Driving and the Older Adult

Question 1

“Driving life expectancy”

Answer 1

refers to the number of years a person can expect to continue driving safely, based on their age, health, cognitive function, and other factors that influence driving ability.

Question 2

Older Drivers: The Facts

What may effect some older people’s abilities to drive?

Answer 2

Age-related changes in vision, physical functioning, and the ability to reason and remember, as well as diseases and medications, might affect some older adults’ driving abilities.

Question 3

Older Drivers: The Facts

How will the number of older adults on the road change?

Answer 3

Expected massive increase in the number of older adults on the road: In 2020, there were almost 48 million licensed drivers ages 65 and older in the US, a 68% increase since 2000.

Question 4

Older Drivers: The Facts

Who has the higher death rates?

Answer 4

Across all age groups, males have higher death rates.

Question 5

Older Drivers: The Facts

How does the number of police reported crash rates in drivers 70-79 compared to those ages 35-54? How about fatal crash rates?

Answer 5

Fatal crash rates per 100,000 licensed drivers and police-reported crash rates per mile traveled for drivers ages 70–79 are now less than those for drivers ages 35–54, but their fatal crash rates per mile traveled and risk of dying in a crash remain higher as they drive fewer miles.

Question 6

What does having a valid driver’s license serve as an indicator for?

Answer 6

Having a valid driver’s license serves as a significant indicator of autonomy.

Question 7

Older Drivers: The Facts

What is the leading cause of injury-related deaths among 65-74 year olds?

Answer 7

Motor vehicle injuries persist as the leading cause of injury-related deaths among 65 to 74 year olds and are the second leading cause (after falls) among 75 to 84 year olds.

Question 8

Older Drivers: The Facts

What is the second leading cause of injury-related deaths (after falls) among 75-84 year olds?

Answer 8

Motor vehicle injuries persist as the leading cause of injury-related deaths among 65 to 74 year olds and are the second leading cause (after falls) among 75 to 84 year olds.

Question 9

Is the following statement true or false?

The decision to give up or significantly curtail driving can be considered a major life event for the older adult

Answer 9

True

The loss of an independent means of transportation affects every aspect of an older adult’s life.

Question 10

What serves as one of the most emotionally charged issues relating to the functional impairment and the older adult?

Answer 10

Decisions about driving a car represent one of the most emotionally charged issues relating to functional impairment and the older adult

Question 11

What is driving linked to?

Answer 11

Driving is linked to personal perception

Question 12

Driving is linked to personal perception
Like

Answer 12

Self esteem
Autonomy
Prestige
Youthfulness
Status
Power
Personal and financial status

Question 13

Driving is linked to personal perception:

Driving retirement: Negative effects include what?
What are these all correlated with?

Answer 13

Negative effects include:

increased social isolation,

depression and loneliness,

all correlated with poor health and a shortened life.

Question 14

In Essays After Eighty, American poet Donald Hall explained what?

Answer 14

In Essays After Eighty, American poet Donald Hall explained how life is irrevocably and excruciatingly changed when a person must let go of his car:

“Old age is a ceremony of losses.”

Question 15

Decisions about driving a vehicle

Transitioning from “driver” to “former driver” effects what?

Answer 15

negatively affects individuals’ physical, mental, and social health;

Question 16

What are some problems older adults face that effect driving?

Answer 16

Older drivers who have diminished visual acuity and contrast sensitivity have difficulty, particularly in low-light conditions, detecting and reading traffic signs, reading variable message signs, and detecting pavement markings and channelization devices (=cones, tubular markers, vertical panels, drums, barricades, and temporary raised islands)

Question 17

What are some eye problems older adults face?

Answer 17

1. Cataracts
2. Glaucoma
3. Macular degeneration

Question 18

What are some eye problems older adults face?

Cataract: What is it? How can it be treated?

Answer 18

Cataract is characterized by the clouding of the eye’s natural lens, leading to blurred or hazy vision.

It can be treated with surgery to replace the clouded lens with an artificial one. (peripheral vision is OK)

Question 19

What are some eye problems older adults face?

Glaucoma: What is it?

Answer 19

Glaucoma: Glaucoma is a group of eye diseases that damage the optic nerve, often due to increased intraocular pressure.

Question 20

What are some eye problems older adults face?

Glaucoma: What can it result in?

Answer 20

It can result in gradual vision loss and is typically managed with medications or surgical procedures to lower eye pressure.

Question 21

What are some eye problems older adults face?

Macular degeneration: What is it?

Answer 21

Macular degeneration: Macular degeneration, also known as age-related macular degeneration (AMD), is a progressive eye disease affecting the macula, leading to central vision loss.

Question 22

What are some eye problems older adults face?

What is the leading cause of vision impairment in older adults?

Answer 22

Macular degeneration is a leading cause of vision impairment in older adults and currently has no cure, although treatments may help slow its progression. (affects central vision so peripheral vision is OK)

Question 23

What are some eye problems older adults face?

Macular degeneration: What does treatment do?

Answer 23

Macular degeneration is a leading cause of vision impairment in older adults and currently has no cure, although treatments may help slow its progression.

Question 24

What are some eye problems older adults face?

Macular degeneration: What part of vision is affected?

Answer 24

(affects central vision so peripheral vision is OK)

Question 25

Care for Prevention of Driving Disability

Common age-related changes that impact functional abilities in addition to medical conditions can make driving difficult, potentially doing what?

Answer 25

Common age-related changes that impact functional abilities in addition to medical conditions can make driving difficult, potentially reducing the older adult’s independence, social contact, and access to nutrition, health care, and other services creating driving disability.

Question 26

Care for Prevention of Driving Disability

Care should be based on what?

Answer 26

It is important to base the decision on current function rather than chronological age.

Question 27

Care for Prevention of Driving Disability

How does driving expectancy compare to life expectancy?

Answer 27

Driving expectancy is significantly less than life expectancy.

Question 28

Assessing and managing potential driving disability

How is assessing?

Answer 28

challenging and time consuming, especially because it is often considered a personal rather than a clinical issue.

Question 29

Assessing and managing potential driving disability

What may deter clinical team from asking questions?

Answer 29

Legal and ethical questions may also deter clinical team members from addressing driving ability in older adults.

Question 30

Assessing and managing potential driving disability

Who do older adult drivers and caregivers turn to for guidance about driving?

Answer 30

older adult drivers and their caregivers will increasingly turn to clinical team members for guidance on safe driving.

Question 31

Assessing and managing potential driving disability

What is there a challenge in?

Answer 31

The challenge is in balancing the safety of older adults against their transportation needs and the safety of society.

Question 32

Clinical Levels of Care for Prevention of Driving Disability include:

Answer 32

Primary prevention

Secondary prevention

Tertiary prevention

Question 33

Clinical Levels of Care for Prevention of Driving Disability include:

Primary prevention

Answer 33

Assess the older person and intervene to prevent the loss of driving ability

Question 34

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention

Answer 34

Addresses issues already causing loss of driving skills and attempt to restore those skills through treatment and rehab

Question 35

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include:

Answer 35

Motor skills

Cognitive skills

Perceptual skills

Spatial awareness

Executive function

Visual acuity

Physical fitness

Question 36

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include: Motor skills

Answer 36

This includes skills related to physical control of the vehicle, such as steering, braking, accelerating, and using turn signals.

Question 37

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include: Cognitive skills

Answer 37

These involve mental processes like attention, memory, decision-making, and reaction time, which are essential for assessing and responding to traffic situations.

Question 38

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include: Perceptual skills

Answer 38

These skills involve the ability to interpret visual and auditory information, such as recognizing road signs, detecting hazards, and judging distances and speeds of other vehicles.

Question 39

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include: Spatial awareness

Answer 39

Understanding the dimensions of the vehicle and its position in relation to other objects on the road.

Question 40

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include: Executive function

Answer 40

Skills related to planning routes, making complex decisions, and adapting to changing conditions on the road.

Question 41

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include: Visual acuity

Answer 41

The ability to see clearly, especially important for reading road signs and recognizing hazards.

Question 42

Clinical Levels of Care for Prevention of Driving Disability include:

Secondary prevention subskills include: Physical fitness

Answer 42

General physical health and fitness can also be considered a subskill, as it influences a person’s ability to control a vehicle comfortably and safely.

Question 43

Clinical Levels of Care for Prevention of Driving Disability include:

Tertiary prevention

Answer 43

Identify irreversible loss of driving skills and recommend alternatives to avoid harm to the older adult and others when driving is no longer an option.

Question 44

Driving History Red Flags:

Answer 44

Recent (past 1–2 years) at-fault motor vehicle crashes

Gets lost in familiar places

Relies heavily on passenger “co-pilot” to instruct or provide essential information

Stopping without reason in roadway

Moving violations or warnings from police

Slow driving or complaints about speed/honks of other vehicles

Expressions of concern from family, caregivers, professionals

Increased fear or stress associated with driving

Question 45

Driving History Red Flags:

Risk Factor: Physical Capabilities:
Signs and symptoms:

Answer 45

*Impaired balance

*Vision and/or hearing impairment (not hearing emergency sirens or horns honking, not seeing street signs)

*Functional impairment, such as sensory or range or motion (particularly ankle) with regard to use of gas or brake pedals

*Decreased ability to turn the head to fully visualize an area

*Slow response to visual or auditory cues

*Problems with reflexes (not reacting quickly when there is a need to brake suddenly)

Question 46

Driving History Red Flags:

Risk Factor :Cognitive ability
Signs and Symptoms:

Answer 46

*Decreased short-term memory

*Decreased or impaired way finding

*Easily distracted

*Inability to learn new information quickly

*Inability to recognize unsafe situations

*Confusion over names and dates

*Difficulty with instrumental activities of daily living

Question 47

Driving History Red Flags:

Risk Factor :Cognitive ability
Signs and Symptoms:

Answer 47

*Not using turn signals appropriately Difficulty turning the wheel and making turns

*Difficulty staying in the correct driving lane

*Difficulty judging the space between cars or upcoming exits

*Hitting curbs when parking or backing up

*Stopping in traffic inappropriately

*Not following stop signs, yield signs, traffic lights, etc.

*Not noticing workmen or activity on the side of the road

*Inappropriate speeds for the weather/ driving conditions History of traffic violations, minor crashes, or warnings

Question 48

Levels of Driving Fitness include:

Answer 48

High risk driver

Moderate risk driver

Low risk driver

Question 49

Levels of Driving Fitness include:

High risk driver:

Answer 49

Driver is currently unsafe to continue driving

Question 50

Levels of Driving Fitness include:

Moderate risk driver:

Answer 50

Driver has a number of symptoms/signs that may increase their risk of MVC

Question 51

**Clinical team members can help older adult drivers maintain safe driving skills using

Answer 51

**Clinical team members can help older adult drivers maintain safe driving skills using the Plan for Older Driver Safety (PODS) algorithm and may also influence older adult drivers’ decisions to modify or stop driving if they develop functional disability which affects driving skills.

Question 51

Levels of Driving Fitness include:

Low risk driver:

Answer 51

Driver is safe to continue driving at this time.

Question 52

CADReS Score Sheet ( on classes)

Answer 52

(=Clinical Assessment of Driving Related Skills)