Tony Marshall knows he won’t be driving forever.
The 80-year-old Halifax resident often drives to attend a local singing group and likes to meet up with friends. But he’s also aware of his family history of dementia and has noticed that he’s lost some of his sense of direction over the past two years and has become a bit absent-minded.
He can’t just jump in the car and go any more. “I have to plan how to get there,” Mr. Marshall says.
He uses his Toyota Corolla’s GPS to map out each route and prevent missing a turn. He says if cognitive issues creep in, he’ll get his wife to drive him or take a cab.
“I will probably keep driving for two or three more years,” Mr. Marshall says. “I know what to expect. But I can live with it.”
Driving is a lifeline for many retirees – a fundamental part of their lifestyle that allows them to maintain friendships, visit family, remain independent and participate in community activities.
But sometimes cognitive, vision, hearing or mobility issues can creep in, making driving less satisfying and unsafe. At that point, a person’s driving skills need to be assessed by a professional, and difficult decisions are made around how much time – if any – they spend on the road.
Just over a quarter (26 per cent) of Canadian drivers hope to keep their licences past age 85, according to a 2017 State Farm Canada survey. However, Transport Canada data shows more seniors die in traffic accidents than any other age group.
It’s why each province tests seniors on their driving, usually beginning at age 80. These guidelines vary by province but usually include a written component and a vision test.
For example, to renew a driver’s licence in Ontario, vision and written tests begin at age 80 and repeat every two years. Drivers also have to participate in a 45-minute group education session, although those have been waived during the pandemic. If the examiner has any concerns, a road test is recommended.
Decisions around when someone should stop driving should be based on the individual, says Bill VanGorder, past chair and senior spokesperson of the Canadian Association for Retired Persons – Nova Scotia.
“Permission to drive or not drive should be based on ability and capability – not age,” he says.
Too often, he says, family members make decisions concerning an elderly family member’s driving fitness. They may be uncomfortable with the idea of their elderly parent driving, instead of determining whether the elderly person is an unsafe driver.
“They will go to the family doctor and say: ‘Tell dad he can’t drive any more.’ But for people who live in rural Canada, losing a driver’s licence is the end of everything – they can’t get to the grocery store,” Mr. VanGorder says.
Sometimes children of elderly parents bully them into giving up driving, says Samir Sinha, a geriatrician and director of Health Policy Research and co-chair of Toronto’s Ryerson University’s National Institute on Ageing.
”Older people are by and large safe drivers,” Dr. Sinha says. “And older people can be devastated when their licence is taken away.”
Rather than having a family member shut down driving, he recommends a thorough conversation with the person who is driving to determine their driving fitness and views around driving.
The discussion might include addressing hearing issues with a hearing aid, tackling arthritis to allow individuals to perform safety checks, or treating age-related vision issues such as cataracts or macular degeneration. If the person feels these issues are getting in the way, they can decide to stop driving.
“That way, you’re giving patients the choice,” Dr. Sinha says.
Not all conditions warrant taking away a driver’s licence. For example, a diagnosis of dementia doesn’t automatically mean a person has to stop driving, according to the Canadian Medical Association.
If a senior is suspected of having cognitive or physical issues that are impeding their driving, such as dementia, Dr. Sinha says they should have a driving assessment done by an occupational therapist. The professional can help to pinpoint exactly what challenges might affect their driving and make a recommendation.
Dr. Sinha also suggests that seniors who have had a medical event such as a stroke forgo driving until they have been cleared to do so by a medical professional and have completed both written and road tests.
For other medical events or surgeries, driving “holidays” can be a good idea during recovery, he says, and a great way to reassess one’s driving ability.
Another approach is using the clinical frailty scale, an assessment of a senior’s strength, fitness and ability to perform daily tasks, to make a judgment call, Mr. VanGorder says. The tool can help determine how physically fit a person is to drive.
Mr. VanGorder believes that a standardized graduated driving system, much like the ones currently applied to young drivers, would help seniors make decisions around driving.
“This might not allow someone to drive at night – or on regular roads rather than four-lane highways,” he says. “But their licence will not be taken away.”
Mr. Marshall plans to continue monitoring his memory and cognition with the help of his wife.
“I’m trying to stay as active in the car as possible,” he says.
He’s also ensuring he gets adequate sleep, exercises regularly and sees friends and family often to prevent isolation.
“I can’t fix the problem of aging but I can certainly extend it,” he says.
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