It doesn't seem that long ago that my wife and I had to make the decision to not let our young son ride in the car when my father-in-law was driving. Now we are the grandparents and our children have to make that decision.
When I was growing up in Chicago I couldn't wait until summer came and I could go to Riverview Amusement Park. At the Fun House I could walk from mirror to mirror and transform myself from skinny to fat; from tall to short; and then back again.
Computers came along and 20 to 30-somethings could take a picture of themselves and have software wizardry transform their appearance to that of a 70-year-old. But, how does it actually "feel" to be 75-years-old and to have to drive to the grocery store, doctor's appointments or to a grandchild's birthday? The mirrors and computers never told me that story.
There is a national discussion on aging that is starting to take place and none too soon. The fastest growing segment of our population is 85 years and older with the Baby Boomers right behind them. It is an "Aging Tsunami." Part of this national discussion was an event at New York's Grand Central Station, which was part of Liberty Mutual's, "National Conversation Drive." It is an effort to raise the level of awareness among baby boomers and their children of the driving problems that occur as we age and the need to plan for a time when we should no longer be driving.
As We Age
The mirrors and computers can play games, but our bodies tell us the truth. As we age, changes take place in our bodies that affect our ability to drive:
- Vision: The lens in our eyes form cataracts and let in less light. We may get macular degeneration and lose our central vision. Depth perception is impaired.
- Cognition: Our judgment and planning skills deteriorate and we react more slowly to sudden changes like a car stopping in front of us.
- Motor Function: Our joints lose their mobility, restricting our motion and affecting our ability to move our neck from side to side or quickly move our foot from the gas pedal to the brake.
- Sensory Function: We lose sensation in our hands and feet and our balance becomes impaired.
As a newly minted 65-year-old, I already know how some of these afflictions feel, but while I was in New York City, I took the opportunity to try out the Liberty Mutual aging simulator. With my Medicare card in hand, I went behind a blue curtain and two young people "aged" me at least 20 years in five minutes. A weighted vest and straps hunched me forward, while lower leg braces restricted my motion. Weighted gloves impaired my hand mobility and sensation while a neck collar restricted my ability to look from side to side. As I felt myself widening my stance to improve my balance, I was handed a pair of glasses with their centers fogged to simulate macular degeneration. I felt as if someone had nailed my feet to the ground and I dare not try to move. With someone at my side to keep me from falling, I shuffled toward a medium sized car, feeling with every step that I had aged 20 years.
A video clip highlights my journey through this process. Watch it, here.
For now, I can take the suit off and lose the 20 years, but some day I will not have that luxury.
What Can We Do?
A recent article in JAMA makes it clear that everyone, including physicians are uncomfortable dealing with taking away someone's ability to drive. It is devastating to tell someone who is independent in their driving that they can no longer drive. The article recommends that physicians administer a screening test, the Assessment of Driving-Related Skills (ADReS) during a routine office visit. However, one-third of those who failed this screening test were still able to pass a behind the wheel test. Their recommendation was to refer the person to a rehabilitation driving specialist, usually an occupational therapist who has more sophisticated tools to help make this difficult decision.
One such device is DriveABLE™, a computer based test that evaluates critical skills that are utilized in driving. It incorporates components of neuropsychological testing in an easy to use test that looks at:
- Motor speed and reaction time
- The ability to pay and shift attention
- Decision making abilities in driving situations
- Judgment in spatial decisions
Tests like DriveABLE™ give the family and their physician hard data to show the person that they may no longer be a candidate to drive. Taking a ride with your loved one is probably the most valuable tool. Why is Mom taking so long to apply her brakes when the car in front slows down? Did she just cruise through that school zone or ignore the stop sign?
Older Employees
I never really thought about the issue of aging employees until it was brought to my attention by David Melton, the Director of The Transportation Consulting Research Institute for Safety at Liberty Mutual. With baby boomers having to work longer we will see more older truck drivers, couriers, service workers and taxi drivers. What would be your reaction to jumping into a cab and finding a 75 year old at the wheel? I know of two people who went to truck driving school after the age of 70 and are driving big rigs. It was something they always dreamed of doing. Are they safe? Did anyone check their reaction time and attentional abilities? Do we know how they will react in an emergency?
The Transportation Research Board has published a literature review on older commercial drivers. The results are somewhat counter intuitive in that older drivers did not have an increase in accidents. Some believe that older drivers become senior drivers, with seniority at their place of work, can select themselves out of those higher risk jobs and situations that are more likely to lead to fatigue and accidents. Mr. Melton is more worried that older sales and service drivers who stay employed longer and will be a larger part of the driving public; driving more "senior" miles than if they were not employed. As we have to work later in life we will be forced to keep driving in situations we might otherwise avoid. The study noted that, "most important is the evidence showing that loss of function for any driver underlies a higher risk of crash causation, regardless of age."
It is time for a national conversation on driving in the elderly and it is encouraging that both the insurance industry and the medical community are addressing the problem. So, "suit up" and a take a look at your family and employees. Should everyone still be driving?