Eye Has Not Seen, Nor Ear Has Heard.
When driving is no longer an option. A pronounced death sentence?
A few months ago on a Friday afternoon, I found a leftover packing box, cut a hole in it, scribbled some markings on it to resemble a television set and placed it on my head. You see, a challenge had been issued by Carboholic's tribe leader, James May, to video oneself having a rant about a car related theme. I will admit that my naivety can be acute at times. I thought my rant would be amongst hundreds of others. I was mistaken, and found myself to be among only a brave few. I must admit I felt slightly foolish about the whole thing, although James was kind enough to acknowledge my endeavors. I was, however, not feeling foolish about the content.
The American Automobile Association’s (AAA), senior website reports that by the year 2030, 70 million Americans will be between the ages of 75-85 and 90 percent will have licenses to drive. Health care technology is a contributing factor to this rise. As we create a generation of people that live beyond what used to be the median age of 70, we also inherit the challenges that go along with this new found longevity.
Mildred, a fictitious person. Photo from CDC and prevention.
Let's consider the case of 90 year-old Mildred. She lives alone and is fully capable of caring for herself under the watchful eye of her son that lives near- by. Mildred has had a license to drive since she was 16 and although she just turned 90, she appears to be fully capable to drive herself around to places within a 10 mile radius of her home. Her son, however, was recently called by the police after she was involved in an accident. Mildred misjudged the distance between her car and a garbage truck, dented in the side of her car and put a significant gash across the side of the truck. Lately, Mildred is showing signs of forgetfulness and when her son mentions that she might consider letting him drive her to appointments and the grocery store, she snaps at him to mind his own damn business. She says, “I am perfectly capable of driving anywhere I need to go.”
Sticks and stones will break my bones.
It is true that some of the challenges the elderly face when driving are in the areas of psycho-motor skills such as vision, and reaction time. Cognitive processes are also affected including memory retention, and ability to problem solve or critically think in abnormal driving situations. The Center for Disease Control in Atlanta, Georgia reports that although drivers between the ages of 70 – 74, surprisingly, tend to have less accidents than younger counterparts, they have a higher risk for severe injury and even death when accidents occur. This is due to medical complications related to chest fragility (inappropriately placed seat belts) and previous medical conditions that make it difficult for recovery from injuries sustained in accidents.
Assessment of competency is a key factor in determining licensure for the elderly. Medical evaluations carry significant weight, but another possibility in the evaluative process can be in the realm of simulation. Driving simulators, like those at the University of Utah, can be one objective way to measure competency without compromising driver and passenger safety. Occupational Therapists and certified driver rehabilitation specialists observe as the simulator measures a driver’s reaction time, and places the person in situations that ask the driver to critically think and make decisions based on road conditions and other vehicle responses. It should be noted that results from simulation exams cannot revoke licenses but can be a mitigating factor when considering license renewal for those elderly persons showing signs of incompetence behind the wheel.
You can drive my car.
Another interesting option to consider was recently presented by Chris Grayling, Secretary of Transportation, for the United Kingdom. In an article by the Daily Mail, November 5, of this year, Secretary Grayling, in discussing automated cars, predicted that the first self-driving car will be on roads in the UK by 2021. He points to one of the positives of these cars as being a method of transportation to those elderly finding themselves unable to possess a driver’s license. Studies show that autonomous cars have less accidents because human error is not a factor. It appears to be a viable option, although the challenge would be to get buy in from those elderly that have been driving most of their adult lives to trust this technology.
What about Mildred?
So there’s still Mildred’s dilemma to consider. Her son is not fully convinced of his Mother’s safety. At her last check up, Mildred’s son requested her physician evaluate her memory, reaction time and perform a vision screening. All of which she performed at less than optimal requirements to keep her license. The physician advised Mildred to consider giving up her license and would not sign her clearance form for a renewal when her current one expires. It appears that Mildred and her son are at a crossroads. Her son could just take her keys away and insist that she let him drive her places. For Mildred, that loss of independence could be like a pronouncement of a death sentence. If Mildred’s son allows her to continue to drive, he is playing a waiting game for another accident to occur which will almost certainly happen and maybe with far worse consequences.
This isn't Mildred obviously, but you get my point.
So, what do you think?
Would you take Mildred’s keys away if you were her son? Maybe it is far easier to let things continue as they have and take a wait and see attitude, gambling that nothing will happen. I would be interested to hear what side of this argument you find yourself on and why you feel as you do. Your “say so” is important to me.
Oh, by the way, this story is somewhat fictional, the names and places have been changed a bit….but the dilemma is personal.
As always, having a spirit of inquiry and humility…..Karen