Physical and Medical Considerations

stop driving; poor vision; too old to drivePhysical and medical conditions affect drivers of all ages. Unfortunately, as people age, these conditions can occur with greater frequency and can have a greater impact on overall abilities. When a loved one is diagnosed with an illness, disease, or impairment, it is important to consider how this diagnosis might affect their ability to drive safely. In some cases, seniors may be able to alter their driving habits or make modifications to their vehicle to accommodate the disease or impairment. In other cases, they may need to eventually retire from driving. Decisions about driving are best made on an individual basis, as no two seniors will be impacted by disease in the same way. Below are some specific conditions that can impact driving.

Conditions that Affect Most Aging Drivers

Vision Changes & Disorders

Although eyesight changes throughout life, changes often accelerate with age, including changes in the way eyes respond to light. Some changes that are directly related to aging involve poor vision in low light setting, increased sensitivity to glare, and greater difficulty distinguishing objects from the background (such as seeing a gray car against a grayish sky). In some individuals, vision disorders such as cataracts, glaucoma, or macular degeneration may occur, which can have severe impacts on driving if not monitored closely. According to the American Optometric Association, individuals over the age of 60 should have an eye exam every year. Most individuals can continue driving safely despite changes in vision, as long as they take steps to minimize the impact of these changes.

How can you help?

  • Remind your loved one to make their annual eye exam appointment.
  • Encourage them to keep their vision prescription up to date.
  • Help them locate low-cost frames, should they need a replacement pair.
  • Encourage them to select frames with narrow sides, so the glasses do not impact their side vision.
  • Encourage the use of sun glasses on bright days to minimize the impact of glare.
  • Discuss limiting driving at night or low light conditions such as dusk, dawn, rain, and fog.
  • If they have been diagnosed with a disorder (cataracts, macular degeneration, glaucoma), talk to their doctor about how this impacts their ability to drive safely.

Physical Changes

It is no secret the human body goes through profound changes over the course of a lifetime. These changes continue through the aging process and include changes in both strength and flexibility, among other things. From middle age on, the body becomes less elastic and muscle mass often diminishes. This can result in decreased flexibility and strength, two physical attributes important for driving.

Flexibility is important for checking blind spots and turning around to back up. Strength is important for maintaining control of the car and manipulating the brake and gas pedals. Strength and flexibility work together for just about all tasks related to driving, including getting into and out of the car. Changes in flexibility and strength can be offset by strength training, stretching, and remaining physically active. Individuals who work to maintain their physical health may be able to continue driving safely longer.

How can you help?

  • Encourage your loved one to be as physically active as they are able.
  • Encourage them to stretch, especially the neck, shoulders, and back to maintain enough flexibility to safely check blind spots.
  • Encourage them to work on strength training so that they maintain the lower body strength to brake and accelerate while driving.
  • Offer to work out or go for a walk with them.
  • Look into senior center or local fitness gym classes that cater to the unique needs of older adults.
  • Discuss how maintaining strength and flexibility can help them continue driving safely.

For your reference, The Hartford Center for Mature Market Excellence together with the MIT AgeLab have created a video and accompanying guide that walks seniors through exercises and stretches for maintaining the strength and flexibility needed for driving.

Medication

Medications have profound effects on our bodies, both positive and negative. Individuals of all ages should consider how the medications they take, including over the counter medications and supplements, might impact their driving. As individuals age, there is often a rise in the number of medications they take. This increases the likelihood of a side effect or interaction that could negatively affect their ability to drive safely. These side effects are often more pronounced when mixed with alcohol, even in small amounts.

Some of the common side effects that impact driving include drowsiness and disorientation. In some cases, side effects that impact driving can be managed by changing the time medication is taken or switching to another medication. It’s important that your loved one discuss any concerns with their doctor and work together with their doctor and pharmacist on any medication regimen changes.

How can you help?

  • Be aware of the medications your loved one is taking.
  • Help them determine if medications might be affecting their driving. One useful tool for this is RoadwiseRx.
  • Encourage them to discuss concerns with their doctor. They can use information from RoadwiseRx to begin the conversation.
  • If you suspect medications may be impacting their ability to drive safely, discuss your concerns with their doctor.
  • Remind them not to stop taking their medication or alter their medication routine without the consent of their doctor.

Specific Medical Conditions that Impact Driving

In addition to the common changes experienced by aging adults described above, seniors are at an increased risk of developing specific diseases that can have an impact on their ability to drive safely. These conditions include: dementia (including Alzheimer’s), diabetes, Parkinson’s disease, stroke, vision disorders, and severe arthritis. To learn how each of these disorders can affect driving and recommendations for how to cope with these conditions, visit the Medical Conditions page (located in the For Drivers section of the website). This information can be beneficial in helping you understand how these conditions may affect your loved ones.

The Hartford group has developed a helpful guide for caregivers entitled, At the Crossroads. Although this guide is primarily targeted toward caregivers of individuals diagnosed with dementia and Alzheimer’s, much of the information is useful to all caregivers. Topics addressed in the guidebook include assessing driving, having conversations about driving with loved ones, and planning for driving retirement. In addition, the guide also includes worksheets for planning alternative transportation, assessing transportation needs, and planning a support system.