Introduction: Organizing Successful Programs Supporting Safe and Appropriate Driving Decisions

The majority of older drivers think they will know when they should stop driving.¹ And most do regulate their driving behavior without the benefit of an objective external assessment or specific self-assessment tool. While many older adults continue to drive until they are very old, they very frequently reduce their risk by driving less, avoiding driving in poor conditions, and reducing their exposure to high-risk situations. Their self-regulating strategies become more complex until, for some, a triggering event (illness, crash or injury) prompts them to stop driving altogether.

Driving Mis-Decisions

While the majority of drivers self-monitor properly, others make inappropriate decisions. Some drivers may stop prematurely, while others - unaware of their declining abilities, unaware of options for coping with them, or lacking other transportation options - operate cars beyond safe driving capacity. As many as 20 percent of older drivers continue to drive even after they fail an assessment by the Department of Motor Vehicles (DMV) and are advised to stop driving.²

Ideally, driving decisions consist of a spectrum of options for making the right choice at the right time.

At one end sits the older person who has a lifetime of safe driving habits and has not yet experienced some of the age- or disease-related declines known to negatively affect safe driving performance.

At the other end is the unsafe driver who requires:

• Transportation from friends and family, or through public or private services
• An environment that provides walkable access to basic services and social supports, or offers delivery services such as groceries and medications

Driving Discussions

Unfortunately, a crisis usually forces driving discussions with older adults, which may focus on approaches to taking away the car keys. Few discussions are about driving behavior and strategies that help avert problems with on-road safety. Not surprisingly, initiating conversations with older adults about driving is difficult at best.

As with the spectrum of driving decisions, planning for driving wellness and safety will ideally engage a range of participants - community members, loved ones, and professionals - to navigate between older adults' needs and transportation options.

For many people, financial planning is central to retirement planning. Encourage older adults to develop transportation strategies in combination with their financial plans. Suggest considering, when moving to a home in later years:

• The availability of transportation in the surrounding area
• The proximity to needed services
• The availability of sidewalks and crime-free neighborhoods for walking to services

Having safety-promotion discussions before a crisis occurs encourages driving wellness and safety. Early planning for an older person's driving future may:

• Reduce stress by creating transportation alternatives for the older driver with diminished skills
• Avoid injuries or fatalities from crashes
• Reduce family and partner stress from struggling over car privileges
• Reduce costs for door-to-door public transportation (paratransit) by ensuring that capable drivers can remain on the road
• Support older adults in their efforts to stay connected and contribute to their community

This section will outline the possible roles that various segments of the community can play in providing options and transitions for older drivers.

¹ Schatz, S., Stutts, J. and Wilkins, J. (1999B) "The Premature Reduction and Cessation of Driving: A Preliminary Study of Women Who Choose Not to Drive or to Drive Infrequently." Proceedings Transportation Research Board 78. Transportation Research Record No. 1693.

² Dobbs, B.M., and Dobbs, A.R. (1997). "Delicensing: Mobility and related consequences for the patient and family members." Paper presented at Transportation Research Board 76th Annual Meeting, Washington, DC, Jan. 12-16, 1997.