When is it time to hang up the car keys and drive no more?

  • To many younger people, it’s when you show the first sign of gray hair.
  • To adult sons and daughters, it’s the first time you misplace something in their presence.
  • To society at large, it should be at age 65.

But for the vast majority of mature adults, none of the above is true.

Age itself doesn’t determine your driving ability. There are people in their 100s who hold licenses and drive well, while there are others in their 60s who are nearly incompetent behind the wheel.

Most of the problems in mature driving are medical or health related, and most can be treated or corrected.

Accidental Path
First, the bad news: Based on actual miles driven, people over the age of 65 are second only to those under age 25 in having or causing automobile accidents. The incidents involving mature adults tend to be worse and cause more injuries than those involving younger drivers.

According to the Merck Manual of Geriatrics, the accident rate does not really increase until age 70, and after age 80 it increases rapidly.

Most common driving violations for those 65 and older are for failure to yield the right-of-way and failure to obey a traffic sign.

Impaired Function
Chronological age is not the cause of bad or dangerous driving; impaired function is. To be better drivers, mature adults can -- in most cases -- correct the impairments. And the causes of impairment may be surprising.

Impaired driving ability may be caused by:

  • loss in vision
  • slowed reaction time due to reactions or side effects from medications
  • reduced strength
  • chronic conditions with debilitating or episodic limitations

Taking Away or Putting Up the Keys
Taking away the driving ability of a mature adult can be traumatic, whether done by adult children or the senior citizen himself or herself. What seems to be a simple act can seriously affect the person’s independence. And by removing independence, the mature adult may experience depression, and that may lead to serious physical conditions.

Therefore, exploring ways to correct the possible causes of driving problems may be the most important first step.

Vision Problems and Correction
Vision is key to driving safely. Your eye specialist should be the authority regarding visual ability for driving. A regular and thorough vision examination is important.

Provide your ophthalmologist or optometrist with a list of medications you’re taking so that he or she can check for side effects that may hamper vision.

Diseases like diabetes and heart conditions can cause vision problems, some irreversible. Diabetic retinopathy and age related macular degeneration (ARMD) might be definite reasons to give up driving, while cataracts and glaucoma may be effectively corrected, particularly if diagnosed and treated early. The new development of miniature biopic telescopes on eyeglasses may even extend the driving ability of seniors with ARMD.

Here are other recommendations:

  • In some cases, you may have to reduce or eliminate driving at twilight or nighttime. Don’t wear sunglasses at night. Don’t drive a car that has tinted windows.
  • As part of the aging process, peripheral vision may reduce from 170 to 120 degrees. If the doctor says your balance of vision is acceptable, one solution may be to move your head left and right regularly to recapture the periphery. Check with your doctor to see if this is an option for you.
  • Eat a healthy diet and exercise. Recent research documents that proper diet and exercise are important to having and retaining the best vision. For example, vitamins E, A and other anti-oxidants are now prescribed for stopping or slowing the formation of cataracts. Ask your eye specialist for recommendations.

Chronic Conditions
Alzheimer’s disease and other forms of dementia should be recognized as valid reasons for giving up driving. The same is true for physical limitations from a stroke. But if a senior misplaced something, this should not be the reason for adult children to take away the car keys. If the senior puts the keys in the oven, then perhaps that’s a reason to call for a medical exam and assessment.

Low blood sugar associated with Diabetes can cause driving problems, but with help from your doctor you can control this condition.

Heart conditions that may get worse all of a sudden should cause concern about driving ability.

But, more problems in driving are caused by:

Reactions or side-effects to medications for chronic conditions, either as a direct result of one medication or as in polyp harmacy, the often serious conflicts of multiple medications. Typical side effects may include slowed reaction, drowsiness and/or lack of mental focus.

Assume that antidepressants or other mood-altering medications may have such side effects; but you’ll often find similar reactions from drugs for heart disease and other problems.

Ask your doctor to explain predictable and possible side effects of any prescription or over-the-counter medication he or she recommends. And read the information in the package to learn if side effects may include drowsiness, disorientation or worse.

Polyp harmacy often happens when you have different doctors who prescribe different drugs, and each doctor is unaware of what the other has recommended. Ask for an analysis of single or multiple drug side effects from your primary care physician or pharmacist.

Reducing activity and exercise. A study by Yale University documents that sedentary lives and not age are key to accidents by those 72 to 93 years of age. Their recommendation: if you want to drive safely in the mature years, take a walk for exercise every day (not a walk from the couch to the refrigerator).

Reduction in strength and mobility. From lack of exercise, many seniors lose the strength, movement and stamina for effective control of a car through traffic conditions and avoiding accidents.

Lack of fitness -- not aging -- is often the problem in driving. The long-held assumption that retirement is the time to rest in a rocking chair is probably the most predictable path to impaired driving ability.

Even the long-held prescription of rest as treatment for arthritis has been buried in the past as new and effective treatment calls for daily range-of-motion and other exercises.

Hand strength is important for controlling the wheel (at least 35 pound strength is recommended), and can be maintained through simple exercise.

Learning Anew
Some accidents by mature adults are caused because they have not observed the changes in road conditions or traffic over the years. And a person is never too old to learn.

Safety experts recommend that you go back to school, to the 55 alive AARP driver training program, locally-available driving courses offered by community colleges and adult schools or frequent courses offered by automobile club local offices, or by the National Safety Council. Check your newspaper for announcements, the telephone book for local office listings, and/or the Internet for more information.

About Gray Driving
Many older adults will have illness-caused limitations to their driving ability, but for the majority of problem mature drivers, that’s not the case. Ninety percent of mature adults do not have Alzheimer’s disease, and less than half of them have noticeable symptoms.

The key to continuing or returning to safe driving should start at your doctor’s office and/or your pharmacist’s counter. Don’t assume the worst until this has been done. Chances are that the cause of the driving problem may be moderated by less, not more, medication, and a prescription for more exercise.

Before you hang-up or take away an older driver’s car keys, take your questions to a doctor or pharmacist.