Part 2: Mental Facilities and Motor Skills
By Heidi Nestor
You’re driving down the road when suddenly a car flashes past you. It slows down just long enough to hover at a stop sign and tease you into perusing it before making a sonic boom and disappearing into the future that would make “Doc” Brown’s DeLorean look like the Clampett’s 1921 Oldsmobile truck. “Damn Kids!” you yell.
Finally, a stop light appears as if divine intervention is settling the score and allowing you to catch up to those irresponsible youths so you can lecture them on the hazards of unsafe driving. You pull up next to the car and are about to start your sermon when you see it’s grandpa! He had no idea he was speeding, and what stop sign are you referring to?
In Part One of, Putting the Breaks on Elder Driving, we questioned if age is a sufficient cause to enforce limits on senior driving. Part Two explores the degenerative mental facilities with motor skills, medications for the aging body, and how to assess any signs of a driving problem.
Though The House Bill, H4466, was passed in February 2010 requiring driver’s over 75 to pass a vision test, and health care providers to report an individual’s inabilities to operate a motor vehicle safely, there still is not a cut-off age or stronger driving requirements for seniors. Several departments of motor vehicles have questionnaires for a senior driver but few of the questions are relevant to aging issues, such as, are you on any medications or do you have physical aliments that may prevent them from driving safely.
In, The Driving Dilemma: The Resource Guide for Families and Their Older Drivers, Elizabeth Dugan explains:
- Contrary to what many people believe, age, by itself, does not determine driving fitness. What matters in driving are three fundamental functions: the ability to see, think and move. These abilities change at different rates for different people. Some people in their 90s and beyond are more healthy and fit for driving than some people in their 50s and 60s.
Growing older doesn’t necessary mean seniors need to be under house arrest. Many are still active, lucid, and young at heart but one aspect of aging we can’t ignore is the affect it has on our brains. The online article, Aging Brain, reveals that:
- Two thirds of all people eventually experience some significant loss of mental lucidity and independence as a result of aging. 60 years and older experience significant cognitive decline, including declines in memory, concentration, clarity of thought, focus and judgment with an increase in the onset of several neurological problems like Alzheimer's disease, Parkinson's disease, stroke etc...
To avoid going into a lecture akin to a high school science class dissecting a frog to see how motor skills work, this writer will spare you the technical lingo and just sum up the highlights of the Aging Brain article which explains that as our bodies age, our brains age too thus decreasing in weight and volume resulting in a loss of neurons and cellular fluid, both key components for mental awareness.
These biological changes can have an affect on thinking and judgment as seen with “Pedal Confusion”, believing your foot is on the brake when it’s on the accelerator. This was the situation when George Weller ran his car through a Los Angeles farmer’s market killing and injuring many people. “George Weller’s not alone in pedal confusion,” remarks researcher Barbara Freund in, When is it Time to Quit Driving? “They [elder drivers] recognize they’re not stopping, so they press the [accelerator] pedal harder. They can’t sort out what’s happening.” Confusion becomes more prevalent as one grows older but these “senior moments” can have a catastrophic outcome behind the wheel.
What about Medications?
Another issue to consider may not have to do with brain function or cognitive ability at all, but just good old fashion achy bones. You or your aged loved one may still have all of your mental faculties but have you ever woken up with a stiff neck? Remember how hard it is to drive with cramped, sore shoulder - so much so - that you really don’t turn around to look out your side view mirrors as much as you should. That is what it feels like to have arthritis in your neck and shoulders. Seniors may not be turning around to look at side traffic as much as they should, not because they’re forgetful, but because it just hurts too much.
But for whatever ails us medically there is an equal and opposite medication that can help. However, with every medication there is also an equal and opposite side affect that, if not careful, could have grandpa calling from the local police department asking you to post bail for his D.U.I.
John R. Siberski notes in, Aging Well, that:
- While few of the normal changes of aging are sufficient to prohibit driving, their cumulative effect, superimposed on medical illnesses and/or dementia, can take a significant toll on driving ability and safety. Medications can also contribute to poor diving performance.
Perhaps it’s not so much the physical ailments that can affect one’s driving, but the treatment that is the problem. By the time we’re in our 50s most of us are taking some kind of pill for this or a prescribed medication for that; when we reach our 60s we can have a pharmacy in our medicine cabinets. Dugan explains that the older we get the more medications we consume:
- Adults age 65 and older consume more prescription and over-the-counter medication than people in any other age group. A recent national survey of the non-institutionalized [not living in a care facility] adult U.S. population found that more than 90% of people 65 or older use at least one medication per week. Approximately one half (46%) take five or more prescription medications, and 12% take 10 or more different medications per week.
With seniors popping as many pills as Ronald Reagan popped jelly beans it’s no wonder the medical review boards are taking action when notified of a driver’s physical or mental inabilities. In, When is it Time to Quit Driving?, Reed Karaim says that states are requiring doctors to report certain health problems of a driver to the local Department of Motor Vehicles.
Let’s say you or your elderly driver are in good health, medications are minimal, and your reflex reaction time has been liken to that of Bruce Lee, there’s still something else to consider; over the counter allergy medication, such as antihistamines, can cause drowsiness and/or muscle incoordination. Moreover, some anti-inflammatory drugs “may increase the risk of heart attack and stroke, which in turn could endanger you when driving” (Dugan). Even someone in their 30s can become a problem on the road if under the influence of some kind of over-the-counter allergy drug, but a combination of a 75 year old who takes an antihistamine can lead to more confusion and less reaction time while driving.
How to assess any signs of a problem:
If you are a senior or a family member of a senior who still drives, companies such as AARP, AAA, and AMA supply lists of warning signs to look for that indicate impaired driving. Dugan lists these in colored categories from the highest risks being RED, to the cautionary risks being YELLOW, and GREEN indicating safety issues that can be corrected. “Having one of the red risks”, Dugan says, “is a signal to immediately begin the conversations about driving and to seek a professional assessment.”
- RED:
- One or more auto accidents in the past five years.
- Recent traffic tickets or police warnings.
- Severely impaired vision, cognition, or mobility.
YELLOW:
Somewhat lower than Red but still a significant safety risk.
- Recent near misses or close calls while driving.
- Having friends/family say they don’t want to ride with you (or the elder driver).
- Accumulation of vehicle dents and dings.
- Having other drivers honk, gesture, or be annoyed at you (or elder driver) when driving.
- Difficulty judging gaps in traffic, at intersections, and on highway entrances/exit ramps.
- Failing to notice objects on the sides of the road when looking straight ahead.
- Not seeing lights, signs, signals, or pedestrians soon enough to respond.
- Taking medications.
- Slow response to unexpected situations.
- Become easily distracted or having difficulty concentrating while driving.
- Difficulty negotiating turns and intersections.
- Hesitating over right-of-way decisions.
- Difficulty keeping the car in the proper lane.
GREEN:
- Trouble seeing over the steering wheel.
- Difficulty looking back over one’s shoulder.
- Trouble physically moving the steering wheel or looking out mirrors.
- Difficulty getting in or out of the vehicle.
The highest level of risk.
Clark, Ron. “Making the 'Key' Decision.” AgeNet., Inc. 2001. November 30, 2009.
Dugan, Elizabeth. The Driving Dilemma: A complete Resource Guide for Older Drivers and Their Families. New York: Harper Collins, 2006.
Karaim, Reed. “When is it Time to Quit Driving?” November 16, 2006. AARP.org December 2009.
"Senior Citizen Drivers: Are They a Menace? Should Licensing Laws Be Tougher?" Seniorjournal.com. 9 December 2009.
Siberski, John. “Knowing When to Break Older Adults and Driving.” Aging Well. Winter 2008: 37-39.
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