Risk and the Older Driver

Just like death and taxes, you can think of age-related physical deterioration as inevitable. Unless there really is a fountain of youth, it’s safe to say that as we age, our physiology changes. However, it doesn’t just “change,” it deteriorates and this deterioration affects our ability to drive safely. Simply put, it’s not age alone that determines unsafe driving – it’s not the actual number of birthday candles that is to blame. It’s our deteriorating physiology.

As a Statistics Canada study about seniors’ transportation habits conveys: “It is not seniors’ more advanced age that increases the risks of traffic accidents, but rather certain medical conditions that they are more likely to have. Driving a vehicle safely requires good vision, good hearing, adequate cognitive abilities and adequate motor skills – functions that deteriorate naturally with age.” Does this age-related deterioration, combined with society’s ageing demographics, foreshadow a future caseload destined to include an increasing number of clients 50+ years of age?

Let’s put this theory to the test by taking a look at what happens to these safe driving requirements as we age. Can we point a finger at deteriorating physiology as a possible suspect in making older drivers more prone to accidents?  

Vision Problems

As most of us eventually experience firsthand – either putting on or taking off glasses to read this article– aging affects our vision in a wide range of ways. Regarding safe driving, age-related vision issues include decreased ability to see well in the dark and to effectively scan the scene. Our eyes become increasingly susceptible to glare because as we get older the lenses of the eyes thicken and the pupils shrink. In addition, refocusing from one object to the next takes longer and our peripheral vision suffers, as well as our depth perception and colour perception. Accordingly, distinguishing between the colour of traffic lights, as well as brake lights and other lights that line the streets becomes increasingly difficult.

Although safe driving requires good vision, a Statics Canada study discovered that 19% or 14,000 seniors with limited sight have a driver’s license. These seniors are at what is considered Level 5: “Unable to read ordinary newsprint and unable to recognize a friend on the other side of the street, even with glasses…” Makes you think: as age increases, vision deteriorates and in turn, safe driving ability deteriorates.

Diminished Hearing

Many aspects of safe driving rely on our ability to react properly and quickly to “signals”–everything from ambulance and police sirens to screeching car tires and honking horns. However, similar to vision, as we age our hearing deteriorates. The age-related decline in hearing, called presbycusis, is usually due to degeneration of the hearing nerves and of the organs of the inner ear.

Although safe driving requires good hearing, a Statistics Canada study discovered that “among seniors who had the most serious hearing problems (Levels 5 and 6), 53% had a licence, and about one-half had driven a vehicle in the previous month.” Makes you think: as age increases, hearing deteriorates and in turn, safe driving ability deteriorates.

Deteriorating Cognitive Abilities

More easily distracted, more easily confused, more forgetful – just some of the milder effects of ageing on our cognitive abilities that don’t sound like positives for safe driving. In addition, these declining abilities can be symptoms of bigger issues to come. For instance, Alzheimer’s disease and other types of dementias are on the rise; currently about half a million seniors suffer from Alzheimer’s disease and other dementias, expected to rise to over a million by 2038.

In addition, many seniors have difficulty sleeping, making drowsiness a common problem – and a dangerous one where driving is concerned. Although safe driving requires adequate cognitive abilities, a Statistics Canada study found that at Levels 5 and 6 – people who are very likely to forget things and have a great deal of difficulty thinking clearly and solving everyday problems – about 40,000 seniors had a driver’s licence. In addition, about 20,000 seniors who had been diagnosed with Alzheimer’s disease or some other form of dementia had a driver’s licence. Makes you think: as age increases, cognitive abilities deteriorate and in turn, safe driving ability deteriorates.

Inadequate Motor Skills

Slamming on the brakes, checking the blind spot, quickly turning the steering wheel – all these actions require motor skills. However, motor skills gradually decrease with age –muscles weaken, reflexes slow down, and flexibility decreases – resulting in diminished ability to react. Motor skills are also influenced by pain that is often associated with physical changes. In fact, pain is increasingly a fact of life as we age with the percentage of pain sufferers reporting severe pain higher for older adults.  
Motor skills can be affected by a wide range of mobility issues like arthritis, which affects numerous older adults, and hip fractures are also more prevalent as age rises. Although safe driving requires adequate motor skills, a Statistics Canada study found that “just over one-quarter (28%) of seniors with reduced mobility had a driver’s licence.” Makes you think: as age increases, motor skills deteriorate and in turn, safe driving ability deteriorates.

Unfortunately, there’s more bad news regarding safe driving ability as we age. In addition to what could be considered natural physical deterioration, many people also experience a range of health issues as they age due to a range of contributing factors like environment, genetics, and circumstance. Just by virtue of living longer, we are likely to have more pre-existing medical conditions than younger drivers. Plus regardless of the type of deterioration, another consideration is the use of medication. Some medications can negatively affect safe driving by causing drowsiness, confusion and decreased reaction times.

Good vision, good hearing, adequate cognitive abilities, and adequate motor skills are all considered safe driving requirements – and they all gradually deteriorate with age. It appears that aging is in fact a key ingredient for increased car accidents and accordingly, your caseload may increasingly include clients 50+ years of age.

The good news is that when car accidents occur, a tailored approach to rehabilitation based on age makes all the difference. Taking a client-centred approach is beneficial regardless of the type of client population; however, it is essential for those 50+ years of age. As we’ve seen, aging affects physiology and consequently, physiological issues specific to the 50+ client population can affect rehabilitation.

For instance, a rehabilitation plan needs to take into consideration characteristics unique to the 50+ client population such as decreased skin sensation, larger adhesions, and tissue shortening, as well as susceptibility to secondary infections and respiratory issues.

All of these issues and more, have a potential impact on healing outcomes and recovery timeframes. As Canada’s demographics continue to age, keep in mind that just as age makes a difference regarding safe driving ability, it also makes a difference regarding the best rehabilitation approach.

Angela Veri, BA, CRS, RRP, CVRP, is senior vice president of sales, Sibley & Associates LP. Additional information about this topic is available through the Sibley Resource Library and Complimentary Educational Training Seminars. Please contact Angela Veri at 1.800.363.8900.