.
  • Drivers with cognitive impairment are three times more likely to have at-fault crashes. Cognitive impairment includes declines in memory, attention, judgment, and decision making. Declines can happen due to a specific illness, such as Alzheimer disease, or because of a combination of several illnesses. One or more medical conditions or medications could increase the risk of unsafe driving.

Medications such as sleeping pills, tranquilizers, pain medications, and those used to treat depression, also increase the risk of unsafe driving. Of course, so does alcohol.

How will I know when I am no longer safe to drive?

Most people think they will be able to tell when it is time to stop. Some are able to be objective and honest and change their driving when necessary. However, many medical conditions that affect the ability to drive also affect insight and judgment. In this case, you may think you are safe to drive when in fact you are not. At this point, others should help evaluate driving ability. Studies show that family members such as spouses are not always good judges of driving safety. If you think that your driving might be unsafe, ask your doctor for a driving evaluation referral. If you are concerned about someone in your family, you can also ask to have that person referred for an evaluation.

What warning signs indicate I may no longer be safe to drive?

Warning signs that involve driving include:

  • missing traffic signs (such as going through a red light or a not stopping at a stop sign)
  • difficulty making lane changes
  • difficulty staying in the lane when turning, or difficulty driving in a straight line
  • making wrong turns (such as turning the wrong way on one way streets)
  • driving too slowly (below speed limit)
  • getting lost while driving in familiar areas
  • being unaware of other vehicles, bicycles, pedestrians, and road hazards
  • having other drivers honk at you.

Warning signs that do not involve driving include:

  • problems with judgment, planning, and organization, such as difficulty in managing finances, making meals and shopping
  • trouble planning common tasks, such as using the stove or TV channel changer
  • forgetfulness, such as frequently forgetting appointments
  • difficulty with comprehension, including inability to follow verbal instructions
  • confusion, such as giving inappropriate responses
  • problems with finding the right words
  • becoming lost and disoriented
  • visual problems, difficulty with vision due to macular degeneration, glaucoma, or diabetic retinopathy
  • musculoskeletal problems such as arthritis.

Since I don’t need to fill in a Drivers’ Medical form until a certain age, does that mean I am safe to drive?

At any age, it is your responsibility and legal obligation to make your provincial department responsible for driver fitness aware of any illness that might affect your driving. Your ability to drive safely is always a concern, not just when a medical is required. Your family doctor can help you decide if illness is affecting your ability to drive.

If there is a medical concern, how can I be assessed?

Visit your family doctor if you have concerns about how your health could affect your driving. A change in ability to do usual tasks such as cooking, banking, or driving can be due to an illness or medications. Your family doctor can assess the change and look for reasons to explain it. Treatment can help you feel and function better. Your doctor may send you for further testing if questions remain about your ability. A DriveABLE assessment can evaluate cognitive concerns while an occupational therapist can assess physical impairment.

Medical examination requirements vary among provinces

  • In British Columbia drivers must take a medical exam when they approach their 80th birthday, and every two years after that. Drivers over 80 are asked to provide regular medical reports.
  • In Alberta, at age 75, 80, and every two years following, drivers submit a medical report and have their vision screened.
  • Saskatchewan Government Insurance (SGI) does not review drivers’ licenses based on age. Each year when renewing their driver’s license, all drivers are required to self-report medical conditions that could affect their driving either upon diagnosis or on license renewal. Also, doctors and optometrists are required to report drivers with medical conditions that can affect the safe operation of a motor vehicle. Through appropriate follow-up, the SGI Medical Review Program helps drivers to keep their license as long as possible, provided standards are met and drivers do not pose a danger to themselves or the public.
  • Manitoba Transportation and Government Services require a medical report only for Class 1, 2, 3, and 4 licenses, not class 5 (the standard driver’s license).

Does a medical condition mean I will lose my license?

Having a medical condition does not automatically make you unsafe to drive. Conditions affect people in different ways, so individual assessment is important. With some medical conditions, you do reach a point when you must stop driving. Anyone with an illness that gets worse over time, such as Alzheimer disease, must plan for this day. If you have difficulty accepting the loss of your license, there are support groups specially designed to help you cope with no longer being able to drive.

If I no longer drive, will I lose my independence?

It is important to plan ahead for a time when safe driving may not be possible. Friends and family may be able to help you to stay mobile. Developing a transportation budget is an important step in helping you to be independent and mobile. Calculate how much you have invested in your car, insurance, fuel, and maintenance. Those dollars can be used to take taxis, use a seniors’ driving service, or pay friends or family for rides.

Driving is a serious responsibility. Many senior drivers have excellent driving records and so deserve our congratulations and respect. However, things change. Even the best driver can become very dangerous if medical conditions and medications affect the ability to drive. Take responsibility for your own health and that of others. Monitor health and medication changes that might affect your ability, and ask others to assist if you seem unaware of them.

Warning signs for unsafe driving

Signs* that don’t involve driving

Signs* that involve driving

Forgetfulness
Confusion
Problems with word finding
Problems with judgment, planning
and organization
Difficulty understanding verbal instructions
Getting lost or disoriented
Trouble with ordinary tasks
Visual problems
Mobility problems
Missing traffic signs
Driving too slowly
Getting lost in familiar areas
Being unaware of others on the road
Difficulty making lane changes
Difficulty staying in the lane
Making wrong turns
Having other drivers honk at you
FAMILY HEALTH is written with the assistance of:
College of Family Physicans of Canada
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of:
College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [GO_FHc11]
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