February 2017: When to Stop Driving -by Renate Justin

“Arthur, we think it is time for you to stop driving.”

“Why? I am a fine driver.”

“We observed you driving in the wrong lane yesterday, putting yourself and others in danger.”

“Poppy cock.”

So it went until we finally took my husband’s car keys from his night table while he was asleep.  Promptly he used a spare set and took out his Oldsmobile.  His family had to drive the car away and not tell him where it was to stop his driving.  He was furious--a scenario often repeated, as I knew from my family medical practice where I was consulted about the driving ability of older patients. 

In order to save my son and daughter from a similar scene, I gave my car away when I started to forget names and at times familiar words.  I decided to use the Fort Collins Transfort system to get around, a challenge at times.       

Surrendering car keys is a life-changing moment. In Fort Collins, giving up driving means no more evening entertainment, no plays, concerts or late night movies, no quick run to the grocery store. No Sunday outings except on foot or with friends.  

Bus service is, on most lines, hourly, with long waits if you have to take more than one bus to reach your destination.  In winter sidewalks are covered with snow, and there is no service evenings or Sundays.  From my personal experience, as long as you can walk to the bus, it is possible to plan daytime outings. Errands take longer but can be accomplished.  A real plus is that the bus drivers in Fort Collins are uniformly helpful, cheerful and always ready with a friendly greeting.

How can we tell when the time has come to make the drastic change from private to public transportation?  There are no easy tests to evaluate mental or physical ability.  Most people become more forgetful as they get older, and their reaction times are prolonged.  At what point those factors represent a danger to driving ability is difficult to determine.  Many older adults limit their driving, -- not at night, not in bad weather, not in Denver traffic -- but does that make them safer on the road in Fort Collins?

Drivers over 75 have more non-fatal crashes than younger drivers, most frequently because of failure to yield right of way or obey traffic signals.  Men have more accidents than woman.  Older drivers have more fatalities than younger drivers because they are frail and therefore sustain serious injuries more frequently.  Predictors of accidents are:

1. Falls in the past two years
2. Visual and cognitive deficits
3. A history of previous car crashes
4. Effects of medication 

Getting lost and near misses, often only witnessed by the driver and not reported, also are predictors of future problems.

Family members, family physicians, even license bureau personnel are reluctant to mandate the difficult change in lifestyle ‘no driving’ represents in spite of the fact that 14% of 75-84 year-old drivers and 20% over 85 have some cognitive impairment, not taking into account visual, hearing and mobility impairment.  The complexity of evaluating an elderly person for adequate functioning becomes clear if you consider that the act of braking a moving car involves:

1. Motor skills, muscle strength
2. Balance and normal reaction time
3. Adequate cognition

Both AAA and AARP have classes for older drivers; most driver-education agencies give road tests to evaluate driving skills.

In all honesty, just as we know when it is time to retire, we also know when it is time to stop driving.  Each individual knows how often he or she forgets words, can’t remember names, makes errors in typing or falls asleep in front of the television.  It does not take superior intelligence to translate those failings to the steering wheel of a car.  Which one of us elders has not made excuses when we ran a red light or ignored a stop sign: “It happens to everyone sometimes,” or “I was thinking of something else.”  We don’t really need our family members, our physician or the police to tell us that our skills have deteriorated and that we might hurt someone by insisting that we are safe drivers.  In the long run, it is up to each individual driver, as he or she ages, to hand over the car keys to the young grandchild and say: “The time has come for you to take over.”

Perhaps, once we have driver-less cars, the transportation problems of the elderly will be solved.  We will be relieved of having to make the difficult decision at what age to give up our mobility and independence, to surrender our car keys.