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Going off-road: Should elderly drivers be subject to special testing?

Seniors protest a move to standardized tests that could take away their licences


 
Going off-road

Carlos Osorio/Toronto Star

Few public policy issues are as fraught with competing interests and short fuses as that of elderly drivers. The ability to drive is an important part of independence for most seniors and the loss of a driver’s licence can be a devastating blow. On the other hand, we want to keep our roads as safe as possible; everyone, it seems, has a story to tell about an aged relative prone to “senior moments” at the wheel. To ensure all elderly drivers are fit for the road, many provinces now impose specific tests or medical requirements on seniors renewing their licences.

However, Ruth Adria, spokesperson for the Elder Advocates of Alberta Society, argues current licensing procedures in her province have become “an injustice.” Earlier this month, her group organized a seniors’ protest outside a Red Deer hospital to bring attention to the issue.

Currently, Albertans aged 75 must pass a medical exam to renew their licences. As a component of this, doctors may additionally request that patients complete two cognitive-ability tests. The first, performed in a doctor’s office, requires patients to answer a variety of fast-paced questions, such as naming 30 things you can buy in a grocery store. If the driver fails that, a computer-based exam called DriveABLE may be required, at an out-of-pocket cost of $250. Both tests are widely used in other provinces as well.

“These tests appear to have little connection with the ability to drive,” complains Adria. As evidence, she musters scores of examples of elderly drivers who failed both exams but later passed a road test on appeal. She bolsters her case by repeatedly citing provincial accident data showing drivers aged 65 and over to have the lowest casualty collision rate among all age groups. Adria argues a physical exam alone ought to be sufficient to spot seniors who should no longer be driving. Besides, she adds, most seniors self-regulate—avoiding trips at night or during high-traffic times.

“These tests are a form of elder abuse,” she charges, “and the worst kind, because losing your licence can be incredibly stressful and damaging to a senior.”

And yet, regardless of Adria’s objections, the prospect of some type of standardized test to determine which seniors should and shouldn’t be driving seems likely across Canada in the not-too-distant future, if only because doctors want it.

In most provinces, physicians have a legal duty to report any patient they believe is unfit to drive. But the typical general practitioner lacks specific training to make this difficult decision. Further, “forcing physicians to take away a licence can really poison the doctor-patient relationship,” warns Dr. Michel Bédard, Canada Research Chair in Aging and Health at Lakehead University in Thunder Bay, Ont. For these reasons, a consistent, arm’s-length procedure to determine fitness to drive is attractive to many doctors.

That said, Bédard finds common ground with Adria in observing current tests may be neither appropriate nor accurate. “Anything that involves computers has the potential to confuse seniors,” he observes. And listing grocery-store items has little to do with road safety. Some tests may specifically disadvantage seniors with limited education.

To better assess elderly drivers, Bédard is a co-investigator with the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (Candrive), a federally funded research project based at the Ottawa Hospital Research Institute that’s tracking almost 1,000 seniors over four years to measure their cognitive and driving abilities. Candrive’s goal is to unveil a simple, scientifically valid (and non-computerized) screening procedure within the next two or three years that could eventually be adopted Canada-wide. “Having a national standard for elderly drivers would make a lot of sense,” adds Bédard. Other countries are struggling with the same issue.

As for her assertion that seniors are the safest drivers on the road, Adria is simply wrong. Older drivers appear safer on statistical charts only because they drive much less than everyone else. “Once you correct for mileage driven, the crash risk for elderly drivers is almost as high as that of novice teen drivers,” says Mary Kelly, professor of insurance at the School of Business and Economics at Wilfrid Laurier University in Waterloo, Ont. Kelly was recently an expert witness at an Ontario Human Rights tribunal hearing that ruled higher insurance premiums for older drivers are not a form of discrimination, but rather a valid response to elevated crash rates.

“The main difference between older and younger drivers is that young drivers are high risk because of their inexperience and risk-taking behaviour,” says Kelly. “But they improve over time. Older drivers don’t.”


 

Going off-road: Should elderly drivers be subject to special testing?

  1. Self-driving cars can’t come soon enough.

    • Googles got a small fleet of unmanned fully licensed vehicles cruising around California right now. Investors in Dribible—- Sorry DriveAble– should start looking for an exit . By the time I can’t figure out how to turn left or remember why I wanted to the car will.

  2. Unless there is some actual reason (like having lots of collisions) to doubt someone’s driving ability , it seems an unnecessary response to base requirements on such an arbitrary thing as age.

    • We use deterministic analysis to make decisions in lots of different areas – why would we provide an exception to seniors and driving? As the article makes clear, data shows that seniors’ driving skills degrade markedly. Not every senior shows significant degradation in driving skills, but the trend seems clear enough to warrant testing to identify who has a problem. Try to apply your logic to other age-related interventions: would it make sense to tell men and women over 40 to not bother with mammograms and prostate exams unless they notice some other problem? No – later intervention could be fatal. At least in that case, it’s only the patient’s own health that’s impacted. In the case of driving, the driver is putting others at risk as well. The inconvenience of having a finger stuffed up your butt, your breasts pressed between cold plates, or having your mental acuity examined unnecessarily is offset by the lives saved when it’s truly necessary.

      • I agree – though it should be more than just mental acuity that should be tested. Physiological impairment is also much more common as we age. A person can be sharp as a tack mentally but have problems with physical response times, mobility, etc. I remember reading in a Car & Driver article on unintended acceleration that one potential cause is that, as we age, we are not always as able to accurately place our limbs without looking; older people could therefore easily think they are applying the brake when stepping on the gas, for example.

  3. They should be undergoing advanced site and reflex tests at the very least. My sister was in a car accident because the 81 year old driver who smashed into her car couldn’t register the red light fast enough to hit the brakes. Yesterday I almost got hit by an elderly neighbor who was trying to back his car out of his driveway, but didn’t feel like craning his neck to see if there was anyone behind him. I don’t really care if more testing hurts feelings, road accidents hurt feelings too.

    • SIGHT… I meant sight.

      • And just how old are you? LOL

  4. I was almost run over while standing beside a traffic light here in Edmonton because a senior couldn’t negotiate a simple right hand turn onto a northbound lane. Then a year later I was almost hit by a nice old lady while in a marked crosswalk with an overhead flashing light because she didn’t feel like slowing down. Thankfully i was able to get both their licences and report them to the police.
    Oh wait. According to GlynnMhor, I should have chuckled and blown them both a kiss for such a small booboo as that. Get a grip on reality putz. Things such as ones mental faculties start to go once age starts to creep up on people.

    • Bad drivers are bad drivers, but age is not a reliable criterion.

      I’ve been deliberately run off the road on my bicycle by a 30-something oaf, for example.

      And I’ve seen lots of bad drivers tailgating, making bad lane changes, speeding, blowing through stop signs, doing ‘road rage’ actions, and few of them look to be older than 50.

      • Yes. We all understand that there are many bad drivers out there. But this post is about seniors. Seniors who need to take a regular drivers test in order to reasess their capabilities to drive competently.

        • Being a senior, though, is not a valid criterion.

          It’s people who habitually get speeding tickets or who commit other moving violations, be they ancient or not, who need testing and retraining.

          • The known diminishment in response time, reflexes, etc that age brings are all valid criteria, however. Not arguing that OTHER drivers shouldn’t be tested, but there are definite physiological and mental impairments that increase with age, and so it makes sense at some point to start testing, for safety’s sake.

          • Those are actually minor factors in driving ability.

            Judgement ability is the strongest predictor for driving success.

          • I believe I covered judgment ability with “mental impairment”. As to the physiological… I read an article (was trying to find it online to post a link, but without success, unfortunately) which indicated that it becomes increasingly difficult as one ages to judge, for example, exactly where you are placing your foot if you aren’t looking at it. You may be an inch or so to the left or right of where you think. It was posited that this explains why those reporting instances of unintended acceleration is skewed toward older drivers; they THINK they are applying the brake, but their foot is on the gas. Conscious thought processes are not impaired; they are betrayed by the body’s inability to translate thought accurately into action.

  5. As a senior I agree with ability based testing for older drivers — I too have experienced close calls involving another senior who didn’t seem fully in control of his/her situation.

    I do, however, insist that the test actually be an accurate measure of driving ability (obviously including such things as vision).

    • Just so.

      A lot of drivers need road testing, not just seniors.

      • I couldn’t agree more. I have seen far too many younger people ( 16 to 40 ) yaking or texting on cell phones and see the total lack of attention. I also see the carelessness and lack of skills of many younger drivers. As far as seniors abilities to drive l have been driving for 55 years. Three months ago l completed and graduated from a very technical 3 day performance driving course. I attended this course to learn new skills, learn the best defensive driving possible and enjoy the freedom of racing a car on a road course. I plan on taking several more of these courses just for the sheer enjoyment of driving. Drivers of all ages are subject to the “seniors” analogy.

    • I’d say most of the close calls have been from young drivers not proceeding with care.

  6. Another concern could be the amount of medications today’s seniors are taking which could inhibit their ability to drive safely.

  7. As somebody who has been in an accident with somebody over 80 who had a “senior moment” I couldn’t care less about hurt feelings. I was hit while going straight through a solid green light by a woman who for some reason couldn’t register that it was a bad time to make a left hand turn. My car was a write off and of course the insurance I received wasn’t enough to get as good of a car as I already had. The physical damage to me was minor but I still cringe at intersections as a result.

    • Funny. A friend of mine was nailed by a young male driver doing just that.

  8. Truck drivers require medical exams based on age. Should the trucking industry revolt as well?

  9. Sadly a lot of those seniors don’t even begin to question their fitness as drivers until they’re involved in a crash or other serious accident, and many don’t even seem to be phased by it at all. Just plain common sense would dictate that someone with cataracts (impaired vision), hearing loss (many refuse to wear a hearing aid), not to mention slow reaction times/reflexes, mental confusion due to prescription drug use or various stages of dementia, inability to turn their heads/necks due to arthritis, is a risk to the safety of not only other drivers but pedestrians.
    Some seem to think that they deserve some kind of special dispensation because they ARE seniors and everybody else should give them the right of way.
    Actual road testing should be implemented for anyone over 75.
    Did you notice that most car rental companies won’t do business with anyone over that age? Maybe they know something the government doesn’t.

  10. Since when are folks’ feelings more important that public safety? We’ve become so ‘kumbaya’ as a society that it is downright pathetic. Driving is a privilege…not a right. If one is mentally and physically capable of driving safely, he/she will pass the tests. It really is that simple.

  11. It’s a load of nonsense. Older drivers accidents are almost nonexistent. It’s nothing but persecution by tyrant government. They try that with me and they be awfully damn sorry.

  12. Ruth Adria is correct.Mary Kelley is inadequate in her analysis. Michael Bedard is right but poorly discussed by MacLeans.

    Here’s why.

    Michael Bedard and Bruce Wayne have an excellent article inthe Canadian Geriatrics Society Journal (V2,Issue 3,2012) in which they discuss the limitations of current senior evaluation instruments. Particularly frowned on is the SIMARD MD (developed by Dr. Bonnie Dobbs of the U of A Department of Family Medicine) which Bedard and Wayne claim very poorly discriminates between cognitively impaired people and healthy people. Try to keep in mind we are talking about people. According to them about half the test takers are scored as indeterminate and are referred on to a private testing firm DriveAble where they are given a computerized evaluation of their driving ability (for $250.00) using a computer procedure developed by Bonnie Dobbs’ husband. As an elderly consumer looking at this whole thing I find the price atrocious,the husband-wife linkage between public UofA employment and private for profit husbands’ computer evaluation troubling. Considering that failing the DriveAble computer test leaves only an on road test option at hundreds of dollars more my advice as a consumer is save your money. Take your lawyer to the doctors office. If you have the wits to do that I am pretty certain you will pass even if they persist in giving it.

  13. Mary Kelley compares urban low mileage seniors to high mileage younger people who do a large portion of their driving on very safe freeway systems between cities and distant urban areas. She should have compared accident rates of low mileage seniors to low mileage younger people. Urban driving and short distance driving has far higher accident rates as Mary Kelley well knows. SHAME ON HER.

  14. And now Ruth Adria’s position. The concern over driving and health handicaps is not just an Alberta or Canadian problem but is world wide.The critical question is not whether a certain small percentage of seniors has a problem. Some do. The question is whether that certain small percentage constitutes such a grave problem that a very large percentage of seniors can be forced to incur quite extreme costs to defend their right to drive.
    Seniors are citizens and if I understand Adria’s position it is that they should not be systemically discriminated against on the basis of age by forcing them to take tests younger drivers are not. Let us just imagine. Every driver with even a trace of alcohol,drugs,speech defect,a handicapped tag,any of a hundred ailments,with driver licence points, under 25, any at cause accident,any criminal conviction; preferably right at the time of offence,were required to be evaluated for “cognitive deficiencies”. Okay you can stop laughing.

    Doing this to seniors on the basis of age but not to younger people with problems of judgement,impulse control,or other impairments is,simply put, SYSTEMIC DISCRIMINATION against seniors.

    • There is no “right to drive”; it is a privilege. Statistics show that seniors, as a group, are more prone to accidents (on a per kilometers driven basis) than any but the least experienced. And their abilities continue to degrade over time, rather than improve.

      We have higher insurance costs (and, in Ontario at least, graduated licencing) for the inexperienced drivers, based on statistical evidence rather than proven characteristics of individual drivers; would you also argue these constitute systemic discrimination that should be eliminated?

      • Compare low mileage urban senior drivers to low mileage urban youth or stay at home mums etc and you will find little or no difference save that younger males below 35 will be higher. Seniors are just old,wrinkled ,poor and easy to pick on.

      • A second comment here. I would be totally in favour of graduated licensing for seniors. Most seniors already self regulate in this manner avoiding rush hours,night driving,long distance marathons as they age. Furthermore I would be totally in favour of senior retraining with meeting field of vision challenges and updates to current road rules and practices including a driver evaluation on the road. All these work to keep seniors active,involved ,healthier and ultimately to reduce the amount of time they spend in any level of taxpayer financed supportive care. But! Cry the superior young. They are just old and getting worse. It’s a waste of money. They should just give it up and get used to it.
        Excuse me? We paid for most of those roads the young are driving on! This is the basis for systemic discrimination.

  15. In BC, the taxpayer foots the $300. private for profit DriveABLE bill for testing seniors. Failure of the test, caused the senior to lose their right to drive. Seniors were denied a road test. Because of a loud outcry, seniors, who fail DriveABLE are now allowed a road test. Numbers are re-obtaining their license to drive.This again demonstrates that the DriveABLE test is not a dependable determinant as to who is fit to drive.

  16. In BC, The taxpayer foots the $300. bill for the private for profit DriveABLE computer test which determines a senior’s right to drive. Failure to pass this test caused the senior to be stripped of their driving license. Seniors were denied a road test. After a loud out cry, they were granted the right to a road test and as a result, numbers of seniors are re-obtaining their right to drive. This again demonstrates that the DriveABLE test is not a dependable determinant as to who is fit to drive.

    • As I understand it, the problem was not the seniors driving abilities but that they were not sufficiently computer-literate. Either way, there is no substitute for a proper in-car road test.

      • You are right–this is a factor but a diminishing one as boomers join the ranks.As a humorous note seniors might be advised to buy the largest touch screen devices available and download multiple editions of ANGRY BIRDS and start playing. Get a grand kid to set you up. They will love doing it.For practice in object identification, spatial awareness and prediction of travel paths it may be very applicable. Lot’s of adults play it. Just go to any hospital and watch all the EMR drivers and techs playing it on their cell phones while they wait for their patients to be admitted. BEAT DriveAble

  17. Considering the incident this week where an elderly lady with the famous square shades almost t-boned me, while I was directly in front of her trying to turn into the parking lot her vehicle was exiting from (to be fair, she was ‘looking’ for traffic), and then proceeded to start moving directly into me… I am all for it! If you are that unaware, you definitely should not be driving. Had testing been mandatory for her age group I am quite sure her license would have been revoked. I live in an area with a HIGH population of older folks. Honestly, when you work on the road for a living, you develop extra cautious driving skills. Even when you are extra alert around my city, you still have a very real chance of being hurt because of the elderly drivers who are very much oblivious to the other vehicles on the road. I am definitely NOT saying all older drivers are bad; that is blatantly untrue. However there are enough of them out there that make the experience of driving very stressful and hazardous.

    • A good point brought up by the wife after reading this to her is:
      Even though testing is a great idea, at two hundred dollars a pop, it does not make it economically feasable to make testing mandatory for just one age group who cannot afford it. Very valid point.

      Lower the testing fees, make it mandatroy for every age group, then we’ll see if the new system will improve driving conditions. And if the Goverment does start to take away licenses due to poor driving, improve the public transportation systems, because it does not make sense to make an elderly person who has to still see doctors, get groceries, etc., stand outside for up to an hour waiting for a bus that may or may not show up. I’ve had the fortunate experience to live abroad in South Korea and used their public transportation which is cheap, fast, and reliable to the point that most of the populace did not own cars. Imagine paying only forty bucks for a cab to travel from roughly Windsor to London. No problems there, so what is ours? Lack of financial support form the powers-that-be.

      I still agree with my original statement though…

  18. the difference is, old people don’t mean to be what they are, yet, the young inexperienced drivers, that are texting while driving, think they are above the law. The attitude is as much of a mental problem

  19. Statisticis

  20. We submit that according to statistics, seniors are the safest drivers on the road, they have the lowest casualty rates. Some would challenge this. They need to look up the articles, “RE-ASSESSMENT OF OLDER DRIVERS AS A ROAD SAFETY RISK” Langford, Methorst, Hakamies-Blomqvist, 2005. or “A RE-ASSESSMENT OF OLDER DRIVERS AS A ROAD SAFETY RISK”, Monash Universtiy Accident Research Centre.

  21. I must take issue with Mary Kelley’s logic. We are trying to assess the likelihood of accidents, based on age. If one group drives very little (elderly) and has the same rate of accidents as another group (under 25) who drive a lot, it is of no importance whether the rate per mile is higher, the accident rate per year is the same and that is what counts.

  22. The Simard test is actually not all that good. I would fail that at 50 and would have failed it at 18 because my mind wanders so I always do poorly in any recall type type testing. Anybody with anxiety would flunk as well because of the stopwatch and timing thingie. If you really want to test for dementia you need something simple like the SAGE Azheimer’s test from the University of Ohio – non threatening at all but easy to pick out anybody with the problem but then again maybe the whole point is to scare people into just giving up their keys!!

  23. Drive Able is just a money making racket for doctors and Drive Able.

  24. Congratulations to the Ontario Government. They got past the self serving junk science of various private businesses eager to “evaluate” seniors; the uninformed prejudices of many individuals too lazy or “cognitively” incapable of looking at real research around the world;and the professional indifference of many doctors wanting an easy way to off load the responsibility of evaluating seniors.As it is here in Alberta I am sure it was in Ontario. New protocols coming in 2014 are fairly progressive.

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