In the State of California ‘does not keep statistics on how many drivers are 100 or older but they do on people over 90. At the end of last year, 71,111 people 90 or older were licensed to drive in the state. .
These older people have traffic accidents. Thus driving is a part of activities of daily living (IADL ) assessment done by a geriatric care manager or senior health professional.
In our automobile-oriented society, many people drive as their normal mode of transportation. Age-related changes can threaten driving ability, however. Health problems can interfere with functioning in this area in obvious and less obvious ways. Problems with vision, reaction time, information processing, concentration, and visual-spatial abilities all interplay to influence driving capacity. Motor skills and coordination also affect performance.
A GCM of senior health professional should determine through discussion the older person’s usual mode of transportation. They should then integrate that with information with the functional assessment that includes the person’s lifelong habits about driving.
Did the person ever drive? How much? It is also important to screen for any concerns about whether the person should be driving and to probe and gather information from various sources to ascertain whether the self-reported behavior can be corroborated. Observing the car itself can also be helpful to see whether there are dents or scratches present and, if so, to learn about their origin. Assessing the older person’s car can be a great tool to tell the GCM or senior heath professional dangers the older person might face.
Accidents with multiple deaths have happened many times with older drivers
For many men and women, driving is both a symbolic and a functional basic necessity. It affords freedom to come and go when and where one chooses, even for persons who no longer venture far, and thus is the hallmark of independence and full personhood. The idea that one can go when, where, and whether one chooses is key to many people’s sense of autonomy. It is not surprising, then, that many people hold fast to driving as a basic right. Not surprisingly, too, many people continue to drive even when age or infirmity, or even the removal of their driver’s license, dictate that they should not.
It is not within the GCM or most senior professional, except a physical therapist’s, scope of practice to evaluate a person’s driving capacity. The GCM or senior health professional should, however, screen for problems and concerns in this area, note transportation modes being used, and note any need for intervention or evaluation or assistance to afford the older client continued opportunities for freedom of movement.
Older drivers have a higher risk of traffic fatalities because they are involved in more accidents per mile driven than middle-aged drivers are and because they are more fragile and therefore more likely to suffer more serious injuries should an accident occur. For their safety and the safety of others, it is important that concerns about driving ability be addressed. The American Medical Association (AMA) has an Older Drivers Project designed to educate physicians about the public health issues related to older driver safety. It has developed a Physician’s Guide to Assessing and Counseling Older Drivers to aid in addressing issues surrounding fitness to drive. Driver rehabilitation and older driver safety training initiatives are available in many communities. Occupational therapists and driver evaluation programs at universities, state motor vehicle departments, or specialty clinics can aid older persons and their families with driving concerns as well.