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Driving Me Crazy | Dec 15, 2014

Dr. Barry

One of the most delicate parts of my job as a doctor is the conversation about whether the mature patient should still be driving. You know the folks…they brag that they never had a ticket or an accident but can’t walk steadily and reliably across the parking lot.

How can you claim you are “safe?” Look at you…your vision is not great. Your hearing…well the less said about that the better…you can’t turn your neck more than a few degrees due to arthritis…you can’t really feel your feet can you? Your strength, focus, coordination, endurance, etc. are all far from peak and you still say it’s fine for you to get behind the wheel of two thousand pounds of steel and plastic and gasoline. All WE can think about is you hitting some kid or plowing into the school bus and the whole thing being quickly engulfed in flames. And it will be our fault because we should have somehow forced you to stop driving.

The scope of the problem? The CDC says that of 2009 there were over 33 million senior drivers on the roads. Fatal crash rates start to rise at age 75 and rise up sharply after age 80. This doesn’t always mean they have more accidents but they get more injured from the accident. 500 senior drivers nationally are injured every day in America. According to the Insurance Institute for Highway Safety drivers over 75 years of age have higher per mile accident rates than middle aged people but still LESS than younger drivers.

First, this whole sticky wicket of senior driving safety becomes mute once the self-driving cars finally arrive. “Car, take me to church, hairdresser, my kids’ house,” etc. How great will that be?! Just say where you want to go and sit back and read, relax, take a nap, make a phone call without worrying about driving distractions. That’s something I will pay extra for when it’s available. I am not saying everyone has to let the car drive them…the tread heads, as my sister Marijo refers to them, will say it takes the joy out of driving, etc. so let them stay behind the wheel but make them pay extra for it because in the end it will not be as safe as letting the computer do it for them.

Until that happy day we must wrestle with the personal and public issue of who should be driving and for how long. Should women be tested more often than men? When do you start testing…only after an accident? Retest everyone at age 80? Of course someone will say testing is racist or sexist. None the less…if you ask me about your ability to drive a car I am going to give you my stock response and no one likes it! If you wonder about your ability to drive, go see the specialist…go take a driving test. You can use the DMV but you can also call one of the driving schools and they will evaluate your driving. Taking the refresher classroom course absolutely doesn’t count. Under my benevolent Caesar-like leadership the rule will be established that everyone will be tested every five years. You can do the DMV or you can do it privately. This puts to rest the issue of who to test and when. We test everyone…regularly. Commercial drivers will be tested yearly. If you are 95 years old and pass the test the car keys are yours! And of course did you notice my solution also provides jobs in both the private and public sectors! I wonder what will happen to all those couples where the husband is demented but the wife lets him drive because she hasn’t in years and he is indeed a better driver. That makes me mention that all you older ladies that let your husbands drive all the time…it’s likely you will outlive your husband and it’s a mistake to stop driving just because right now things are easier. Keep your skills up!

So you don’t think your mom should drive anymore…you do know that taking away her driving is like stabbing her in the heart with a dagger. Maybe that nice carving knife she got your husband for Christmas…that’s it…the very one, and remember to come up under the ribs. You want to set off indoor fireworks? Just try working in “you should probably give up driving” into casual conversation. The fact is that you are robbing her of her independence. It might be what you think is the right thing to do but it is not likely to be appreciated. This doesn’t usually go over well. It’s a sure trigger for depression…akin really to the loss of a spouse. And I am supposed to make that better with a little white pill?

Sometimes one of my roles as a physician is to be the bad guy…to take the blame. Much better to be mad at me regarding getting some help in the home or mad at me for telling you not to drive…rather be mad at your family member. I routinely refer patients for driving testing but they never go…I am pretty sure they are afraid of taking the test and not passing. I can’t force them to stop driving. I can’t force them to take the test. I can only offer my advice and insight. What I cannot do is notify the DMV if I think you are unsafe behind the wheel. It is a violation of your confidentiality. So you are safe in bringing up your driving concerns but I am always going to be on the side of personal freedom. Now, while I can’t report you to the DMV your family or for that matter anyone who wants to can. Although the NY DMV says on their website that a physician can report a patient my lawyers tell me this isn’t true. There is a form you can fill out that will prompt an evaluation of the person’s driving skills.

Although my periodic retesting scheme makes sense to me as long as the current system allows seniors the right to drive I don’t think we should infringe on this right unless and until something happens…the fender bender in the mall…the garage door frame…and yes, even some of the worst sort of accidents…your freedom and independence are important enough for this risk. In the end, it comes down to common sense like not driving at night…not driving long distances to new places…extra care when backing up…keeping your cell phone available but not in use, etc.

So let’s keep giving our seniors the benefit of the doubt when it comes to staying independent when driving. When trouble finally happens, an independent reevaluation of driving skills takes the emotion and guilt out of the decision.

Don’t forget the fair. You owe it to yourself and the grandkids to go. Stop with the negatives and enjoying the sun, the sites, the wild food, the music, the exhibits, the petting zoo, the Iroquois Indian Village…how can you have this great attraction in your backyard and not support it and enjoy it!