With the increase in our nation’s ageing population comes an increase in safety concerns. And one of those concerns, older road users, is an area gaining attention. Given that ageing is associated with functional changes which may have an effect on driving safety and skills, it’s important drivers plan for driving cessation well in advance.
According to the Centre for Accident Research and Road Safety Queensland (CARR-Q), although the risk of being involved in a crash is lower among senior adults in terms of rate per population, the risk of being killed when a crash occurs is much greater, due to increased fragility as the body ages.
Statistics presented by the CARR- Q indicate throughout Australia in 2011, 295 fatalities were senior adults aged 60 years or older, which represented 22.9 per cent of the national road toll. Of these, 107 fatalities involved adults aged 60-69 (8.3 per cent of the national road toll), while 188 were adults aged 70 years or older (14.6 per cent of the national road toll). Of the 295 senior adults aged 60 years or older killed on Australian roads in 2011: 139 (24 per cent) were drivers; 54 (18.9 per cent) were passengers; 72 (38.1 per cent) were pedestrians; 20 (10 per cent) were motorcycle riders; and 10 (28.6 per cent) were bicyclists. These statistics indicate that all older road users, not just drivers, need to be made aware of road safety initiatives. Maintaining mobility for as long as possible is important to most people and there are many programs being developed through all states which raise awareness and skills when it comes to driving.
The Retiree Magazine spoke with Jacqui Liddle, an occupational therapist and Doctor of Philosophy at the University of Queensland. Dr Liddle is recognised as an authority on the subject of planning for driving cessation.
What are the major signs that indicate you should consider giving up driving?
Driving is something that can be a really important part of life, and a convenient way to get around. Being a driver can feel like part of being an independent adult, but it also has some responsibilities that come with it. To start with, there are formal responsibilities as a driver which mean that if you have a medical condition which could impact on your driving, you need to declare this condition to the licensing body. If you are not sure if medication or medical conditions might affect your driving, as a driver, you need to check this with your health professionals, particularly your GP. When you are 75 years or older, you are also required to have regular health and vision checkups, get a medical certificate showing your fitness to drive and carry it with you.
Less formally, you should always be checking up on your driving and how you feel about driving. There are some signs that you might be having trouble with driving. They are:
- Feeling stressed and having trouble when driving
- Having friends or family worry about your driving
- Having near misses or accidents
- Getting lost more often
How do you best approach the topic of driving cessation with a loved one?
Research shows that managing driving issues can be one of the most stressful situations that some family carers experience. We have asked family members and retired drivers for their recommendations about how best to manage this difficult issue. A summary of some recommendations include:
1) Choosing the right person for the conversation. The best person to have a conversation with the driver is someone:
- Respected and in a good relationship with the driver
- Knowledgeable about the driver’s health conditions and
- Who can closely monitor the driver’s driving ability.
Sometimes there is an obvious person to talk with, such as a respected doctor who has known the driver for a long time, a spouse or a sibling.
2) Get the facts and stay calm. Feeling confident that you know and understand the driving issues is important in having the conversation. Keeping note of driving skills and any changes over time can help you have the needed facts. You might also want to arrange to talk together with the health team to understand the impact of medical conditions and medications on driving. Choosing a quiet time to calmly and factually point out the sorts of troubles they have been having might help people to understand better than shouting during a difficult time in traffic. Saying, for example, “I noticed that you have been having some trouble getting the car in the garage. Have you had any other troubles with driving?” starts the conversation better than yelling while someone is having trouble in a carpark.
3) Start early and keep it simple and direct. It is never too early to talk about stopping driving. When you notice changes in driving, try to avoid a heated discussion while everyone is upset. Make sure everyone is safe, take note of the incident and have a conversation later. Stick to the facts about what happened and why you are worried.
4) Finding other ways. When you talk about driving, it is a good idea to talk about alternatives for getting around. Be understanding of the loss that someone faces, and try to understand why they are keen to continue driving. It is helpful to have information about what is available in the local area, and you can find out more together. Discussing how to still get to the shops, leisure activities and to visit friends can be an important part of the conversation
What is a driving assessment?
To find out how medical conditions and getting older may have affected your driving, your doctor may refer you for a driving assessment with a specially trained occupational therapist. Occupational therapists do not assess just because a person is older, but rather because of specific medical conditions. Some of these may include: Parkinson’s disease; arthritis; diabetes; heart problems; any other medical conditions that could affect driving.
The assessment involves both off-road and on-road assessment of the skills of driving, and actual driving ability.
Some of the skills that affect how well you can drive include:
- Vision including: how well you see, how well your eyes adjust to different light, what your brain does with what it sees, and how quickly you respond to what you see.
- Thinking and memory: memory, how well you plan driving, how well and how quickly you make decisions, how well you pay attention to driving, how aware you are of what is happening on the roads.
- Bones and muscles: how strong your muscles are, how coordinated your movements are.
- Your understanding of traffic situations and road rules.
If you have concerns about your driving, you may want to have an assessment to see if there are any areas that can be worked on to improve your safety. It can also help you to know whether or not you should be driving.
A medical driving assessment can be requested by a doctor, but is carried out by a specially trained occupational therapist. There are driving assessment clinics run through some major hospitals or you can find a driving assessment trained occupational therapist at the following website http://www.otaus.com.au/divisions/qld or phone OTA (QLD) on 07 3397 6744.
When people are forced to give up driving they often suffer from a loss of independence. What steps can they take to minimise that loss?
Feeling forced to stop driving can feel very sudden and people can report feeling extremely sad, lost and isolated. It is important to get help with dealing with the change and with both the practical and emotional losses. Practically, it is important to think about which activities and destinations make your life meaningful. With support, problem solve ways that you can still get out into the community from walking, using public transport or taxi, to swapping favours for lifts from friends or families. There are also many services to people get around that you might not be aware of including council cabs, subsidised taxis, transport services and courtesy buses. Other options include staying involved by doing some activities from home or having things delivered.
How can you prepare for losing your license?
Being prepared is one of the best things you can do to have a smooth transition to life without driving. We have talked to people who have retired from driving and their advice for how to best prepare is as follows:
1. Start to think about your options early
While you are still driving, try out different ways of getting around including public transport, transport services and lifts from family and friends. Have a long term plan to make sure you can get to your valued activities and destinations. Some people talked about gradually reducing the amount of driving they did, while gradually increasing their use of other transport options.
2. Weigh it up
Take the time to think through all the factors involved in driving, and retiring from driving. Look into your priorities and values, and put plans into place. Think about the positives and negatives about retiring from driving. Things to think about are:
- The stress and worry that driving can cause
- The costs of running a car compared with alternatives
- Knowing if there are other convenient transport options
- Activities you do that require transport, and options for staying involved in these
- Changes to your daily routines that retiring from driving might cause, and ways to cope with these.
3. Talk to key people
Talking about the situation to family, friends and health professionals might help you to consider all of your options. Some retired drivers have said that it was important to make the final decision to give up driving themselves rather than waiting for family members or doctors to do this. While it is not always possible to have the final say on this, it does show how important it is to plan ahead.
4. Other ways
It is important to stay involved in the community. This can be done by using different transport options, and taking up new roles and activities. Your community may have transport options including buses, trains, taxis and volunteer or community services.
The sorts of schemes may include:
- Transport services to take you to and from medical centres and hospitals
- Multi-Ride service, which is a door-to-door service that will take you to a local shopping centre for a small fare
- Council Cab to take you to your local shopping centre for a small fare.
- Other community services to help people get to medical appointments, social outings and grocery shopping
- Local clubs may also run courtesy buses or informal ways of arranging car pooling.
Your friends and family may be able to drive you to places. You could offer to do something in exchange so that you feel okay about accepting help. You might be able to use different options for different outings. For example, you could catch a bus to the shops, and take a taxi home with your parcels. You can also car-pool. This way everyone saves money. Walking also may be a good way of getting around to local destinations.
5. Stay involved and active
Staying active after giving up driving is important. You should keep doing the things that are important to you. This is vital for your physical and mental health. It is important to have roles and activities that you enjoy, and ongoing contact with other people. To keep up an active lifestyle, some people find they need to change their routines, and others move to areas with better transport options.
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