55+ The Mature & Older Driver. ASSESS and ADAPT: Durham Seniors Safe Driving Coalition

Transcription

1 Durham Seniors Safe Driving Coalition 55+ The Mature & Older Driver DURHAM REGION ASSESS and ADAPT: A self-assessment and information booklet for older drivers and their families Durham Health Connection Line Oct09

2 TABLE OF CONTENTS Introduction Older Drivers: An Overview Getting Older and Driving Ability: Strength, Co-ordination and Flexibility Vision Hearing Decision Making Medications Drowsy Driving Senior Drivers (80+) Testing and Licence Renewal, Ministry of Transportation of Ontario Retiring from Driving Rules of the Road Resources Other Options to Test Driving Ability Conclusions Additional Resources for Older Drivers and Their Families References THE MATURE AND OLDER DRIVER

3 INTRODUCTION The ability to drive provides freedom and independence. This activity helps older adults to manage their daily activities, to feel good about themselves and to be socially active. Age is not a reason to stop driving. Older drivers are among the safest drivers on our roads. As we get older, age related changes can affect our driving. This booklet has been developed as a resource and a tool for you, your family, neighbours and friends. Please share it and talk about it. It is intended to help older drivers to drive safely as long as possible. It may also help with the decision to retire from driving when this becomes necessary. The Durham Senior Safe Driving Coalition membership consists of representatives from several organizations. They include the Ministry of Transportation of Ontario, the Alzheimer s Society of Durham Region, the Durham Regional Police Service and the Durham Region Works and Health Departments. A local pharmacist and a professor from Laurentian University serve as expert resources to the coalition. OLDER DRIVERS: AN OVERVIEW In 2006 one out of every seven Canadians was over the age of 65. This is 13.7% of the total population. This number will grow, as 1 the baby boomers (those born after 1946) become older. In 2007 about 63,439 Durham residents were 65 years and older, (10.7% of the total Durham population). The number of residents 75 years and older was 29,306, or 4.9 % of the total Durham 2 population. In 2002 there were 176,444 Ontario drivers aged 80 and older. This number increased to 3 219,262 in Older drivers aged are among the safest drivers on our roads. However, drivers face limitations due to medical conditions when their age increases above 75. Drivers of this age and older have much higher crash rates. They drive less and travel on busy high-risk roads, increasing their risk for a crash. The crash rates for drivers aged 80+ are like the rates for young beginner drivers. Older drivers are less likely to survive injuries resulting from a 5 collision. Durham Health Connection Line

4 GETTING OLDER AND DRIVING ABILITY You have probably heard about medical reporting. Under the Highway Traffic Act, a health care provider must report any patient 16 years or over who has a medical condition that may impair 7 driving ability. Examples of medical conditions which need to be reported are seizures and serious strokes. You must talk to your health care provider about health issues that affect driving ability. Take Charge! Assess Your Ability and Adapt Your Driving Strength, Co-ordination, and Flexibility: To drive you need to co-ordinate your hands, feet and eye movements. You also need to make decisions in response to what you see, hear and feel while driving. You must decide quickly how to react. This includes braking, steering, accelerating or a combination of these actions. As you grow older your vision, hearing, physical fitness, and reflexes change. You are likely using more medication. You must be aware of these changes and adjust your driving. This will help you to drive safely 6 longer. The next section of this booklet gives you information to help you to look at yourself and your driving. You assess yourself and check the boxes that apply to you. You then go to the next box and check off what you can do to stay healthy and drive safely longer. It may be helpful to review this booklet with a family member or your health care provider. Strength, coordination and flexibility are important to be able to drive a car safely. The more active you are, the better you feel THE MATURE AND OLDER DRIVER

5 ASSESS Ask yourself these questions to check your strength, co-ordination and flexibility: 8 Have I had at least one fall in the past year? Do I walk less than one block a day? Do I have pain in knees, legs, or ankles when going up or down a flight of ten stairs? Do I have trouble looking over my shoulder to change lanes or looking left and right to check traffic at intersections? Do I have trouble moving my foot from the gas to the brake pedal? Do I have trouble turning the steering wheel? ADAPT Things you can do to have an active lifestyle and stay strong and flexible: 9 Have a physical examination by your health care provider. He/she may ask that you see another health care provider such as a physiotherapist and may prescribe medication if necessary. Stay active with your health care provider s approval: Active living includes activities that improve endurance, balance and flexibility. Activities that improve endurance: Activities such as walking, swimming, dancing, aerobics and biking. They will make you feel warm and breathe deeply. They will improve your heart and lung function. It is helpful to do endurance activities 4-7 times a week. Activities that improve strength and balance: Activities such as lifting weights, laundry, grocery shopping, stair climbing and wall push-ups. It is helpful to do these 2-4 times a week. Activities that keep and improve flexibility: Activities such as gentle reaching, bending and stretching will keep your muscles relaxed and joints mobile. This will help you move more easily and be more agile. e.g. dancing, yoga, golf, gardening. Durham Health Connection Line

6 Vision: 10,11,12,13 Most information that helps us to drive comes from our eyes. Vision changes are a normal part of aging. You may notice that it becomes more difficult to read small print. It may take you longer to adjust from light to darkness. Your eyes become more sensitive to light. Peripheral vision or side vision narrows. You may find it more difficult to judge distances. You may also find it harder to see fine detail and objects against low contrast backgrounds. At night, an older driver s vision becomes worse. At age 60, a driver needs 10 times more light than a 20 year old! You must be aware of visual limitations. You can then have your vision corrected, adapt your driving and drive safely longer. ASSESS Ask yourself these questions to see if your vision has changed and is making it difficult for you to drive safely: Do I have difficulty reading road signs or recognizing someone familiar from a distance? Do I find that it takes longer to adjust from light to darkness? Do colours become harder to see? Do I have difficulty seeing signs, lane lines, curbs, other traffic and pedestrians? Is this worse at dawn, dusk and at night? Do I find the glare from lights at night a problem? Do I have difficulty judging the speed of cars coming from the opposite direction? Do I have difficulty seeing cars, and pedestrians on or beside the road? ADAPT Things you can do to adapt to deteriorating vision: Travel only in low risk areas and conditions such as: familiar routes lower speed areas quiet times of the day daytime and good weather conditions Wear your glasses (current prescription). Get a yearly eye exam. Avoid very dark windshields. Keep glass, mirrors and headlights clean. Turn up the brightness of the instrument panel. Sit high enough in your seat so you can see the road within 10 feet in front of your car. This helps reduce glare from opposing headlights at night. Look to the lower right side of the road when there is oncoming traffic at night. This will also reduce the glare from headlights. Be alert for pedestrians or cyclists. They may not see you. If they do not wear light or reflective clothing, you may not see them THE MATURE AND OLDER DRIVER

7 Hearing 14 Hearing loss is also part of getting older. Often you do not notice it. Hearing helps keep you in touch with what happens around you. Hearing loss makes it difficult for you to hear high-pitched sounds such as sirens and instrument panel warning signals. You may also find it hard to hear certain sounds when there is background noise. ASSESS Ask yourself these questions to check for warning signs of a hearing problem. Do I always ask someone to repeat things? Do I strain to hear? Do I favour one ear? Do I think that people always mumble? Do I hear ringing or buzzing in the ears (tinnitus)? Do I misunderstand conversations? ADAPT Things you can do to hear better and make up for poor hearing: Have regular hearing exams or speak to your health care provider. Wear your recommended hearing aid(s). Keep extra batteries on hand. Limit background noise while driving (e.g. radio, chatter, air conditioner). Watch for flashing lights of emergency vehicles. You may not hear the siren. Watch for the flashing lights and barriers at railway crossings. Durham Health Connection Line

8 15, 16 Decision Making Older drivers do not react as quickly as they did when they were young. You will notice that this happens particularly in fastpaced motor activities. Some older drivers are aware of this and drive more slowly. Older drivers do have experience and good judgement (unless they have dementia). Most older drivers avoid risky situations. When you drive, you must pay attention to many activities at once. You may need to make as many as 12 decisions every kilometer you drive! With age, the processing of this information and the reaction time takes longer. Some drivers become frustrated, and may not admit to these changes. They may keep driving without adapting to these changes. It is important to assess your ability to concentrate on driving and your reaction time regularly. ASSESS Ask yourself the following questions regarding warning signs of changes in decision- making ability, attention and reaction time such as: Do I not have confidence when merging with traffic or making turns, particularly left hand turns? Do I feel nervous while driving on the freeway (e.g. 401)? Do I miss stop signs or other traffic signs and signals? Do I react slowly to flashing lights and sirens of emergency vehicles, such as ambulances, fire trucks and police cars? Do I find it more difficult to judge distances and the speed of oncoming vehicles? Do I have other drivers often passing me or honking the horn, even in slow traffic? Have I been involved in two or more near-misses? Do I feel that signs, signals, people, vehicles and road markings are too much to handle at once? Do I have a history of dizziness, seizures, or loss of consciousness? Do I get easily lost or confused? Do I use a co-pilot (counting on my passenger to help me find the way)? Do I hit curbs? Do I have dents and scratches on my car from driving into posts or parked cars? Do I travel the wrong way on a one-way street? Do I receive tickets or warnings from the police? Am I getting more forgetful? THE MATURE AND OLDER DRIVER

9 ADAPT Things You Can Do: Increase the distance between your car and the car in front. This space between cars will allow enough time to stop. Instead of making left hand turns make three right hand turns wherever possible. If you must make a left hand turn, give yourself lots of time and space. Be ready to stop for pedestrians. Plan your route. Use familiar roads on which you feel comfortable. Do not drive in rush hour. Watch for hazards and problems in the distance. Allow someone else to do the driving. Do not drive at night, when it is busy or in bad weather. Listen to concerns and advice of family and friends. Have an assessment at a recognized driving assessment centre. Take warnings from the police seriously. Use a GPS (Global positioning system) if available. Durham Health Connection Line

10 16, 17 MEDICATIONS: THE EFFECTS ON DRIVING Medication can affect a driver s reaction time, steering ability, concentration, vision, and the ability to do more than one thing at a time. The more medications you take, the greater the chance that driving ability will be affected. Medications used for stress, anxiety and muscle spasms can double the chances of a crash. ASSESS Ask yourself these questions about your medications and driving: Do I take more than 4 medications, including over-the-counter and herbal medication? Do I take medication that makes me sleepy, makes me dizzy, gives me blurred vision or makes me unsteady on my feet? Does my medication affect my co-ordination? Am I easily distracted while driving? Do I feel that my judgment is impaired? Has someone ever questioned my driving decisions? Do I move more slowly than before? Do I find it difficult to focus or pay attention? ***Speak to your doctor or nurse practitioner if you have checked any of these boxes. ADAPT Things you can do: Talk regularly to your health care provider or pharmacist about your medication and possible side effects. Take medications as prescribed. Report side effects to your health care provider or pharmacist as soon as possible. When taking a new medication, do not drive until you know how your body reacts to the medication. Be aware that medications can affect people differently THE MATURE AND OLDER DRIVER

11 DROWSY DRIVING Older adults will notice changes in their sleeping pattern. They spend most of the night in light stages of sleep, causing them to wake up often in the night. In addition, an alarming number of people live with an undiagnosed or untreated sleep problem such as obstructive sleep apnea. In this condition, you stop breathing for short periods. Your body reacts by waking up each time. Together, these facts show that there are drivers on our roads that are short on sleep. This is a worry. With too little sleep, driving performance begins to look like the driving of a person who has been drinking alcohol. 18 ASSESS Ask yourself these questions about warning signs of changes in your level of alertness: Do I notice a change in my sleeping pattern? Have I ever been diagnosed with sleep apnea? Do I notice that my reaction time is slower? Do I have difficulty concentrating on the driving task? Do I yawn or rub my eyes when I drive? ADAPT Things you can do: See your health care provider for a physical examination and advice. Get plenty of rest. Stop to take a nap on longer trips. Have a sleep apnea test done. Plan your trips when you are alert. Share the driving. Take short trips only. Do not drive when tired or drowsy. Keep the temperature in the car cool. Durham Health Connection Line

12 SENIOR DRIVERS (80+) TESTING AND LICENCE RENEWAL, MINISTRY OF TRANSPORTATION OF ONTARIO The goal of the program is to keep drivers over 80 mobile and independent longer by providing information to help improve their driving. The program identifies older drivers who are at a greater risk of being in a collision. At age 80, your driver s licence will be renewed every 2 years instead of every 5 years. You must pay the licensing fee, and complete the following to renew your licence: 19 Vision Test A vision test will be done at the scheduled group session. If you bring a recent certificate from the eye doctor, another vision test will not be necessary. Group Education Session The group education session is a presentation with discussion, questions and answers. It takes place before the written test. It gives drivers information on driving, risk factors, and the effects of aging on driving. It also informs drivers about trip planning and preparation. It informs drivers how to minimize the risk of crashing. It gives drivers tools to check their own driving, and describes changes which drivers can make to continue to drive safely. Written Test The knowledge test has 20 questions on road signs and 20 questions on rules of the road. How to Prepare for the Written Test The best way to prepare for the written test is to buy and study the most current Official MTO Driver s Handbook. It s important to review Chapter 2 on safe and responsible driving and Chapter 3 on traffic signs and signal lights. You can get the handbook at retail stores or you can download it from the Ministry of Transportation of Ontario website THE MATURE AND OLDER DRIVER

13 At the time of the test, think carefully about the questions. Driving is common sense. There is no time limit to write the test so there is no need to rush. Take a deep breath and RELAX. Renewing your licence: When you receive your renewal application, you must call to make an appointment. You may need to have a new photo taken. Ministry of Transportation of Ontario Regional Scheduling Office or When you go to the group education session, remember to take: your licence the renewal application your good eye glasses and hearing aid if you use one the results of your recent vision test, if already done If you forget your renewal application you can get one at the MTO office. It will take time to complete the form. Road Test Sometimes, as part of 80+ testing and licence renewal, an older driver must take a road test. The road test will look at your basic driving skills, but no freeway or expressway (e.g. 401) driving is required. This happens when: There are demerit points on your licence in the past 2 years. The instructor at the Ministry of Transportation Licence Renewal Program notices that an older adult does not understand the topics or does not participate in the group discussion. There is more information on the Ministry of Transportation Ontario website: driver/senior/renewal80.shtml Durham Health Connection Line

14 RETIRING FROM DRIVING Self-assessing your driving skill is very important. Since you have now completed the selfassessments in this booklet, you have a better idea of your ability and what you can do to adapt your driving. The time to think about retiring from driving is when the adjustments you have made to your driving and refresher courses you may have taken are no longer enough to allow you to drive safely. ASSESS You have already looked at these points, but in review, check if anyone has ever told you or reminded you: That they were concerned about your driving. That they noticed things about your driving that you may have missed. That you had two or more collisions or near misses in the past two years or that you received two or more traffic tickets or warnings in two years. That you have forgotten to put on your seatbelt. That you have a problem merging on freeways or turning on busy streets. That you have a problem using the pedals. That they saw that you are unable to look over your shoulder to check your blind spot. That they noticed that you find it hard to see cars, cyclists and pedestrians, especially at night. That you missed a stop sign or traffic light. That they noticed that you got lost. If you have answered yes to any of these questions, you need to be concerned. Visit your health care provider. Make sure that you have an eye test and take a driving refresher course to improve your driving ability. You may need to have a driving assessment performed at a recognized assessment centre. However, it may be time to retire from driving. Giving up the keys is a difficult decision. It can be either a sudden event (e.g. because of an illness or medical diagnosis) or a gradual process. It helps to be prepared and to know what to expect. Retiring from driving may cause feelings of dependence and social isolation. There are ways to make this transition easier THE MATURE AND OLDER DRIVER

15 ADAPT What you can do when you retire from driving: 20 Talk about your feelings and needs to family and friends. Look into public transportation or taxi service. Encourage support from family, friends and neighbours. Ask family, friends or neighbours for help for transportation needs and pay them. Think about using a subsidized transportation service such as Community Care Durham. Find out if your place of worship offers a transportation service. Shop at grocery stores and pharmacies with home delivery service. Set up an activity and recreation schedule and match it with transportation opportunities. Durham Health Connection Line

16 RULES OF THE ROAD RESOURCES Rules of the road change. It is important to stay up to date on these rules. The Ministry of Transportation s Driver s Handbook is available from all major bookstores, other retail stores or can be downloaded from the MTO website if you have a computer. OTHER OPTIONS TO TEST DRIVING ABILITY Driving assessment centres are another option to help make the right decision about driving. In Durham Region the Lakeridge Health Wellness and Assessment Centre offers the DriveABLE assessment program. There is a cost for this service THE MATURE AND OLDER DRIVER

17 CONCLUSION You have looked over information about the changes that happen when you become older. Medical conditions that affect driving ability also become more common as you age. It is important to regularly look at your ability to drive and adapt your driving to this changing ability. Also, listen to family and friends if they talk to you about driving, and think about retiring from driving when it is no longer safe to continue. Durham Health Connection Line

18 ADDITIONAL RESOURCES FOR OLDER DRIVERS AND THEIR FAMILIES In addition to this booklet, there are several resources available. Alzheimer Society Durham: or toll-free The Alzehimer Society has educational information, provides educational sessions and gives support to people living with dementia and their families. American Automobile Association (AAA) Foundation for Traffic Safety They have several resources available for senior drivers. Canadian Automobile Association (CAA) South Central Ontario, 60 Commerce Valley Dr. E. Thornhill, ON L3T 7P9: or Canada Safety Council: Durham Region Transit: Durham Region Health Department, Durham Health Connection Line: or This is a general information line for the public. You can speak to a public health nurse, and ask for educational resources. Lakeridge Health Wellness and Assessment Centre: 223 Brock Street North, Whitby Ontario This is the site for DriveABLE assessments. Ministry of Transportation Ontario Official MTO Driver s Handbook: Available at major bookstores. They also have educational information on their web site. Ministry of Transportation Ontario (2007) How's your driving? Safe Driving for Seniors Ontario Highway Traffic Act can be found at public libraries and major book stores. Public Health Agency of Canada Website Roadwise Review: A Tool to Help Seniors Drive Safely Longer: This is an interactive CD ROM to check your driving abilities at home. It is available to borrow from your local library, some senior centres or for purchase at the Canadian Automobile Association (CAA) stores. Regional Municipality of Durham Website: : Information about traffic signs, pavement markings, traffic signals and rules of the road, and traffic by-laws. SAFE Clinic: Specialized Assessment for Frail Elderly Seniors INFO line (To find out if your area has special transportation services for seniors). Telehealth Ontario (TTY: ). This is a no cost government service available to answer questions about your health 7 days a week, 24 hours a day THE MATURE AND OLDER DRIVER

19 REFERENCES 1. Statistics Canada Census: Portrait of the Canadian population in 2006, by age and sex: National portrait. Retrieved April 22, 2009 from www12.statcan.ca/census-recensement/2006/as-sa/97-551/p3-eng.cfm 2. Durham Region Health Department. Population by Age & Sex Durham, 1997 & Retrieved April 22, 2009, from 3. Ministry of Transportation Ontario. (2008) Driver Annual Statistics. Licensing and Control Branch: Author. 4. Canadian Council of Motor Transport Administrators (2007). Aging driver strategy Ottawa: Canadian Council of Motor Transport Administrators. Retrieved April 9, 2009, from 5. Vanlaar, W., Emery, P. & Robertson, R. (2008). The road safety monitor 2007: Elderly drivers. Ottawa: Traffic Injury Research Foundation. 6. Anstey, K., Wood, J., Lord, S. Walker, J. (2004). Cognitive sensory and physical factors enabling driving safety in older adults. Clinical Psychology Review, 25, Highway Traffic Act R.S.O. 1990, CHAPTER H.8 Retrieved April 17, 2009, from statutes/english/elaws_statutes_90h08_e.htm#bk U.S Department of Transportation National Highway Traffic Safety Administration Safe Driving for Older Adults. Retrieved Feb 13, 2009, from index.html 9. Public Health Agency of Canada. (2003). Canada s physical activity guide for older adults. Healthy Living Unit. Retrieved April 17, 2009, from AAA Foundation for Traffic Safety. (2003). Drivers 55 + check your own performance. [Brochure]. Washington DC. AAA Foundation for Traffic Safety: Author. 11. Public Health Agency of Canada, (2006). Vision care Info-sheet for seniors. Retrieved April 20, 2009, from AAA Association (n.d.) Straight Talk for Mature Drivers. Retrieved April 20, 2009 from Maryland Research Consortium on Older Drivers. How is your driving health? A self-awareness checklist and tips to help you drive safely longer. [Brochure]. Model Driver Screening and Evaluation Program. Volume 1: Project Summary and Model Program Recommendations. Retrieved April 24, 2009, from people/injury/olddrive/modeldriver/1_app_c.htm 14. Public Health Agency of Canada. Aging and Seniors Hearing Loss Info-sheet for Seniors Retrieved February 20, 2008 from Ministry of Transportation Ontario (2009). Senior driver group education. Retrieved April 7, 2009, from American Automobile Association Foundation for Traffic Safety. (2001). How to help an older driver. A Guide for Planning Safe Transportation. [Brochure]. Washington DC. AAA Foundation for Traffic Safety: Author. 17. Halasi, Susan. (2006, May). Medication Effects on Driving. In Promoting Safe Driving for Mature and Older Adults. Workshop conducted by the Durham Senior Safe Driving Coalition, Whitby, Ontario. 18. Dr. G. Legault, personal communication, March 2, Ministry of Transportation Ontario. Renewing your licence: Drivers 80 years of age and over. Retrieved April 30, 2009, from American Automobile Association Foundation for Traffic Safety. (2001). How to help an older driver. A Guide for Planning Safe Transportation. [Brochure]. Washington DC. AAA Foundation for Traffic Safety: Author. Durham Health Connection Line

20 Durham Seniors Safe Driving Coalition 55+ The Mature & Older Driver DURHAM REGION ASSESS and ADAPT: A self-assessment and information booklet for older drivers and their families Durham Health Connection Line Oct09