Printer friendlyTips from older adults on playing it safe while driving
What is included in a driving evaluation?
What if physical problems exist?
What if a person is fearful of driving?
What if the person is a senior driver?
What if cognition for driving is affected?
Are driving tests mandatory after you turn 80?
Driving can be more difficult for older adults due to a decrease in physical and mental health including visual, hearing, motor and cognitive (such as problem solving) abilities. By playing it safe, older adults can prevent accidents. However, it’s important to consider refresher and an evaluation rather than risk unsafe driving.
Older adults who are in accidents recover less quickly and less fully than younger people which can lead to unnecessary dependency on others and most likely a stop to your driving.
Here are some tips that older adults practise to ensure their own safety and that of their passengers.
Your fitness to drive
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Have your eyes and hearing tested regularly and wear those recommended glasses and hearing aids!
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If you are on medications, check to make sure it is safe to drive while taking them. Do not drive if you are tired and avoid long hours of continuous driving.
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Do not drive if you are emotionally upset.
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Keep your wits about you! As you drive, try the game “what if” to stay alert and mentally prepared for driving emergencies.
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Do exercises and stretches to improve your neck and body flexion so you can easily look around you when backing up, turning, etc.
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Drive only. Do not use a cell phone, eat, smoke, etc.
Adjusting your car
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Wear your seatbelt.
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Adjust your seat and headrest for comfort, to prevent injury and improve viewing.
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Adjust your mirrors for a clear view.
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Ensure your visor can prevent glare.
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Keep all windows clear and clean, inside and out.
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Keep unnecessary noise to a minimum: radio, fan and passenger noise.
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Make sure your car is properly maintained.
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Make sure your car is safe to drive in adverse conditions (e.g., snow or rain).
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Consider purchasing or adapting your car for safety. Click here for some considerations.
Traffic congestion
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Heavier traffic and fast moving highways may be more difficult. Consider alternative routes or take a re-fresher course or lesson.
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Avoid rush hour when you can.
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Difficult left turn? Try making three rights instead to decrease risk and get you going in the right direction.
Weather conditions
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Heavy rain, wind, snow and ice make driving hazardous for everyone and avoid this if at all possible.
Driving at night, dusk or dawn may be more difficult for those with poorer eyesight even when wearing glasses.
What is included in a driving evaluation?
Driving Evaluations
Driving is a skill of daily living that most people value. When injury, disease, illness or aging potentially affect your ability to drive, a comprehensive driving evaluation should be taken. These are different than screening tests to renew your licence. This type of evaluation helps to determine if your medical condition or age may be affecting your driving ability.
What is included in a driving evaluation?
There are two parts of the evaluation. One is done in a driving clinic and the second is done on the road.
Part one: Clinical evaluation
The occupational therapist begins the evaluation by determining the effects that the client’s medical condition, medications and functional limitations may have on the driving task.
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Visual screening is completed. This is a check to see that your eyes meet the minimum standards for driving in your province. As well, how you move your eyes, your ability to judge distance and how well you see out to the side when you keep your eyes straight ahead.
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The occupational therapist will also look at your arms and legs to see that you have enough movement and strength to control all of the features of the car. If you have some difficulties, adaptive equipment will be recommended to help you.
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Perceptual and cognitive abilities are evaluated by measuring your reaction time, seeing how you can pay attention to more than one thing at a time and completing some thinking skill tests to check your memory, problem solving abilities and how well your brain can interpret what you see.
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The occupational therapist also takes a driving history, notes the type of vehicle driven, and discusses potential adaptive driving equipment.
Part two: On-road evaluation
In this part all aspects of the driving task are assessed and include:
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Physical ability and endurance to handle the vehicle.
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Cognitive/behavioural skills. For example, ability to be aware of potential hazards, being aware of the full traffic environment.
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Visual/perceptual skills. For example, how effectively you use your eyes, look around when you are driving and be able to take in the information you see correctly, make sense of it and act appropriately.
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All responses to the traffic environments. For example, your ability to handle unusual situations, how you handle pedestrians, ability to cope with busy traffic areas or even the expressway.
Based on all the information gathered during both parts of the evaluation, the occupational therapist, usually in collaboration with a driver instructor, interprets results and makes recommendations based on performance strengths and limitations as well as on driving potential.
What if physical problems exist?
Different vehicles offer different space behind the wheel, and very simple positioning or a cushion may provide an easy solution to a presenting problem. However, some clients may need to drive with adaptive driving equipment, and training would thus be recommended prior to installation of driving aids in their own car. In some instances, such as people who use a wheelchair or scooter, a modified van will be necessary. Occupational therapists are aware of state-of-the-art and safety-tested equipment. They know the width of lifts to accommodate specific wheelchair sizes, the benefits and limitations of full size vans versus minivans, lifts versus ramps, about power seat-bases, different types of hand controls, wheelchair securement, etc.
What if a person is fearful of driving?
There are some clients who have phobias and anxiety about driving. Occupational therapists have training in emotional and mental health issues, however most who specialize in this field also have extra training for working with persons with driving anxiety. Occupational therapists assist clients using a systematic desensitization and graded treatment plan to return the person to driving comfortably and safely. Sometimes, the occupational therapist works collaboratively with a psychologist.
What if cognition for driving is affected?
Often after brain injury or stroke, reflexes and mental functions (attention, concentration, decision-making, speed of information processing, etc.) are affected. This may result in the person being unsafe to drive either temporarily, or in some cases, permanently. Potential to benefit from driver training would be determined at the time of assessment, or re-assessment may be recommended at a later date.
What if the person is a senior driver?
Age alone does not stop a person from driving. When family members, family doctors or even the person himself/herself are unsure of driving ability, they are often referred for an evaluation. The occupational therapist is knowledgeable about age-related changes that may affect driving ability. Through a comprehensive assessment, fitness to drive is determined. Adaptive equipment, altered driving techniques and self-restriction are often very helpful to keep seniors driving longer and safely.
Are driving tests mandatory after you turn 80?
Driving licence assessments are more of a screening tool and not the same as what is described here. To renew your license, some provinces do require that people at age 75, 80, and so on, have a medical examination to confirm they are physically able to drive safely. These assessments are not the same as a comprehensive evaluation described above which can pin point difficulties and hopefully offer solutions other than taking your licence away.
How do I know that this is a valid evaluation?
Driving evaluations differ across the country and steps are being taken to standardize the testing. For example, the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (CanDRIVE), led by Dr. Malcolm Hing and Dr. Shawn Marshall, is an interdisciplinary health related research program dedicated to improving the safety of older drivers.
In the meantime, if you are referred to a driver evaluation program the evaluation should be as detailed as possible to ensure that all the information is available to make recommendations regarding retraining, equipment purchases and adaptations. In Ontario, the Ministry of Transportation requires that all evaluations be completed by a registered occupational therapist and all driving programs must be approved by the ministry. For those outside of Ontario, please check with your provincial Motor Vehicle Licensing Board.
You may also look at the Association for Driver Rehabilitation Specialists (ADED) for more detailed information. The ADED web site details codes of ethics, contents of evaluations and much more. There are also several occupational therapists who also hold the ADED qualifications who can be found on this web site.
Refresher Education
Many formal and informal driver refresher courses are available. This section provides information about these courses but does not endorse any of them. At this time, there is not much evidence that supports the ability of these courses to improve safe driving abilities. However, there is some evidence that indicates that refresher courses that include an on road (driving) component are more useful than those that do not.
Taking a refresher course, such as sessions offered by the Canadian Automobile Association or the 55Alive program, will provide information about signs that driving is no longer safe, conditions and behaviours that may affect the ability to drive safely and strategies to enhance safe driving abilities. Some organizations provide an on road evaluation that helps drivers pinpoint aspects of driving that are problematic.
While we don’t know how much effect these courses will have on driving in the long term, gaining this information may help older drivers and their families identify signs that driving is no longer safe and strategies that can be used to enhance safe driving skills.
* Many thanks to Dr. Jan Miller Polgar and registered Occupational Therapist, Wendy Nieuwland for their assistance in compiling this list.*