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Know the Facts
The population of the United States, as a whole, is aging. This trend will continue for some time as the Baby Boomers continue to retire from the workforce. In 2016, individuals aged 65 and older made up over 15% of the North Carolina population, according to estimates from the NC Office of State Budget and Management (NC OSBM). By 2030, the percentage of individuals age 65 and older in North Carolina is projected to rise to greater than 20% (NC OSMB). This current population trajectory, which will result in one out of every five residents being age 65 or older, will have important implications for transportation and road safety.
Contrary to popular belief, aging drivers are not, as a whole, unsafe. Older drivers often self-regulate to minimize exposure to more challenging driving situations. They may limit driving at night, in low light conditions, in poor weather, on unfamiliar roads, or on high speed roads, among others. It is important to understand that driving cessation is associated with negative health and social outcomes, including increased incidence of reported symptoms of depression and declines in physical and social health (Chihuri et al., 2016). Given these outcomes, it is clear that older drivers should continue to have the option to drive as long as they can safely do so.
While older drivers may generally be safe drivers, with increasing age many will experience physical and/or cognitive changes that can impact their ability to drive safely. In some cases, these changes can be mitigated by considering the greater environment (ex. signage can be updated to better accommodate eyesight changes that result from the normal aging process). In other cases, changes to the vehicle may help drivers continue driving safely (e.g. spinner knobs to help an arthritic driver more comfortably turn the steering wheel). And, in some cases, a medical condition impacts driving to a level where the individual can no longer drive safely. It is clear that a comprehensive approach to managing aging drivers is necessary to maintain safety for all road users. Professionals from various fields all play a vital role in addressing the challenges faced by aging drivers.
Older driver related NC driver licensing policies and practices
North Carolina driver’s licenses are renewed at fixed intervals. For individuals younger than 66, licenses are renewed every 8 years. For individuals 66 years and older, they are renewed every 5 years. Aside from more frequent renewals, NC DMV policies do not include any age-specific requirements or restrictions for obtaining a renewal. However, the NC DMV does have a Medical Review Unit that reviews specific cases where medical conditions may be affecting the ability of an individual to drive safely. (N.C.G.S. § 20-7.) While the Medical Review Unit reviews the impact of medical conditions on drivers of all ages, seniors are at an increased risk of developing a medical condition that could impact driving, and therefore undergoing the medical review process.
Process for reporting unsafe drivers
Drivers who have medical or mental health concerns that might impact driving can be referred to the DMV for an evaluation by the Medical Review Program, regardless of age. This program is specifically designed to evaluate drivers who have impairments that may interfere with their ability to drive safely. According to the NC DMV, “The goal of the Medical Review Program is to help protect highway safety without causing unnecessary hardship on drivers.”
A Medical Evaluation is started whenever the DMV receives a request for review. While anybody can submit a request for review, requests cannot be submitted anonymously. Because of this, family members may prefer to have a professional complete the request in order to limit conflict. It is important to keep in mind that a medical review may not be necessary if professionals, families, and/or caregivers are able to work with the driver to determine what limitations to driving are appropriate. However, if the driver does not adhere to appropriate limitations, a referral to the Medical Review Unit may be necessary.
Driver medical review process
Once a request has been made, the DMV may request that a medical evaluation form be completed by the driver’s doctor. This information, along with driving history, will be used by the Medical Review Unit, made up of licensed medical professionals, to determine what, if any, driving restriction should apply based on the unique situation of each individual. In some cases, the Medical Review Unit may require additional testing or an evaluation, such as meeting with a driver rehabilitation specialist or occupational therapist. Restrictions might include limiting speed, distance, or time of day. In some cases, the Medical Review Unit may determine the person is unable to continue driving.
The Medical Review Program may reassess drivers to evaluate changes in their medical conditions. The timeline for these additional evaluations depends on the individual circumstances and will be determined by the Medical Review Unit. These periodic reviews may result in continued restrictions, additional restrictions, or release from the Medical Review Program, depending on the unique set of circumstances.
If a driver’s condition has improved and they would like to be released from the Medical Review Program, they can mail a letter to the Medical Review Program requesting removal. The Medical Review Program may require updated medical documentation in order to be released.
Drivers can appeal decisions made by the Medical Review Unit, but appeals must be made within 10 days of receipt of the Medical Review Unit decision. Drivers who request an appeal will receive an in-person hearing, where a panel of physicians will reconsider the documentation and restrictions and make a final determination. Individuals can also appeal their case to the Wake County Superior Court, if they continue to disagree with the reconsideration panel.
Visit the NC DMV Medical Review webpage for more detailed information on the medical review process and for information on how to contact the Medical Review Unit.
Driver Evaluation and Rehabilitation
Drivers who need a comprehensive evaluation to determine fitness to drive, 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 an individual retire from driving due to safety concerns that cannot be remedied with additional training or vehicle modifications. 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.
More information on Driver Rehabilitation Specialists, including a directory of providers can be found on the following association webpages:
NC Office of State Budget and Management
Chihuri, S., Mielenz, T.J., Dimaggio, C.J., Betz, M.E.,DiGuiseppi, C., Jones, V.C.,Li, G. (2016). Driving cessation and health outcomes in older adults. J Am Geriatr Soc, 64, 332–341. https://doi.org/10.1111/jgs.13931
Uniform Driver's License Act, N.C.G.S. § 20-7.