Sunday, May 24, 2009

Senior Drivers in Ontario

In an Ministry of Transportation of Ontario PPT (Jan. 11, 2004), I read that Senior Drivers in Ontario over the age of 80 numbered 165,758 in 2001.

About 65,000 have a semi-annual licence renewal consisting of a vision, knowledge and road test. I recall my late mother studying for her test. She had not driven in more than 30 years, but had kept up her licence. Once Dad's brain tumour required his licence be taken away, she was the driver again. She had issues navigating their mini-van up and down the driveway, especially in snow. Sometimes she would ask a neighbour for help --information that I felt I should have been given, and with her doctor we could have made some better-informed decisions. She may have been a danger to others when she drove.

Stories abound of seniors driving when they were incapable of doing so safely. Jim Taylor, a Canadian writer/blogger, titles one 2004 blog, "Seniors becoming a scapegoat for social discontent." His stats, from Canadian sources, demonstrate the need to concern. Transport Canada warns of those in intersections being the most at risk. Current stats, in the recent Ontario move to more severely curtail teen drivers, reveals statistics that demonstrate seniors are more risky than newbie teen drivers:
  • 6.4 % of fatal accidents caused by those less than 20 years of age
  • 7.3 % caused by those over age 65 (with fewer km traveled).
  • With 16 - 19 yr. olds have accident rates of 2.47 per 10,000
  • Adults over the age of 65: 2.9 per 10,000

The American Safety Council has publicized these concerns. It is suggested that adult children drive with their parents to see what is going on. If they do not feel safe, then they are not only a danger to others but to themselves.

The Japan Automobile Association demonstrates similar concerns, as this problem is not limited to North America. gives some warning signs:
  • watching for mobility issues, confusion, slow reaction times, drifting into other lanes, failure to use turn signals or missing exits.

Generally, if they have problems meeting their needs at home, it is likely that you will have to intervene and discuss your concerns. There is a duty on the part of Family Physicians to report to Ministry of Transportation of Ontario (MTO) medical conditions that may impair driving. Unfortunately, those who have dementia may be able to appear quite normal, and can cover up big problems they may have -such as getting lost, or may not realize function issues, such as remembering which is the gas, which the brake. I know that my father could no longer use basic technology (TV clicker and the phone) once his dementia was severe. Hidden dementia can affect some seniors and getting lost can compound driving errors. The Toronto Star says 20% with dementia are still on the roads.

There are three responses on the part of the MTO: immediate licence suspension, referral to Medical Advisory Committee, or further evaluation.

The Mayo Clinic empowers family members to take responsibility for their parents, in a very difficult role reversal they recommend reporting the senior to their physician, taking the car keys, disabling the car, assisting with alternate transportation such as those the Legion, senior centres, and volunteer groups may offer. Setting up an account with a taxi company can help, too. You must take responsibility, since those with TIA, or dementia, or other issues once they have progressed, cannot make the decisions necessary for the safe operation of a vehicle.

Warning signs of unsafe driving include:
  • Forgetting how to locate familiar places
  • Failing to observe traffic signals
  • Making slow or poor decisions
  • Problems with changing lanes or making turns
  • Hitting the curb while driving
  • Driving at an inappropriate speed
  • Becoming angry and confused while driving
  • Confusing the brake and gas pedal
There are senior driver improvement programs, such as 55 Alive, which are available through safety organizations and various driving schools. This helps seniors maintain their skills and adapt to changing physical abilities. There are 4 important issues: vision, hearing, movement and reaction times. Course content helps them adapt to new societal issues: adapting to new laws, technology, anticipate actions of other drivers (i.e., road rage), and to self identify health issues that assist them in determining when how often, and whether they should be driving.

Drivers make 8 - 12 decisions every km, with only seconds to respond in some cases.
There are physical issues of concern to seniors: checking blind spots, looking for traffic or pedestrians, merging, yielding, which can affect the ability of a senior to drive safely.
Hearing impairments mean that they cannot locate sirens, horns, and hear brakes; all clues to impending accidents.
Some are seeing less clearly: night vision or glare becomes an issue. They are more sensitive to light and dark levels.

Polypharmacy can cause drowsiness, dizziness, blurred vision, concentration, coordination, memory lapses, resulting in an inability to keeping a steady course. Road conditions in North America require different strategies in winter. Transport Canada offers a booklet in winter driving to provide valuable information.

Delirium is another issue, as well as dementia that puts drivers, and the cars and people around them, at risk. Be proactive and take responsibility for safety on the road.

Senior Driver Education
offers some suggestions:
  1. Introduction
  2. Strengths of Older Drivers
  3. The Effects of Getting Older
  4. The Possible Effects of Drugs on Driving
  5. Good Practices to Maintain Driving Fitness
  6. Personal Action Plan
  7. The Safety Driving Cycle
  8. High Risk Situations
  9. The Importance of Signs
  10. Alternatives to Driving
  11. Closing Reminders
  12. More Information
  13. Individual Notes

No comments: