ON REQUIRED TESTING FOR DRIVERS ABOVE AGE 70

Sen. Jehlen hosts summit on impaired driving

By Brad Petrishen/Staff Writer

Fri Sep 18, 2009, 07:40 AM EDT

Winchester, MA - State Sen. Patricia Jehlen, D-Somerville, made an appearance at the Jenks Center Monday to speak with seniors about pending legislation aimed at decreasing the number of impaired elderly drivers on the road.

“I think the biggest problem is dementia,” she said. “It’s not that all older people can’t drive. The problem is that some older people don’t know that they can’t continue to drive.”

Jehlen’s Second Middlesex District includes all of Winchester and Medford, and several wards in Somerville and Woburn.

Though some seniors at the meeting said they believe the media has over-reported accidents involving seniors, Jehlen said she believes the problem needed to be thrust into the spotlight.

“I’m glad newspapers have called attention [to this],” she said. “I think there are a lot of things we can do to make things safer, but we need to do the right thing based on real evidence.”

For example, Jehlen said she does not support one of the major proposals on the table, which would require vision and road testing for those who renew their licenses after age 85.

“I don’t think the road testing is necessary,” she said. “A recent study in the Journal of the American Medical Association said that you get no bigger bang for your buck out of a road test.

“The study found that when they instated in-person renewals, that’s all it took to screen people [with impairment] out.”

Jehlen’s approach, which she outlined in a July 2 opinion piece, which ran in The Winchester Star, involves what she believes to be more comprehensive and sensible steps (see table below).

Jehlen emphasized the importance of increasing testing on people of all ages, not just seniors.

“I believe that more frequent in-person vision testing at a younger age, along with other safeguards, would better protect public safety at a lower cost [than road tests],” she said.

By a show of hands, most of the more than 80 audience members, most of them seniors, agreed that it would be a good idea to mandate that seniors over the age of 75 renew their license in-person.

Currently, in-person renewals are only required once every 10 years.

Other impairments

Although many audience members agreed that their response times slowed with age, they also agreed that younger people often drive impaired as well.

Resident Marcia Wood said she recently read that of all the crashes in the state of Maine each year, about one-third of those crashes are caused by distracted drivers.

Jehlen said she would support legislation that would ban text messaging while driving.

“On the Mass Turnpike the other day, I was watching a guy texting in the lane next to me,” she said. “I tried to get away from him.

“I have not yet seen a person with white hair texting,” she added with a smile.

Jehlen said drivers of all ages shouldn’t talk on cell phones while driving, either, though she said that would be tougher to legislate.

“It’s a situation where we have a debate between public safety and people who say, ‘It’s my car, get out of my face.’”

Resident Helen Babcock said she knows firsthand just how distracting phone conversations can be while driving.

“I took a call on the way from Woburn to Gloucester,” she said. “The next thing I knew, I was parked in front of my office with no recall of how I got there.”

Although she was not involved in an accident that day, Babcock said she was once the victim of a crash in which a cell phone played a role.

“I was hit from behind while stopped at a red light by a teenager on a cell phone, and I had to tell her to hang up afterward,” she said shaking her head. “After the accident, she stayed on the phone and was giving her friend a play-by-play of what happened.”

State Rep. Jason Lewis, who also attended the meeting, said that banning the use of cell phones while driving, not closer scrutiny of elder drivers, is his top priority in regard to driver safety.

He said although some people view it as a citizen’s right to use a phone while driving, he believes that the rights of other citizens’ personal safety is more important.

“If my having the freedom to use my cell phone in the car is putting other lives at risk, then that’s a problem,” he said.

Lewis said his second priority is tightening up seatbelt laws.

“Massachusetts has the lowest rate of seatbelt [wearers] in the nation,” he said, adding that this is in large part due to the fact that not wearing a seatbelt is a secondary offense, meaning that you can only be cited for not wearing your seatbelt if you are already being pulled over for a separate reason.

He said he will support efforts to make not wearing a seatbelt a primary offense.

Suggestions

Jehlen said that although no perfect solution can ever be implemented, there are steps seniors can take to decrease the probability of getting into accidents.

For instance, she suggested that seniors be honest with themselves about their abilities and make good choices about when and where to drive.

“The biggest cause of accidents among seniors is left turns,” she said. “I’m not sure if my mother knew this, but she always chose a route to the grocery store that had no left turns.”

Jehlen said her father also served as a good example of when it’s a good time to stop driving altogether. She said she knew he shouldn’t be driving when he got lost one day on the way to her home.

“When he went into assisted living, he didn’t have to get a ride to the grocery store, and he ate better,” she said. “And he was so much happier and safer when he lived with other people.”

Jehlen said she understands that many seniors don’t want to give up their license because they view it as an important part of their identity, and suggested that increased modes of public transportation should be made available for seniors.

“People would be more willing to give up their licenses if they could be more independent,” she said.

Resident Pat Wells said that although she will probably be relinquishing her license in the near future, she doesn’t appreciate the stereotypical manner in which younger people, even those in law enforcement, view elderly drivers.

“I was in an accident in which I was less than 50 percent at fault,” she said. “I got a big lecture from a cop about my reaction time.

“He asked me how old I was twice,” she said, adding that he also asked her how she would feel if she killed someone.

Jehlen said such an example is emblematic of the difficulties she and other legislators will face in regard to laws surrounding impaired driving.

 “All of us have defects and impairments, so where do [we draw] the line and say, ‘That person isn’t fit to drive’? It’s very tricky.” There are prepaid cell phones at tracfone.com available for emergency-only cell phone users, as well as the cell phone users who don't talk on the phone all that much. 

Sen. Jehlen’s plan

• Requiring in-person renewals with vision tests every two years for those over age 75 (Rhode Island does this).
• Requiring a doctor's signature on a checklist of dangerous conditions for all renewals over 75. This would make the driver have a conversation with the doctor, not leaving it to the doctor’s initiative (Nevada has this system for mail renewals).
• Establishing tiered testing for all drivers over 75 similar to that in California. Anyone who fails vision or mental acuity tests on renewal, or shows other signs of diminished capacity, must take a road test.
• Requiring doctors certifying drivers for handicapped permits to state whether the person’s condition might make it dangerous for them to drive
• Allowing the Registry to issue restricted licenses; for example, allowing the person to drive only during daylight hours or on certain streets.
• Improving public transportation and other methods of mobility (like SCM in Somerville and Medford) for disabled people. Elders will be (a little) less reluctant to give up the keys, and families will be less reluctant to take them away, if they can retain some independence
• Protecting doctors from liability if they report to the Registry of Motor Vehicles a change in their patient’s condition that makes it dangerous to drive.

Source: State Sen. Patricia Jehlen

Driving Resources On the Web

• Massachusetts Registry of Motor Vehicles
• AARP
• American Medical Association Guidelines for Older Drivers
• AAA 

The original of the above article is at: http://www.wickedlocal.com/medford/town_info/government/x393148131/Sen-Jehlen-hosts-summit-on-impaired-driving

Elderly Driving/Age Factor -- Web Links

www.nhtsa.dot.gov/people/injury/research/MedicalAdvisory/pages/In-depth-j.html 
This article shows a debate about whether visual exams should be administered during renewals. It discusses the fact that people between 20 and 40 should not have to be tested again every five years.  It did a good comparison between elderly drivers and young adults.

 http://www.motorists.com/issues/elderly/elderly.html
This article seem interesting because it gave a different approach to elderly drivers.  Normally people attribute bad driving of the elderly with poor motor skills, but this article says it is disease related.

http://www.ama-assn.org/ama/pub/category/8925.html
older driver safety – Per mile driven, the fatality rate for drivers 85 years and older is NINE times higher than the rate for drivers 25-69 years old.

http://www.ama-assn.org/ama/pub/category/9115.html
vision, cognition, motor functions of older drivers and how that put them at risk

http://familydoctor.org/487.xml
This website talks about the driving skills of older people.  It talks about the signs to look for concerning when an elderly person should stop driving.  It also talks about why a person should stop driving.

See also this directory of links on elderly drivers:
http://www.drdriving.org/elderly/

Research on Aging as it impacts senior drivers -- see the following Bibliography.

Older Drivers at Risk

From the book Road Rage and Aggressive Driving by Leon James and Diane Nahl

Driving elderly requires new adjustments that challenge personal philosophy and ideology. For instance, night vision loss for some drivers is due to glare, and this does not necessarily affect their day vision. Scheduling driving times to avoid night driving, and possibly rush-hour traffic and bad weather is a good coping strategy that preserves driving freedom and maximizes safety. Automotive sociologist J. Peter Rothe has interviewed many elderly drivers and listened to them in focus groups. These conversations reveal concerns senior motorists have about themselves and concerns others have about them.²¹

1.      Insufficient self-confidence due to inexperience ("After my husband passed away, everything was pushed on me.")

2.      Anxiety due to decline in ability ("I'm sometimes a bit nervous on the blind side on my right when I'm in the left hand lane. The only way I can see is to turn my head and take a look.")

3.      Resentment due to social ostracism ("They think older drivers are worse and should stop driving.")

4.      Hostile behavior addressed to older drivers which they find degrading ("One time one of the ladies yelled at me in the parking lot, 'You’ve got all day but I haven't.' I guess what she thinks is we're just a bunch of old fogies.")

5.      Lack of awareness of how family members see them as drivers, and disbelief when told of their criticisms.

6.      Inability to see their slowness as others experience it, equating slowness with caution and patience.

7.      Increased difficulty in certain vehicle maneuvers such as parallel parking ("The curb disappears from your rear view mirror before you're really close so I have to kind of guess how far I am."

8.      The distressing experience of information overload on multilane super-highways ("Cars are coming and going on either side and it's taken me a long time to learn to keep in my lane, to signal, to look before I get into that other lane.")

9.      The experience of fatigue during extended driving hours on highways  ("They just go on for miles and miles and there is no stimulation. It puts you to sleep.")

10.  Frustration with signs whose letters aren't big enough or are too similar to each other, and other vision problems ("Driving would be easier if there were more lines, reflectors, and larger signs placed in the center, not on the side.")

11.  Being very fearful of hitting a pedestrian ("Pedestrian crossings should be better marked and lit.")

12.  Coping with disabling diseases or injuries like arthritis, loss of vision, and other health problems. ("I just hope my health stays well enough so I can drive for a long time.")

13.  The dread of crashing or getting into a collision ("I worry about someone going through a stop light, especially late at night with drunks."

14.  Rigidifying driving style due to a preoccupation with taking great precautions ("You don't take chances you did sixty years ago.  When a car comes too fast to a stop I just wait until he stops, until I'm sure.")

15.  Strong anxiety about being tailgated, seeing it as an infringement and an attack. ("It's a selfish invasion of my rights."

16.  Refusing to concede that the left lane is not a cruising lane ("I'm already driving the speed limit so I don't need to drive faster. It's my right")

17.  Experiencing greater difficulty in talking while driving ("My friend was talking but I tried not to talk because it could have distracted me.")

18.  Lapsing into daydreaming episodes ("Somehow I had missed the stop sign there.  I didn't see it.")

New drivers who are elderly and female have a double handicap to overcome in the eyes of society and the motorists on the road. They need to learn how to manage people's hostility toward both older drivers and female drivers. They especially need to learn to monitor their driving in relation to other motorists. Every stretch of road has regular users who develop "local norms" about how people should drive in that area. Anyone who drives differently violates their expectations, arouses ire, and is treated aggressively and with hostility by regulars. This hostile treatment adds to the stress and confusion of the novice elderly driver.

Many widows over the age of 65 never learned how to drive a car. Their husbands were the drivers, and when their husbands passed on, they had to become more independent, doing a lot of walking and learning how to take buses and subways. After speaking to many widows over 65, most of them agreed that they did not learn to drive because their husbands didn't encourage them and/or they were very afraid of driving. Obviously, nowadays, women are not as afraid of driving anymore. (A correspondent, July 1999)

Since this is a cultural practice in certain layers of society, many 65+-year-old widows whose husbands have passed on, or who are no longer able to drive, find themselves in a predicament created by societal values. Besides understanding safety principles, these women need driver education that includes a driving psychology component to learn how to cope with the interactive nature of the highway environment, which can be aggressive, hostile, and overwhelming.

A common bitter complaint motorists voice about older drivers is that they travel at speed limit in the passing lane and refuse to move over into the slower lane. This blocking behavior causes a flurry of dangerous activity around them as drivers angrily scramble to pass them in the right lane. New drivers who are older need training to remain alert to this problem of cruising in the passing lane, and how to monitor and facilitate the activity of vehicles around them. This is a special concern for older drivers because reaction time tends to slow with age. Older drivers typically take longer to get going at traffic lights and intersections, to make turns, or to park. What older drivers call "being patient" others around them call "obnoxiously slow." Since the number of older drivers will increase dramatically over the next two decades, there is a critical need for age groups to better understand each other, and this requires developing a greater tolerance for diversity.

The increasing age of American drivers is a serious national concern. Everyone agrees that drivers need additional skills to compensate for the decreased abilities due to aging. People 65 years and older represent 13 percent of the population and 17 percent of all motor vehicle deaths. The aging process reduces the driver's ability to deal with traffic incidents both physically and mentally, and increases the seriousness of injuries. Elderly drivers are more likely to receive citations for failing to yield, improper turns, and running red lights and stop signs. AARP, the largest association of older Americans, opposes licensing restrictions and testing of elderly drivers, citing age discrimination. This powerful lobby group argues that restrictions should be based solely on driving ability and not age, and a program of universal testing for 177 million licensed individuals in the U.S. is not considered practical.

Several organizations, have developed special training courses for older drivers. The American Automobile Association (AAA), AARP, and the National Safety Council offer refresher courses for seniors. Illinois requires a driver re-examination every three years for those over age 75 and Louisiana requires that drivers age 60 and over obtain a physical examination. Several states require re-examination if a driver is determined to be unsafe or mentally or physically unfit. However, there is no known reliable test that predicts how well a driver will operate a motor vehicle. Recent research with driving simulators is promising because the program varies light conditions as well as the dynamics of driving situations. We recommend that new drivers who are elderly participate in QDCs. Older women drivers can benefit from these group interactions that can provide support and motivation to continue to develop their driving skills.

Older drivers have two things going for them. First, driving experience accumulates with age, and since driving is a complicated bundle of skills, being more experienced is an advantage. For example, older drivers excel in the skill of assessing risk, while young, inexperienced drivers do not, so collision rates for youth are three times higher than rates for older, more experienced drivers. Consequently, insurance costs are higher for young drivers, and they have more traffic citations and license suspensions. Older drivers think more critically behind the wheel than younger drivers. Second, older drivers manage their emotions and impulses better than younger drivers.

The results from our 1999 Internet survey in show marked differences:²²

The majority of young drivers swear and speed. Young men outdo older drivers in flipping the bird, while young women are either too scared or more compassionate. Tailgating, dangerous lane hopping. and running red, are far less common among older drivers. Other driving behaviors that decrease with age and experience include, "Enjoying fantasies of violence", "Experiencing rage while driving" and "Feeling impatient" ,"Feeling hostile" or "Feeling road rage". Older drivers "feel more compassion" behind the wheel. But when asked, "How do you rate your aggressiveness as a driver?", young drivers chose 6 and older drivers selected 5. Not much difference! When asked how much stress they experience daily as a driver, the picture is reversed:  33 percent of younger drivers pick 5 or above, while 50 percent of older drivers experience higher stress. Driving stress thus increases with age, and there are both medical and psychological consequences to consider. Medically, stress kills by weakening immune system functioning and raising the concentration of potentially harmful chemicals in the blood. If one in two older drivers experience high stress while driving, a certain percentage of them will suffer medically unless they learn to manage driving stress. Psychologically, stress is a depressant. People tend to be more pessimistic when in a depressed state, they're less happy and contribute to the unhappiness of others. It makes sense for older drivers to use their experience and maturity to practice stress management skills while driving.

The above is from the book Road Rage and Aggressive Driving by Leon James and Diane Nahl