Safe Driving for Older Adults

One of the challenges associated with older drivers is the prevalence of mild cognitive impairment, which affects about 17% of people over the age of 65—around 8.2 million individuals. This condition can increase the risk of car crashes, yet there is no simple way to accurately assess an individual’s driving skills within a typical medical setting. While there are driving safety evaluation programs available, these are not currently covered by Medicare, making them financially inaccessible for many families. In Massachusetts, for example, a comprehensive driving assessment costs between $500 and $800—a considerable expense for many older adults and their families.

Researchers from Brigham and Women’s Hospital have called for Medicare to cover driving safety evaluations, which would provide health care professionals with essential information to determine if an older adult is still capable of driving safely. As Dr. Kirk Daffner, MD, an author of the study, notes, “Driving is a multifaceted activity that requires learned skills and the coordination of complex cognitive and physical functions. As we age, we are vulnerable to declines in our cognitive, visual, and motor skills that can impact our ability to drive safely.”

Given the financial burden of private evaluations, many older adults with mild cognitive impairment may continue driving without proper assessment, potentially endangering themselves and others. And the cost associated with not identifying potentially unsafe drivers is also substantial. In 2016, Medicare expenses for traumatic injuries, including those resulting from motor vehicle crashes, exceeded $16 billion.

Giving older adults and their loved ones easier access to driving safety evaluations is not just about mitigating individual risks but also about enhancing public safety. “Motor vehicle crashes can be devastating, and impaired drivers pose safety risks for not only themselves but also the public at large,” says Daffner. “Accurate assessment of driving fitness is critical to mitigating harm and improving safety on the road.”

Promoting open, respectful conversations

When it comes to discussing driving safety with older relatives, families often face the difficult task of addressing the issue without making their loved one feel patronized. It is wise to approach these conversations with empathy, recognizing that driving is not just a means of transportation but also a symbol of independence and autonomy.

Deciding when to stop driving can be one of the most challenging discussions for seniors and their adult children. It’s much better to address this topic before an accident or other crisis occurs. Understand that it may take some time for your loved one to come to terms with the change. Be patient and respectful, allowing them to express their emotions, which can range from anger and grief to relief or a mix of all these feelings. Dr. Emmy Betz from the University of Colorado School of Medicine suggests creating an “advance directive” for driving. This would involve the person agreeing to stop driving if their doctor or family determines they can no longer do so safely.

As we seek to ensure the safety of older drivers and those around them, it is necessary to balance respect for their independence with the need for thorough and accessible safety evaluations. By promoting open dialogue, supporting alternative transportation options, and advocating for policy changes, we can better protect our aging population and the broader community.