Senior Drivers – When are they no Longer Safe Drivers?

 

Safe driving requires a variety of key skills, including visual, cognitive, and physical abilities. Decreases in these capabilities can occur at any stage in life, but are especially prevalent for elderly persons. A copious body of research over the past several years indicates that these decreased skills can contribute to more automobile accidents. With that said, when are senior drivers at risk to themselves and to others who share the road?  Who monitors the ability for seniors to safely drive and whose responsibility is it to mandate stricter regulations for senior drivers? 

According to Robin K. Olson, CPCU, ARM, ARP, author and principal research analyst for International Risk Management Institute’s (IRMI) newest reference service, Personal Risk Management and Insurance, during the next 30 years, the United States will face increasing challenges concerning the number of senior drivers. According to the U.S. Department of Transportation, there are 35 million Americans age 65 and older, approximately 13 percent of the population. By 2030, this figure will double to 70 million persons, projected to be 20 percent of the population. This trend is a major concern because drivers age 65 and older experience higher crash death rates per mile driven than all age categories, other than teenagers. In addition, many studies show that these drivers, particularly those age 80 and over, also pose higher risks to other drivers, cyclist and pedestrians.

Today, the population in the U.S.—and the world—is older than ever before. By 2020, for the first time in history, there will be more people over age 65 than under 5.  With the foresight to address this trend, Congress established the National Institute on Aging (NIA) in 1974. It is now one of the 27 institutes and centers that make up the National Institutes of Health—the nation’s primary federal agency for research on aging and the effects of aging. 

The NIA recently conducted an in depth research ranging from the study of basic cellular changes that come with age to the examination of the biomedical, social, and behavioral aspects of growing older.  This work has led to important scientific discoveries about aging and the inabilities to safely operate a vehicle.  The following are their discoveries.    

Joints may get stiff, and muscles may weaken. Arthritis, which is common among older adults, might affect their ability to drive. These changes can make it harder to turn their head to look back, turn the steering wheel quickly, or brake safely. 

Eye sight can change with age.  It might be harder to see people, objects, and movement outside of direct line of sight. It may take longer to read street or traffic signs or even recognize familiar places. Some elderly drivers experience trouble seeing things clearly at night. Glare from oncoming headlights or street lights can be a problem. Depending on the time of the day, the sun might be blinding.  Eye diseases, such as glaucoma, cataracts, and macular degeneration, as well as some medicines, can also cause vision problems. Hearing can change, making it harder to notice horns, sirens, or even noises coming from another car or the driver’s car.  Hearing loss can be a problem because these sounds act as warnings to pull over or to get out of the way. 

Reflexes might get slower, and the ability to react quickly.  A shorter attention span, can make it harder to do two things at once. Stiff joints or weak muscles also can make it harder to move quickly. Loss of feeling or tingling in your fingers and feet can make it difficult to steer or use the foot pedals. Parkinson’s disease or limitations following a stroke can make it no longer safe to drive.  Mental awareness is greatly affected as one ages and the speed of processing.  Other mental diseases that affect memory and recognizing familiar places is Alzheimer’s disease and dementia.  If feelings of being lost can also cause panicking.  Medication can have drowsy effects, lightheartedness, or less alert than usual.  Some medicines have a warning about driving.  Many medications have side effects that can make driving unsafe.

I have a friend who almost lost her daughter due to a fatal car accident involving an elderly woman who struck her as she was walking home from school.  Ten year old Rachel was walking home in a quiet neighborhood and approached a corner with a stop sign.  A car was approaching the stop sign and Rachel stepped off the curb to cross the street.  The driver ran the stop sign and hit Rachel, dragging her 60 feet under her car until a nearby neighbor saw the accident and ran out into the street and stopped the driver.  The neighbor called 9-1-1 and emergency response team arrived immediately.  When the elderly female driver was asked what happened, she claimed to have not seen the stop sign or Rachel crossing the street.  Rachel laid in the hospital for 6 months in a comma, not expecting to live.  However, Rachel came out of the comma and required several plastic surgeries on the right side of her body to reconstruct her face, shoulder, hip and thy.  Her pelvic was crushed and was told she would not be able to have children. 

I met Rachel and her mother Bonnie when Rachel was 16.  Bonnie shared the story with me from her perspective and I could not believe her strength and how she pulled through such a horrific time in her life.  Even after several plastic surgeries her wombs were very evident, some wombs were not able to be repaired.  Not only did Rachel suffer from physical scars from this car accident but also emotional scars.  Rachel developed low self-esteem due to her appearance and visible scaring.  Rachel did not like to wear shorts, reveling her thy and had a permanent deformity on her upper lip.  This driver was a high risk driver on the road.  She almost took the life of a young girl but although Rachel lived, she would never be the same again.  This was an accident that could have been prevented had this elderly woman’s health been properly monitored and reported to the DMV that her eye sight was tragically failing.       

Recently, my daughter and I were involved in a minor car accident in a parking lot.  My daughter, her two small children and myself were sitting in her stopped car, waiting for other cars to move, when a parked car started to back out and was coming directly at my daughter’s passenger door.  Immediately, I told my daughter to honk the horn and she held the horn for approximately 0 seconds before the car smashed into the door.  When we all got out of our cars, I asked the elderly female driver if she could hear the horn honking.  Her reply was, “No.”  I noticed that she had hearing aids in both ears and had to wonder if they worked properly.  Another car accident that may have been prevented.

In July of 2003, an 86-year-old man drove into a crowded farmers market in Santa Monica, California, killing 10 and injuring dozens more. Six months later, the police department recommended prosecution on manslaughter charges. The incident “touched off a national debate over the safety of elderly drivers” Smith and Krasnowski, 2003. More accurately, the incident renewed attention to a problem that has been evidenced not only in similar triggering incidents (Cobb and Coughlin, 1998) but also in an accumulating stack of statistical evidence on the elevated accident fatality rate of elderly drivers Lyman, Ferguson, Braver and Williams, 2002.

On June 13, 2012, 89-year-old Margaret Tomascik was speeding 2014 when she failed to stop at a stop sign. She proceeded to strike a passing vehicle, jump a curb, and crash onto a construction site. Margaret Tomascik hit two individuals, Thomas Cooney and Joseph Rubino, who were working on the construction site. After severely injuring Thomas Cooney, and nearly killing Joseph Rubino, it remains unknown if Margaret Tomascik was charged with any driving offenses.

As determined by IIHS HLDI Insurance Institute of Highway Safety Highway Loss data Institute, in 2016 car crashes took the lives of 37,461 in the US alone.  Male passenger vehicle occupants 85 and older had the highest fatality rate, followed by males ages 20-24 and 80-84.

When measured in terms of total crashes per million vehicle miles traveled (VMT), the accident rate drops extraordinarily dramatically as age increases, until the 55-60 age range; it then begins to increase again, never coming near to the astronomical rates of teenagers but nevertheless 2.4 times the rate of 55-60 year-olds Cerrelli, 1998. In addition to their elevated crash rate, older drivers are, because of their greater fragility, more likely to be fatally injured when they are involved in crashes. Indeed, the driver fatality rate (per million VMT) escalates quite sharply after middle age, and for drivers 75 or older is even higher than the rate for 16-year-olds Cerrelli, 1998.

Elaine Sharp and Paul Johnson from University of Kansas, prepared a research paper, titled, Taking the Keys from Grandpa: Policy Diffusion Failure or Stealth Policy?  They stated that the regulation surrounding driver’s license renewal reform for elderly drivers is a growing concern.  Varying solutions have been proposed or implemented regarding this issue. However, regulation across the country remains inconsistent, as states have failed to uniformly address the dangers associated with elderly drivers and their diminishing capacity to operate a motor vehicle.

Sharp and Johnson added, it is apparent that states have tried a wide variety of policies in the past fifteen years and still exhibit a great deal of variation in their approach to this problem. One can conceptually differentiate at least four dimensions along which elderly driver policy approaches can be differentiated. All but the last involve the crucial occasion of driver’s license renewal. Pennsylvania is the only state that requires doctors to notify the state when their patients are unfit to drive (for any reason), and this is a requirement that affects all ages. Another approach is to demand more rigorous testing based specifically on age. In the 1980’s this approach was used by some states to target certain kinds of renewal tests to the elderly. For example, even before the 1990’s Illinois required a road test specifically for the elderly, and still does so (National Highway Traffic Safety).  In stark contrast, several states (California, Massachusetts, and Maryland) have specifically prohibited license renewal testing based only on age on the grounds that this would constitute age discrimination Mercier and Falb, 1997.

My suggestion to this growing problem is so regulate the health of seniors closely and on regular bases.  We need stricter laws for seniors when they review their license.  Seniors should be required to renew their license more frequently than every 4 years and should require a full physical from their physician verifying that that the senior driver is in a healthy state and is capable to safely operate a 4,079 pound vehicle. Along with a physicals thorough physical, seniors should be required to perform the behind the wheel assessment on a bi-yearly basis.  Police Officers should be required to provide formal reports when either they are either siting a senior driver or at the scene of an accident.  Both reports from the law enforcement and physicians are required to submit a copy to the DMV.  The Federal government should mandate for all physicians to notify the DMV when their patience require any type of disability equipment.  For example, pace makers or earring aids.  Also, if their patience has suffered a stroke or heart attaches leaving them paralyzed or partially paralyzed.  This would include early signs of dementia and or Alzheimer’s disease.  As baby boomers continue to age and in less than a few years our nation will have more people alive over 65 years old and with the number of accidents caused by senior drivers, I believe it is the responsibility of the Federal government to regulate the renewal of a senior drivers.