Welcome ...

All too many times overwhelmed caregivers are physically and emotionally depleted and need to take time to rest and care for themselves. Believing in a holistic approach to caregiver stress and a strong commitment to helping our members find the right solutions, we created this blog to help you connect with others who, like you, may be facing the same eldercare issues and challenges. Feel free to comment, ask questions, and submit articles. Please forward the blog link to your family and friends. They'll be glad you did.

Warm regards,

Patricia Grace
founder & CEO
Aging with Grace

Wednesday, October 03, 2012

Who determines when the elderly stop driving...families or doctors?

Families may have to watch for dings in the car and plead with an older driver to give up the keys — but there’s new evidence that doctors could have more of an influence on one of the most wrenching decisions facing a rapidly aging population.
A recent study in the New England Journal of Medicine found that when doctors warn patients, and tell driving authorities, that the older folks may be medically unfit to be on the road, there’s a drop in serious crash injuries among those drivers.

The study, could not tell if the improvement was because those patients drove less, or drove more carefully once the doctors pointed out the risk.

But as the number of older drivers surges, it raises the question of how families and doctors could be working together to determine if and when age-related health problems — from arthritis to frailty to Alzheimer’s disease — are bad enough to impair driving.
Often, families are making that tough choice between safety and independence on their own.
By one U.S. estimate, about 600,000 older drivers a year quit because of health conditions. The problem: There are no clear-cut guidelines to tell who really needs to — and given the lack of transportation options in much of the country, quitting too soon can be detrimental for someone who might have functioned well for several more years.
Doctors aren’t trained to evaluate driving ability, and the study couldn’t tell if some drivers were targeted needlessly, noted Dr. Matthew Rizzo of the University of Iowa. Yet he called the research valuable.
“The message from this paper is that doctors have some wisdom in knowing when to restrict drivers,” said Rizzo. His own research shows some cognitive tests might help them better identify who’s at risk, such as by measuring “useful field of view,” essentially how much your brain gleans at a glance — important for safety in intersections.
Today, the American Medical Association recommends that doctors administer a few simple tests in advising older drivers. Among them:
—Walk 10 feet down the hallway, turn around and come back. Taking longer than 9 seconds is linked to driving problems.
—On a page with the letters A to L and the numbers 1 to 13 randomly arranged, see how quickly and accurately you draw a line from 1 to A, then to 2, then to B and so on. This so-called trail-making test measures memory, spatial processing and other brain skills, and doing poorly has been linked to at-fault crashes.
—Check if people can turn their necks far enough to change lanes, and have the strength to slam on brakes.
Dr. Gary Kennedy, geriatric psychiatry chief at New York’s Montefiore Medical Center, often adds another question: Are his patients allowed to drive their grandchildren?
“If the answer to that is no, that’s telling me the people who know the patient best have made a decision that they’re not safe,” said Kennedy, who offers “to be the bad cop” for families or primary care physicians having trouble delivering the news.
There are no statistics on how often doctors do these kinds of assessment.
“It’s this touchy subject that nobody wants to talk about,” said Dr. Marian Betz of the University of Colorado, whose surveys show most senior drivers don’t think their doctors know whether they drive. She is testing if an advance directive would help get older adults talking with their doctors about how to keep watch on their driving fitness before trouble arises.
More objective measures are needed — and to help find them, hundreds of older drivers are letting scientists install video cameras, GPS systems and other gadgets in their cars as part of massive studies of everyday driving behavior.
Identifying who needs to quit should be a last resort, said Jon Antin of the Virginia Tech Transportation Institute. He helps oversee data collection for a study that’s enrolling 3,000 participants, including hundreds of seniors, in Florida, Indiana, New York, North Carolina, Pennsylvania and Washington. The drivers undergo a battery of medical checks before their driving patterns are recorded for 12 to 24 months.
For now, advocacy groups like the Alzheimer’s Association and KeepingUs Safe offer programs to help family’s spot signs of driving problems and determine how to talk about it. 
Founded in 2008, Keeping Us Safe is an organization that serves older drivers and their families across both the United States and Canada. "Beyond Driving with Dignity is a workbook to help your family make driving-related decisions that are in the best interest of the older driver", says founder & President Matt Gurwell.


  1. This is a touchy subject and for a lot of elders it comes down to losing their independence. Although, it eventually gets dangerous for them to drive themselves places, most elders have an idea if it is getting too dangerous for them to drive themselves. Sometimes, it takes more than just the elders giving up their keys willingly. In that case, would it not be better if it was a joint suggestion from both the family and the doctor? The family knows the elder the best and can see what the elder's daily life is like more than the doctor can. (Let's face it, we do not always tell our doctors everything.) If the family notices troubling driving behavior could they not discuss possible causes with their elder loved one's doctor? The doctor can then help determine if there are some medical issues that could hinder responsible and safe driving of your elder loved one.

  2. I had to go through with this with my grandfather a couple weeks ago. We went to a doctor and he made the determination (mainly because I did not want too). We decided that he was no longer fit to drive. However, the doctor said something interesting to me. He told me that there is certain exercise for older women that will allow them to be able to drive longer. He told me it keeps there minds fresh and their bodies healthy, which allows them to have increased senses and reflexes. I found this very interesting and told my grandma about it.


Search This Blog

Helpful Resources

Low Vision Therapy Services

Children of Aging Parents (CAPS)

Well Spouse Association

U.S. Administration on Aging


Nursing Home Compare

Senior Safety Online

Mature Market Institute

Connections for Women

50Plus Realtor

Alzheimer's Speaks

Official VA Website