- Many things impact an older adult's driving ability, including visual impairment, hearing loss, reaction time, and medications
- If family and friends have expressed concerns about a loved one's driving, or there have been moving violations, fender benders, or a worsening chronic illness, its time to have them assessed
- While it’s important (and in some instances required) to get re-tested for the DMV driving exam, relying on that on its own is not the best way to assess ability
- Working with your loved one’s physician and having them take a cognitive assessment in addition to the DMV test can help you make a decision
Many older adults see the automobile as the ultimate symbol of freedom and exploration. As a result, determining whether someone is still safe behind the wheel can be highly emotional and needs to be treated with care. Here’s what to know about assessing an older adult’s driving ability.
What Impacts An Older Adult’s Driving Ability?
There are many things that can impact an older adult’s driving ability, including:
- Visual impairment: Issues like cataracts, glaucoma, and macular degeneration can all introduce risks while on the road.
- Hearing loss: While driving, many sensory cues come from our ears, so hearing loss can be particularly challenging (like the failure to hear a honking horn).
- Reaction time: Reaction time can slow naturally with age, impacting our ability to avoid a sudden change in conditions.
- Medications: Medications may lead to drowsiness, causing the driver to lose focus or even fall asleep at the wheel.
- Undiagnosed dementia: Dementia can cause errors in judgment, like when to merge or change lanes.
These problems can occur alone or in combination. Some may be treatable, while others are not.
As you assess your loved one’s ability, it’s important to get their physician involved in the process. They can help you understand and address any of the causes that may be treatable and help determine the right path forward.
How Do You Know When Someone Needs to Be Assessed?
Any of the following scenarios are a reason to have your loved one’s driving ability assessed.
- Concerns expressed by you or other friends and family: If you or someone else in your inner circle is expressing concerns about your loved one’s driving ability, it’s important to take them seriously, especially if this is someone who has driven with your loved one for a long time and is noticing a recent downward trend.
- Moving violations: Tickets can be a sign of eroding judgment or ability. If your loved one has gotten any sort of ticket recently, it’s a good signal to get their driving assessed.
- Fender benders: Similar to moving violations, minor scrapes or worse are an immediate sign that ability needs to be reassessed.
- Worsening chronic illnesses that could affect driving: Any worsening chronic illness that could affect driving (arthritis, Parkinson’s disease) should raise concerns. The most worrisome is memory loss or another cognitive decline. Driving problems are sometimes the first manifestation of Alzheimer’s disease or other forms of dementia.
Don't Rely On a DMV Test Alone
Many people take a driving test at the DMV to "re-validate" their driving ability. In some states, this is required — the Insurance Institute for Highway Safety has a summary of which states require renewal for older drivers, including those that require proof of adequate vision. In other instances, an older driver might go to the DMV to retest because a worried family member, friend, or physician expressed concerns.
While it’s important, and in some instances, required, to get re-tested, relying on the DMV driving exam on its own is not the best way to assess driving ability. Older drivers are often good at driving fundamentals, like making a three-point turn or parallel parking, which are a big part of the assessment. Unless an older adult is highly impaired, the test might not detect “real world” hazards, like a pedestrian unexpectedly darting in your path, or driving in inclement weather like a hailstorm or fog. Instances like these are often where the real risks lie.
How to Get a Driver Assessed
Ultimately, unless impairments are severe and dramatic, the determination that someone can no longer drive is not based on any one test. A combination of your loved one’s physician and a cognitive assessment can help you make a decision.
Your loved one’s physician should be a key ally in the process. They can weigh in with their thoughts, look for treatable contributors to decline, and make referrals to specialists. Driving is one area where physicians err on the conservative side because of the danger to not only the older adult, but also to pedestrians and other drivers.
Another helpful resource is to find a driving rehabilitation specialist. These are professionally trained driving specialists who assess ability and provide driving tips. The Association for Driver Rehabilitation Specialists has a database on their website that allows you to find one in your area. The American Occupational Therapy Association also has a database that helps you find driving rehabilitation providers. These services are sometimes covered by insurance.
As a complement to a DMV test, it’s essential to take a test that is focused on cognition, like CogniFit’s Online Cognitive Assessment Battery for Driving ($49.99). This online test takes 30-40 minutes and provides a detailed report upon completion. Some states also have evaluation centers with cognitive tests; these are often computer simulations that realistically portray real-world driving conditions to test how you respond.
How To Help Your Loved One
If your loved one has been deemed safe to drive but you’re still feeling uncomfortable, a good approach is to see if they’d be open to pulling back their driving, but not giving it up completely. Examples include only driving during the day when there’s better visibility, only driving shorter distances (no trip longer than 10 miles), and limiting trips to familiar places on roads they know well.
Ridesharing Apps to the Rescue
Uber and Lyft have made getting around much easier and are highly recommended for older adults. If your loved one is unable to use these apps reliably, we recommend GoGoGrandparent (paid; monthly fee varies), a service that enables you to call to schedule a ride with a ride-sharing service.
What if a Loved One Is Resistant to Giving Up Their Keys?
If your loved one needs to give up their keys but is refusing, it’s best to work with their physician and have them take the lead instead of having it continue to come from you. Their physician is more likely to be seen as an objective arbiter of the decision, and the older adult may view it as more of a “prescription” than an opinion from an over-protective family member. It allows you to put it on them instead of increasing the tension between you and your loved one.
What if They Still Won’t Give Up Their Keys?
If an older adult is a danger on the road and still refuses to give up their keys after speaking with their physician, the physician will likely need to report them to your state's DMV. This is the last resort after taking the steps outlined above. Through this process, it’s important to continue working with their physician to ensure that the proper steps are being taken and that the older adult is off the road.
- Reach out to your loved one’s physician to alert them of your concern and get their thoughts. Get a sense of what underlying issues — treatable or not — may be contributing to the decline.
- Check to see if your loved one’s state requires them to take a driving test at the DMV to “re-validate” their driving ability. The Insurance Institute for Highway Safety has a summary of which states require renewal for older drivers.
- As a complement to a DMV test, recommend that they take an additional test focused on cognition, like CogniFit’s Online Cognitive Assessment Battery for Driving ($49.99).
- Consider hiring a driving rehabilitation specialist who can assess ability and provide driving tips. The Association for Driver Rehabilitation Specialists has a database on their website that allows you to find one in your area. The American Occupational Therapy Association also has a database that helps you find driving rehabilitation providers.
- If your loved one has been deemed safe to drive but you’re still feeling uncomfortable, see if they’d be open to pulling back their driving, but not giving it up completely. Examples include only driving during the day when there’s better visibility, only driving shorter distances (no trip longer than 10 miles), and limiting trips to familiar places on roads they know well. Ridesharing apps like Uber, Lyft, and GoGoGrandparent are also good solutions.
- Continue to work with your loved one’s physician through the process, and have them speak to your loved one directly if they need to get off the road. If they’re in danger and still refusing to give up their keys after the conversation, the physician will likely need to report them to your state's DMV.