Some seniors should stop driving

Society needs to do a better job helping seniors drive for as long as is safe and helping them adapt when the time comes to stop, says a new editorial in the Canadian Medical Association Journal.

TORONTO — Society needs to do a better job helping seniors drive for as long as is safe and helping them adapt when the time comes to stop, says a new editorial in the Canadian Medical Association Journal.

The journal suggested the already pressing problem is going to become even more difficult in the coming decade or two as the massive baby boom generation hits this stage in life. By 2025, one in every four Canadians will be 65 or older, noted the editorial, published in Tuesday’s issue of the journal.

In addition to finding ways to get seniors who can no longer drive safely off the roads, communities and governments need to put in place programs that help seniors who give up their licences to continue to live independently if they are able.

“Solutions to the dilemma of who will drive our seniors — and eventually us — must be found. The status quo leaves too many seniors isolated and puts too many people at risk,” Dr. Paul Hebert, editor-in-chief, and Dr. Noni MacDonald, public health section editor, wrote in the editorial.

They suggested society should plan for driving retirement the way it plans for job retirement.

The aim, they and others said, is not to get all older drivers off the road, but to find a way to identify those who need to stop driving and put in place systems to help them cope once they do.

That goal is harder to meet than one might expect, said Jonathan King, program director for driving research at the U.S. National Institute of Aging.

“We do not know as we would like to know about what would be predicting better or worse driving, driving cessation or the effects of driving cessation on people’s well-being,” he said from Bethesda, Md.

“We really need more on that.”

King said so far researchers have not found a valid way to predict which drivers are going to be able to drive safely well into their older years and which will suffer from health or other problems that erode their driving skills.

King said the criteria used by motor vehicle departments — vision tests, for instance — are “surprisingly less effective than you would think.”

The challenge of figuring out when seniors are getting to the point where they can no longer drive safely is complicated by a defence mechanism older drivers commonly use. Researchers call it “self-restricting.”

Seniors know their night vision isn’t great, so they don’t drive at night. As they become less comfortable with speed, they may avoid busy highways and drive in off-peak hours. Experts know seniors self-restrict and the technique helps — until it doesn’t.

Government funding agencies in both Canada and the U.S. are working on the question of older drivers. One of the studies King’s program funds is exploring the concept of “useful field of vision” processing as a way to both screen older drivers and perhaps retrain some, he said.

In Canada, a five-year, $5.5-million study called CanDrive is attempting to answer some of these questions. But Dr. Shawn Marshall, one of the principal investigators of the study, said there aren’t any easy or quick solutions.

For one thing, seniors may live in communities with little public transit; taxis may be unaffordable or non-existent. And even in places where public transit is available, it is generally geared more toward commuters, not seniors, Marshall said.

Meanwhile, in situations where a person is resisting giving up his or her licence, getting the person to stop driving may be problematic.

Seven of 10 provinces require doctors to report patients they feel should not be driving any longer. But doctors don’t like being put in this situation.

Hebert argued they don’t have the training to make this call and the damage to a doctor-patient relationship can be devastating.

“The difficulty is not only do we squeal on people but we remove their licence. And how then do you face patients whose lives you’ve just changed forever?” he asked.

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