Myths About Older Drivers

To better understand issues of driving as we age, let's look at the some of the myths about older drivers.

Effects of Aging on Driving
Myth:	Aging is associated with inevitable functional declines that make all older adults high-risk drivers.
Fact:	While specific abilities needed to drive safely - such as vision, memory, physical strength, reaction time, and flexibility - may decline as we age, the rate of change varies greatly across the older-adult population. If older drivers practice safe driving habits in their middle years, they usually continue those habits as they age.

By improving their functioning and by teaching compensatory strategies to those who have experienced some degree of functional loss, we can help older adults continue to drive safely longer. Providing education about alternative ways to get around, communities can also help older adults make smoother transitions from driving full-time to cutting back and/or stopping altogether.

Older Drivers and Public Safety
Myth:	Public safety will be significantly improved by getting older drivers off the road just because they are old.
Fact:	Although it is essential to do a better job of detecting older drivers whose age-related functional impairments place them at risk for crashes, most older drivers are safe drivers. Older drivers are much less likely to drink and drive. Older drivers involved in fatal crashes in 2001 had the lowest proportion of intoxication of all adult drivers.3 Older drivers are less likely than younger drivers to strike a vehicle, resulting in a fatality. In 2001, in fatal two-vehicle crashes involving an older and a younger driver, the older driver's vehicle was three times as likely to have been struck.4 Older drivers are the least likely to kill other drivers. Older people are less likely than drivers ages 16 to 34 to be involved in crashes that kill other people. However, if older people are in a car crash, they are more vulnerable to injury and death.5 Older adults drive much less and maintain much lower fatal crash rates than younger drivers.6
Older Drivers and Self-Assessment of Driving Ability
Myth:	All older drivers know when to restrict or cease driving.
Fact:	Some drivers know when to stop and some don't. Some problems, such as declining central vision, may be quite obvious to drivers. Changes in mental abilities - memory and judgment - are more subtle, however; their onset reduces the driver's ability to detect loss of function. Whether because of dementia or normal age-related cognitive slowing, some individuals have difficulty in judging their own abilities to drive safely. Objective assessment is needed.
Myth:	Elders who stop driving do so because they know it is unsafe for themselves or others.
Fact:	Some elders who are physically and cognitively capable of safe driving may simply lose the confidence to drive, or no longer feel comfortable or secure traveling at certain times or under certain conditions. In particular, older women who drive infrequently may lose confidence or key driving skills only through neglect. When undergoing a driving assessment, they often demonstrate competence.

Professionals' Ability to Assess Older Drivers
Myth:	Physicians know how to identify which of their older patients are likely to experience driving difficulties, and counsel them about driving issues.
Fact:	Physicians commonly state that they know little about the effects of specific functional losses on driving safety, and would prefer to leave the entire issue to the state department of motor vehicles (DMV). Many physicians feel that they violate a patient's trust if they express a professional opinion that could result in the loss of a driver's license. Others may have concerns about losing the patient or about the possibility of facing legal action. But an increasing number of physicians recognize their ethical obligation to discuss the dangers of driving with patients who are diagnosed with conditions that could compromise the public's safety and their own. Note: The American Medical Association (AMA) has published a guide for physicians on older-driver safety issues found on the World Wide Web: www.ama-assn.org/ama/pub/category/10791.html
Myth:	If an older person has a significant problem that could compromise his or her driving safely, it will be caught when he or she goes in for license renewal, and the DMV will take care of it.
Fact:	In-person renewal of driver's licenses is not required in many states, and even where it is required the interval between visits to the DMV may be as long as 18 years. Even in states with in-person renewal, DMV staff is frequently not trained to recognize signs of risk. Road tests are given rarely, and they are not designed to identify the common safety problems of older drivers. Note: In Maryland and California, the departments of motor vehicles are currently in the process of testing and implementing new driver-assessment tools. As few as 2 percent of older adults actually lose their licenses; most quit driving on their own. Any one of us may collaborate at one time or another with an older individual who continues to drive unsafely: family members find it too awkward to confront the issue; police officers perceive it as a kindness to only give warnings for erratic driving behavior; and physicians don't want to antagonize their patients by bringing up a possible need to restrict driving.

Changing the Driving Environment
Myth:	Improvements to highways that could make them "friendlier" to older users are prohibitively expensive and are hard to justify, in that they only serve a small segment of the population.
Fact:	Quite often, it costs no more to build roads the right way, from a driver-needs perspective, than the wrong way. If made when new facilities are constructed or in the course of a planned reconstruction project, many engineering improvements can be accomplished at little or no added cost. Any improvements that make highways safer and easier for elders to use, such as larger traffic lanes, generally will make them safer and friendlier for all drivers.

Older Adults and Public Transportation
Myth:	Public transportation is an effective transportation choice for older adults who have quit driving for one reason or another, at least in more urban areas.
Fact:	Unfortunately, many older adults do not use public transportation because it doesn't take them where they want to go, when they want to go there. Others may not understand the complex routes, have difficulty negotiating the steep steps onto the bus, can't walk the distance to a bus stop or simply have difficulty standing while waiting for public transportation. Improved attention to routes, scheduling and other comfort measures would make public transportation much more attractive to elders. Although current forms of public transportation are difficult or impossible for elders with diminished capabilities, such as those with Alzheimer's disease or physical disabilities, paratransit provided under the Americans with Disabilities Act seeks to address this barrier, but expenses and capabilities of the systems do not adequately answer the growing need.

Older Adults and Driver Education
Myth:	Re-education or refresher courses are sufficient to help elders keep driving safer longer.
Fact:	Only a very small percentage - less than 5 percent - of eligible elders complete such courses, and this may be accomplished merely by showing up to class. The benefits of classroom instruction that does not also add time behind the wheel are widely disputed. Refresher courses may offer some useful information to functionally intact elders, but individuals with functional deficits need to use a wider array of tactics to maintain safe mobility.7

"It's the Other Drivers" - Myth or Reality?

Many older drivers often identify other drivers' aggression as the problem, not their own driving. Recent research points to aggressive driving as a nationwide problem. According to a survey by the National Highway Traffic Safety Administration (NHTSA) on aggressive driving attitudes and behaviors in the United States, more than 60 percent of drivers of all ages see unsafe driving by others, including speeding, as a major personal threat to themselves and their families. More than half admitted to driving aggressively themselves on occasion.⁸ NHTSA has written a guidebook for communities entitled Strategies for Aggressive Driver Enforcement, containing examples of programs implemented by communities to curb aggressive driving.

Just the Facts In summary, what do we know?
Fact:	Functional decline (diminished physical and mental abilities) related to aging does not affect all drivers at the same rate or in the same way.
Fact:	Older drivers are actually safe drivers.
Fact:	Many older adults avoid public transportation because of inconvenience, inaccessibility, lack of affordability or availability.
Fact:	Some drivers know when to restrict or cease driving and some don't. Objective assessment may be needed.
Fact:	Less than 5 percent of eligible elders complete driver refresher classroom courses. Drivers with deficits in physical or cognitive functioning need a wider array of tactics to maintain safe mobility.

Even after separating the myths from the realities, comprehensive strategies addressing the mobility needs of older adults remain an important factor. Both myth and reality demonstrate our society's tendency to isolate older adults as a population.

Chapter 4 discusses available tools for assessing driving ability among older adults, and for counseling and educational resources geared to concerned drivers, families, loved ones, friends and professionals.

³ NHTSA, Traffic Safety Facts 2001, p. 2, Table 1.

⁴ Ibid., p. 3.

⁵ American Society on Aging (May 2003) "CDC Initiative Aims to Prevent $20 Billion a Year Problem of Devastating Injuries and Deaths From Falls by Older Americans." Retrieved from ASA Media Center on the World Wide Web: www.asaging.org/media/pressrelease.cfm?id=9.

⁶ NHTSA, Traffic Safety Facts 2001, p. 1, Figure 1.

⁷ Sampson, S., and Staplin, L. (2003) "Myths and Facts about Older Drivers." Generations 27(2):32-33.

⁸ NHTSA (May 1999) "Aggressive Driving and the Law." Summary Report. Retrieved from NHTSA on the World Wide Web: www.nhtsa.dot.gov/people/injury/aggressive/Symposium/introduction.html.