Fitness to Drive

One of the most important things a caregiver can do is keep an eye out for warning signs of driving impairment and help the older driver assess their skills as necessary. If there are serious concerns about driving safety, seniors may need a professional evaluation to determine if they are still safe to drive and/or what adjustments can be made to improve safety. It is important to keep in mind that while the NC DMV may on occasion reassess a person's driving skills, examiners are not trained to assess medical fitness to drive. Because of this, caregivers should not rely on the DMV to make decisions about driving retirement for their loved ones.

Warning signs

Warning signs for potential driving impairment include both behind-the-wheel clues as well as signs of changes in an individual’s behavior and reasoning abilities. It is important to keep in mind that drivers shouldn’t be considered unsafe simply because they are older. Instead, concerns about safety should be based on observation of the person’s behavior both on and off the road. Understanding the warning signs may help you better detect changes before they affect a driver’s safety. In some cases, adjustments can be made to address the causes of concern, which may allow the senior to continue driving safely.

Warning signs directly related to driving:

• Becomes lost or confused when driving to familiar places or on familiar routes
• Feels nervous while driving or exhausted after driving
• Receives traffic violations, warnings, or has been involved in crashes or close calls
• Unexplained scrapes and dents on vehicles, mailboxes, fences, garage doors, etc.
• Difficulty negotiating sharp turns and intersections
• Difficulty merging onto freeways, turning onto busy streets, or gets easily confused in traffic
• Difficulty making right-of-way decisions (i.e. can’t determine when or if to yield)
• Difficulty moving foot between pedals (ex: pressing on the brake and accelerator at the same time or hitting the gas pedal instead of the brake)
• Difficulty turning to see traffic, checking blind spots, or backing-up
• Misses stop signs, runs red lights, or slows/stops at green lights
• Difficulty seeing or reacting to pedestrians, bicyclists, road hazards, etc.
• Problems maintaining a consistent or appropriate speed (too slow or too fast)
• Other motorists frequently honk at driver
• Problems staying in their lane
• Difficulty judging distances

Warning signs related to changes in behavior or reasoning are often an indication that your loved one is experiencing a change in their physical or medical well being. It is important to recognize that these conditions can have a negative effect on driving. If you notice these, contact your loved one’s doctor to discuss what you’ve noticed and see if there is a way to minimize these changes. Warning signs include:

• Forgetfulness or memory loss
• Confusion or disorientation
• Difficulty with judgment or making decisions
• Fatigue
• Changes in vision or hearing
• Withdrawal from social situations
• Tripping or falling (can indicate changes in strength and coordination)
• Trouble with fine or gross motor skills (can be caused by stiff joints)
• Dizziness
• Accidents in home (ex: cuts or burns)
• Stops reading or engaging in activities previously enjoyed
• Changes in self-care (ex: not eating or grooming)
• Functional losses (walking, incontinence, swallowing)

How can you help?

• Observe your loved one’s driving by riding along if possible.
• Don’t assume they are unsafe simply because they are older.
• Make note of warning signs that might indicate safety concerns.
• Talk to your loved one about the best ways to stay safe behind the wheel before concerns emerge, if possible.

Evaluation

There are various methods for assessing driving that may help you better understand your loved one’s abilities and safety behind the wheel. These include self-assessments that can be done online and professional evaluations completed by a Driver Rehabilitation Specialist.

Self-Assessment

Self-assessments can often be completed online at the driver’s convenience. These assessments are based on the driver’s report of their driving habits, strengths, and weaknesses and provide general feedback about potential areas of concern. While these self-assessments might help determine areas of strength and weakness and offer suggestions and next steps, they are not comprehensive and should not be used to determine if or when to retire from driving.

Important note: Self-assessments should be used with caution since independent evaluations have not been able to show that they predict actual driving performance. Self-assessments that focus on physical and medical conditions may have some value as screening tools to identify gross impairment, but not to determine overall fitness to drive.

One of the self-assessment tools that drivers might try:

• AAA Drivers 65 Plus is a short, self-scored assessment. Drivers 65 Plus is a printable brochure that includes a 15 question self-assessment, as well as facts and suggestions for safe driving with the primary goal to help drivers continue driving safely for as long as possible.

Driver Evaluation and Rehabilitation

Self-assessments are not appropriate for every driver. This is especially true for drivers who have memory problems or cognitive impairment. Drivers who need more detailed feedback and suggestions, including those with a medical condition, should consult with a Driver Rehabilitation Specialist. These specialists are trained to identify physical and mental challenges that impact drivers and offer individualized feedback on what, if any, changes can be made to improve safety and keep drivers on the road safely longer. In some cases, these specialists may recommend that a driver retire from driving due to safety concerns that cannot be remedied with additional training or vehicle modifications. Unfortunately, driver rehabilitation services are not typically covered by insurance, except under certain circumstances. Your provider can help you determine insurance coverage and out of pocket costs.

For more comprehensive information on the services provided by Driver Rehabilitation Specialists, The Hartford Center for Mature Market Excellence has created a guidebook, Your Road Ahead: A Guide to Comprehensive Driving Evaluations.

To locate a Driver Rehabilitation Specialist in your community, visit:

• The Association for Driver Rehabilitation Specialists
• The American Occupational Therapy Association
• Or call the Association for Driver Rehabilitation Specialists: 1-866-672-9466

How can you help?

• Discuss the benefits of driver evaluations with your loved one.
• Help them set up an appointment with a Driver Rehabilitation Specialist, if they need an in-person or more extensive evaluation.
• Remind them that acting early may help them continue driving for as long as possible.