Driving and the Elderly

Last month Health Affairs published an article about drivers who are elderly and infirm. The author is a physician who has grappled with the question of whether she should intervene when she judges a patient to be mentally or physically unable to drive but the patient is unwilling to lose the independence and convenience afforded by driving.

This is a problem not only for physicians, but also for family members. What should we do when we feel our elderly loved ones are endangering themselves and others whenever they get behind the wheel but they refuse to discuss the possibility of relinquishing the driver’s seat? What should we do when they have car accidents but the police simply issue a ticket or warning and take no further action? The risk of permanently damaging the relationship with our elderly relatives, the knowledge that a confrontation about driving is sure to be heated and painful, and perhaps a sense of powerlessness to actually enforce a driving prohibition likely deter many of us from pursuing the matter once we meet initial resistance.

According to the Health Affairs article, by 2020 there will be approximately 40 million licensed drivers over the age of 65. Only a handful of states require physicians to report potentially unsafe drivers to the Department of Motor Vehicles; 14 states mandate that older drivers renew their licenses more often than younger individuals; and only 17 states have added testing for older drivers. Other information can be found at a useful website provided by the American Medical Association. As our population ages, it would be wise for state legislatures to revisit their driving regulations and consider establishing testing programs for elderly drivers. Any other thoughts or advice about handling this difficult issue would be welcome.