Talking Points
Questions surrounding older driver safety and community mobility are getting increasing attention in the media and from policymakers, advocates for the elderly, government agencies, and a variety of health professions. Because for many people driving is an instrumental activity of daily living, occupational therapists have a dual role in (1) assessing a driver’s skills and (2) remediation to improve driver safety or help transition older drivers to other forms of transportation.
It is important to maintain an ongoing discussion about older driver safety and community mobility in your community. Whether it’s in a conversation with a physician or an interview with the local media, these talking points will help you focus attention on facts that can help shed light on the issue for the public and other audiences.
Background
- The most common cause of unsafe driving by older drivers includes vision impairment, cognitive limitations, side effects of medications, slower reaction times, muscular difficulties, and limited range of motion.
- Most seniors depend on an automobile for the bulk of their travel, with 90% of their trips taken in private vehicles, either as drivers or passengers.
- Traveling in a private vehicle, particularly driving it, provides seniors with independence, enabling them to get to essential services and make social contact outside the home. It is an important aspect of wellness and aging in place.
- When physical and mental limitations make it difficult to drive safely, most older adults gradually withdraw from driving.
- When driving is curtailed, seniors may find themselves isolated from the activities that had filled their lives, especially if they live in suburban or rural areas where public transportation can be cumbersome, if available at all. Isolation can undermine one’s quality of life and accelerate health decline.
Scope of the Problem—The Baby Boomers Are Coming!
- Our population is aging at a rate faster than it is growing. While 1 in 8 people older than age 65 today, the ratio of people who will be older than 65 by 2030 is expected to be 1 in 5. In real numbers, the figure is expected to jump from 35 million in 2003 to 70 million in 2030.
- The rate of driver deaths in automobile crashes rises after age 60 and grows sharply as age increases. For those ages 75 to 79, the rate of driver deaths per year is almost triple the rate for people ages 30 to 59. For ages 80 and older (the fastest growing age group), the rate is more than 4 times that of drivers ages 30 to 59.
Older Drivers’ Driving Habits
- Although seniors actually have fewer crashes than do drivers in other age groups, they are more likely to be seriously injured or killed in a crash.
- Older drivers pose the greatest risk to themselves and are not a significant risk to others.
Public/Private Response
- To ensure safe mobility, transportation experts are focusing on improving transportation safety on several fronts: safer roadways, safer automobiles, better alternative transportation services, better walkways, and improved competency of older drivers.
- Automobile manufacturers such as Ford and Volvo have begun redesigning cars that are easier to use, and they are promoting adaptive devices to accommodate drivers with special needs, including older drivers.
- Some states are revising licensure laws for seniors, starting at 75 years of age.
AOTA/OT Solutions
- Occupational therapists can perform activity of daily living skills assessments that determine if an older driver should be referred to a driving specialist.
- Occupational therapists and occupational therapy assistant driving specialists can conduct clinical and on-road driving assessments and offer treatment plans that range from modifying driving habits to installing adaptive equipment in the automobile. These specialists can also help ease seniors through the possible transition to other modes of transportation.
- AOTA is working with policymakers, government agencies, and other advocacy groups to address older driver safety and community mobility.
- AOTA has received funding from the National Highway Transportation Safety Administration (NHTSA) to develop and disseminate education modules for occupational therapy and occupational therapy assistant students and continuing education modules for occupational therapists and occupational therapy assistants already in practice. The grant also covers development of recommendations to revise accreditation standards in this area, develop a database of driver assessment programs, and develop a “good practices” guide for NHTSA review. (These items were completed in 2004.)
- AOTA has received funding from the Centers for Disease Control and Prevention to conduct an exhaustive evidence-based review of literature on occupational therapy-based older driver rehabilitation therapies and publish clinical practice guidelines on driving. The grant also calls for development of an Internet-based information and referral source for older driver rehabilitation professionals and the public. (These items were completed in 2005.)
