Wednesday, December 22, 2010

Too Old To Drive

Have you ever endured the aggravation of being stuck behind an elderly driver, unable to pass as they maintain a constant speed of 15 miles per hour below the speed limit? Have you ever narrowly avoided a crash because an elderly driver was no longer able to operate their vehicle in a safe, capable manner? If so, you're not alone. In a report done by the Insurance Institute For Highway Safety, accident claims drastically increase after a person turns 65. Further research by has found that older drivers are more likely to be involved in multi-vehicle crashes than younger drivers, and with the number of drivers over age 70 expected to triple in the U.S over the next 20 years, things will only get worse.

In 2007 there were more than 20 million licensed drivers 70 years and older in the United States, according to The Federal Highway Administration. That same year in the state of Massachusetts, drivers in this age group accounted for 32 fatal accidents, or 11 percent of the state's fatal crashes, while accounting for only 13.5 percent of the total population in the state. Nationally, drivers between the ages of 75 and 84 are responsible for a vehicular fatality rate equal to that of teens; the rate quadruples for drivers over the age of 85. This comes as a great surprise because teenage drivers are often considered to be the most dangerous liabilities to safe driving. It is alarming to see how clearly the statistics show a direct correlation between aging and car accidents.

So, what's being done? Not much for many states. Advocates for the rights of the elderly have made it difficult to impose driving restrictions against older drivers, claiming that these restrictions are the product of age-discrimination. There are some states, however, that have been able to move past this debate and impose regulations to ensure the safety of elderly drivers.

The most logical approach in guaranteeing a person's driving ability would be mandatory driving tests; however New Hampshire and Illinois are the only two states who have successfully enforced these road tests. Both states require all drivers age 75 and over to be retested in order to continue operating a motor vehicle legally. Using A less progressive approach, 23 different states are enforcing drivers over age 65 to renew their driver's license every two years, in person. These states feel that a person proves to be a competent driver just by showing up at the Department of Motor Vehicles. There are 16 states, however, who have taken it a step further by mandating all applicants participate in an eye exam with each renewal. This method has had greater results than simply enforcing renewals every two years. In Florida, where eye exams are required for drivers over the age of 80, only 7 percent have actually failed the test. The program was still a success, however, encouraging 20 percent of the over 80 population to forgo renewing their licenses out of fear of failing the eye exam. Since the eye exam was enforced in 2004, vehicular related fatalities for drivers over the age of 80 dropped from 14.88 deaths per 100,000 residents to 12.34 per 100,000 residents. This may not sound like a major improvement, but in a state with 15 million residents, the numbers are actually quite large. .

While vision testing has certainly proven to be effective, there are many other ways that aging impacts a person's driving abilities. The National Highway Traffic Safety Administration states that "safe elderly drivers require the complex coordination of many different skills. The physical and mental changes that accompany aging can diminish the abilities of elderly drivers. These include: a slowdown in response time; a loss of clarity in vision and hearing; a loss of muscle strength and flexibility; drowsiness due to medications; and a reduction in the ability to focus or concentrate." Many elderly drivers are involved in crashes that occur because of reasons beyond poor eyesight. In 2009, within a 3 week period of time in Massachusetts a 92 year old man killed his wife when he slammed into her while backing their car into a parking space, an 83 year old woman died when her husband collided with another vehicle and a 4 year old girl was pronounced dead after an 89 year old woman hit her in a crosswalk. One of the worst cases of poor elderly driving occurred in Santa Monica, California, when an 86 year old man drove 300 yards through a crowded farmer's market, killing 10 people and injuring many more. Blood tests were taken following the crash confirming that the man was not under the influence of alcohol and had not been using prescription or recreational drugs. In a statement following the crash, the man claimed that he had tried everything from stomping on the break pedal to jamming the car into park, but could not get the vehicle to stop. Apparently, the pedal he was stomping on was the accelerator, not the break pedal, which lead to speeds in excess of 60 miles per hour during his 300 yard plunge through pedestrians and street vendors. The man was convicted with 10 counts of vehicular man slaughter with gross negligence, the harshest penalty for his actions. He faces a possible 18 years in prison.

Recently I met with Tony Forbes, a 95 year old resident of Winchester, Massachusetts about his experience operating a vehicle as an older man. Until a few months ago Forbes drove his vehicle every day, but after missing a stop sign, as many senior drivers do, he caused a three car collision. Fortunately no one was seriously injured in the crash, but his family took the car away and sold it in order to prevent further incidents. When I asked Forbes about the collision he exclaimed, “It wasn't my fault. I don't know why everyone keeps making such a big deal out of this.” Later he offered to show me his car so I could see the damage from the crash. I reminded him that his family had sold the vehicle months ago, but he insisted that I was wrong and that the vehicle was parked out front. Eventually I obliged for him to show me and he was very concerned to see the car was missing. “Somebody stole my car! I'm calling the police” he declared. Fortunately his daughter lives next door and was able to remind him that the car really had been sold, which took much convincing and left him very upset. Since the sale of the car 3 months ago he has called to report the vehicle stolen twice, according to his daughter, who is his primary caregiver. It's scary that this man is still legally licensed to drive by the state of Massachusetts and, if not for his family, could still be operating a motor vehicle on a daily basis with no concern from the state.

The state of Maryland has recognized the many ways age effects the driving abilities of the elderly. After assembling a group of nearly 1900 volunteers between the ages of 55 and 96, state officials conducted a test consisting of basic commands and asked the subjects to repeat simple movements. The criteria was designed specifically to test the cognitive skills of the volunteers. In January, 2006 the results were published in The Journal of the American Geriatrics Society and concluded that those who performed poorly on the test were 25 percent more likely to cause a car crash. Because of the test results Maryland is the only state that mandates cognitive screenings for drivers with concerning records and behaviors. The only trouble with this program is that it is not necessarily preventative. Drivers with concerning records have already caused accidents. Sure, the state is keeping them from causing more, but true prevention would keep them from causing any.

In 2003, California had introduced a trial program designed to prevent unfit drivers from maintaining a driver's license, and hopefully reduce the number of accidents caused by incapable drivers. The system required drivers of all ages to pass a driving knowledge test, cognitive screening and a vision exam. Each step was considered a tier in this three-tiered system. If a driver were to fail either of the first two tiers, a road test would be required in order to renew their driver's license. Those who could not pass the vision exam, however, were automatically failed. The trial only involved 152 drivers, and the results were inconclusive, which lead to California abandoning the project before it could be implemented.

The number of accidents caused by older drivers is undoubtedly concerning. It may not be possible for all states to require road testing for all older drivers, but most states need to consider a more aggressive screening system for the elderly. Some may argue that this is age-discrimination, however, the numbers prove the safety risks created by unfit elderly drivers, and it is clear that more needs to be done to improve this problem.

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