Della Barrett loved to drive. After the great-grandmother of two retired from hospital nursing in 1991 at age 63, she says, there wasn’t a day she stayed home and watched television. She filled her days bargain-hunting at the mall, eating out with friends, grocery shopping at the supermarket and joining in her church’s senior club.
But in January after her second car accident, which landed her in an emergency room, the Baldwin resident reluctantly gave up her keys. “My children thought I should stop [driving] because of my poor peripheral vision and reaction time,” said Barrett, 93. “In the beginning I was angry and depressed, but then I gave myself a good talking to. You forget how old you are and that your systems are slowing down. I convinced myself it’s time.”
With her two daughters working full-time and caring for families of their own, Barrett now spends most of her days crocheting. “I loved getting in the car and going where I wanted to go and doing what I wanted to do; I miss that,” she said.
When it was time to insist her mother stop driving, Barrett’s daughter Stacey Barrett says she felt like the “bad guy.” “She viewed driving as her independence,” said Stacey, 52, of Baldwin. “Now, she relies on us to take her where she wants to go.”
People are driving longer
While the elder Barrett has given up driving, many older adults are holding onto their licenses longer. According to the Insurance Institute for Highway Safety, the number of licensed drivers 70 and older increased 48 percent between 1997 and 2016. By 2030, at least 90 percent of the 70 million Americans 65 and older are projected to have driver's licenses, says auto insurer AAA.
Although older drivers are safer drivers — they typically observe speed limits and don’t drink and drive — mile for mile they have higher crash rates than other age groups, except teenagers, according to the Journal of Traffic Safety. Failing eyesight, slower reflexes and a decline in memory and thinking skills can challenge an older adult’s ability to drive safely. Compared with other drivers, older adult motorists, especially those age 75 and older who are more fragile, have a higher crash death rate than any other age groups, except teenagers, says the National Highway Traffic Safety Administration. By 2040, older Americans are projected to outnumber children, according to the U.S. Census Bureau. An uptick in the older-driver population raises concerns that seniors might become an ever-increasing proportion of collisions and fatal crashes.
There is no mandated age to stop driving, and experts say figuring out when and how to approach a loved one about giving up the keys is a challenge. Driving represents freedom and independence, and seniors who have limited transportation alternatives are at risk for isolation and depression. A patchwork of volunteer driver services, nonprofit organizations and municipalities in Nassau and Suffolk offer seniors free or discounted transportation to doctor’s appointments, shopping, recreation and county- or town-operated senior centers.
Dr. Elizabeth Dugan, associate professor in the Department of Gerontology at the University of Massachusetts in Boston and the author of “The Driving Dilemma: The Complete Resource Guide for Older Drivers and Their Families” (HarperCollins, 2006), points out that age is not a “great marker of driving fitness.”
“People age at different rates,” she said. “Someone might be in horrible shape at 50 and another is doing great at 95.”
Challenges for older drivers
She explained that conditions that challenge driving fitness range from vision changes, such as cataracts, and mobility problems that make it difficult to get into and out of a vehicle, to diabetes that could cause numbness and weakness in the feet, and medications for arthritis pain that can cause drowsiness.
A study by the AAA Foundation for Traffic Safety examined the amount and types of medications used by older drivers. Of the nearly 3,000 older motorists in the study group, 70 percent took medications that affect the nervous system, such as muscle relaxants, antihistamines and antidepressants, many of which have been associated with increased crash risk.
Warning signs of an unsafe driver include fender-benders, near-misses, multiple traffic tickets, finding dents or paint scrapes on the car, fences or mailboxes and getting lost in familiar locations.
“There is no magic number of collisions that signal it’s time to stop driving,” said Robert Sinclair Jr., AAA Northeast spokesman. “It might only be one collision if it’s serious enough. The inability to concentrate; memory problems; other drivers honking or yelling at you because of your driving behavior; family, friends, doctors and the police expressing concern. You have to look at these things and make a determination if it’s time to limit driving or give up the keys.”
In a 2014 Liberty Mutual Insurance survey of 1,000 adults age 75 and older, 85 percent said they would avoid driving in bad weather, after dark or during rush hour to improve their safety on the road. However, only 6 percent had spoken with someone about their driving abilities.
To help competent older drivers stay behind the wheel, AARP and AAA along with driving schools offer refresher courses that review a driver’s knowledge of the rules and hazards of the road.
Limits of refresher courses
Elin Schold-Davis, an occupational therapist and the project coordinator of the Older Driver Initiative at the Bethesda, Maryland-based American Occupational Therapy Association, says refresher courses have their place but they are not designed to address the needs of the “medically at-risk driver.”
She recommends that motorists in the early stages of dementia have a comprehensive driver evaluation by an occupational therapist to “get a baseline on cognition and physical ability.” The evaluation can also suggest equipment modifications to help a person compensate for a weakness.
“Smart” car safety systems available in some new cars or as add-ons, such as drowsy driver alerts, lane-departure warnings, blind-spot monitors and front-collision avoidance, are a few of the top technologies helping to reduce crash rates by as much as 50 percent, said Kyle Rakow, vice president and national director of AARP driver safety.
Experts say it’s too early to tell if the advent of autonomous vehicles in coming years will solve the transportation woes of senior nondrivers. They caution against relying on smart vehicle technology that can sometimes fail. AAA’s Sinclair points out that in some cars, automatic braking may stop one car and slow down another.
Many factors contribute to a safe driving environment. Currently, the federal government is proposing that individual states develop consistent procedures to renew licenses for older motorists. Only 18 states require older drivers to renew their licenses more often than other drivers. In New York, the Department of Motor Vehicles requires drivers of any age to renew their expiring licenses every eight years and pass vision tests.
When it’s clear that an older adult can no longer get behind the wheel, experts recommend that conversations about “driving retirement” be approached “carefully and compassionately.”
“Ideally, it should be one-on-one where you’re expressing your concerns, but if that doesn’t work, you would have to gather the family,” said Norman Miller, a psychologist in private practice in Merrick and an adjunct professor at Hofstra University. “Their fears are surrendering to old age and asking people to help them out...it’s very humiliating and there’s role reversal. They are used to being in charge and now they are no longer.”
The risks of not driving
Taking older drivers off the road needs to be weighed carefully. Studies have shown that seniors who no longer drive are more likely to experience loneliness and social isolation that not only doubles the risk of depression but leads to declines in physical health.
Stopping a frail loved one from driving is no easy task. Ask Della Barrett’s daughter Stacey. When she approached her mother about giving up her keys, Della was “angry, defiant and didn’t want to acknowledge that she wasn’t capable of driving anymore,” Stacey said. “Initially, there was some animosity towards me because I’m the daughter and she’s the mother.” Now, the two see eye to eye.
Police can sometimes help initiate the conversation of driving retirement. In the past two years, Arnold Herman, 88, had had a series of fender-benders driving his 2012 Honda Accord. But one collision that occurred in an intersection — where the Institute for Highway Safety says half of the “safety problems” of senior drivers occur — caught the attention of police.
“He seemed confused and disoriented [at the scene of the accident], and the police officer took notice,” explained Herman’s daughter Andrea Vocke, 55, of Huntington. In October, Herman received a letter from the Department of Motor Vehicles requiring that he take a road test. By Dec. 5, he learned that he posed a risk on the road and that his license was revoked.
“I shouldn’t be driving, and I realize that,” admitted Herman, of Huntington, a retired Massapequa High School history teacher and grandfather. Although he depends upon rides from his daughter, other family members, neighbors and congregants from his Freeport church, he had to give up his passion of coaching chess at Massapequa High School because he can’t get a ride there.
Experts agree healthy aging means having a plan in place for driving retirement. “As we plan for our finances in retirement, our housing, we add grab bars in the bathroom to increase safety, we also have to think of the vehicle the same way,” said the American Occupational Therapy Association’s Schold-Davis. “Our skills will change at some point and being car dependent will add to the stress of what’s to come.”
Extending the driving years
•AARP offers Smart Driver defensive driving course (AARPdriversafety.org) and Smart DriverTek workshop (https://campaigns.aarp.org/aarp-smart-drivertek) that familiarizes drivers with high-tech vehicle safety features and what technology to look for when shopping for a car.
•AAA offers CarFit, a program that ensures older drivers’ cars are properly adjusted for them; visit Car-Fit.org.
•To find an occupational therapist driver rehabilitation specialist, email the American Occupational Therapy Association at driverhelp@AOTA.org.
A sampling of transportation resources
•Nassau County provides free transportation to and from its 14 senior centers; call 516-227-8900 or visit nassaucountyny.gov/1438/Aging.
•Able-Ride Paratransit Program provides public transportation through the MTA-Long Island Bus service for individuals with disabilities; call 516-228-4000.
•FISH (Friends in Safe Hands) of Wantagh offers free door-to-door service for Wantagh’s senior residents; call 516-861-6032.
•Town of North Hempstead’s Project Independence Senior Transportation Program can provide discounted taxi service for town residents 60 and older; call 516-869-6311.
•Suffolk County’s 10 townships offer free transportation to and from its senior centers; call 631-853-8200 or visit suffolkcountyny.gov/aging/.
•Suffolk County Accessible Transportation offers discounted paratransit services; call 631-853-8337.
•Essential Transportation provides free jitney service in each of Suffolk’s townships; call 631-224-5686.
•Ride-share services: To use Uber or Lyft without a smartphone, call GoGoGrandparent at 1-855-GOGO-USA (1-855-464-6872).