Recent traffic fatality on Girard Avenue raises questions about elderly drivers
Transportation options for seniors
Senior Express: La Jolla Community Center (LJCC) officers this service to destinations within La Jolla and UTC Monday-Saturday. Seniors must book rides three days in advance. The service is free for LJCC members or $10 for nonmembers. To reserve a ride or get more information, phone (858) 337-0275.
On the Go: Jewish Family Service of San Diego has a donation-based program On the Go for those age 60 and older. For an enrollment form or details, call (858) 637-7320.
UberWAV and uberASSIST: Loved ones can pay to have mom or dad picked up for doctor appointments or afternoon shopping excursions. Wheelchair accessible vehicles are available upon request. Uber.com
On the Web
TREDS program: treds.ucsd.edu
DMV info for senior drivers: bit.ly/seniordriverinfo
DMV senior driver warning signs: bit.ly/seniorwarningsigns
Although the investigation is ongoing into the traffic accident on Girard Avenue that led to the death of 45-year-old mother of three, Melissa Ratcliff, the incident has renewed concerns about the ability of elderly drivers to safely operate a motor vehicle.
Ratcliff was struck and killed by a 91-year-old motorist Oct. 7 in the 7700 block of Girard Avenue as she was unloading her car. At press time, San Diego Police had not filed charges against the driver, though they have ruled out mechanical error as the cause of the accident.
Although many people can drive safely into their 80s and beyond, people age differently and a variety of factors may impair the ability of older drivers.
“We encourage people to drive as long as they can, as long as they are safe on the road,” said Jaime Garza, a public information officer with the California Department of Motor Vehicles (DMV).
Yet, the DMV is conscious of the affects of aging on motorists, and requires drivers to visit a DMV office at age 70 for a written and visual test. “Then seniors have to come in every five years after that,” Garza said. “We want to ensure that they’re OK to drive.”
Although Garza said some statistics show that seniors are better drivers and involved in fewer accidents in their 70s than beginning teenage drivers, Linda Hill, a professor of family and preventive medicine and with UC San Diego School of Medicine, cites statistics showing a person’s crash rate per mile driven also begins to rise in their 70s. By their 80s, senior men are as dangerous behind the wheel, in terms of driving fatalities per mile driven, as teenage males.
It is estimated that by 2030 one in five California drivers will be age 65 or older.
Hill is director of the Training, Research and Education for Driving Safety program (TREDS), which trains physicians and law enforcement to recognize the warning signs of impaired driving skills and to take “appropriate, compassionate action.”
UCSD researchers have developed a roadside tool to help police screen drivers for dementia, disorientation or cognitive impairment if spotted driving erratically.
“Our goal is to reduce the number of fatalities involving older drivers and to prolong the time that seniors can drive safely,” Hill said. “We help (law enforcement) to better recognize medical conditions that can interfere with driving.”
Hill said broaching the subject of impaired driving with a senior may be uncomfortable for both family members and physicians.
“Yet the public really expect that their physicians are going to step up to the plate and help the patient and their family … recognize when they have medical conditions that interfere with driving,” she said. “Everybody, at some point, reaches the point where their medical conditions are such that safe driving is no longer an option. Nonetheless, some people are still on the road … who either haven’t self-regulated or don’t have the insight to recognize when they’re no longer safe to drive.”
Adrienne Fierra, a medical social worker with Mission Healthcare, which provides in-home health care and hospice for seniors, said signs that a senior driver should be retested include: confusion, forgetfulness, loss of hearing, placing objects closer to the eyes, not responding when spoken to, misplacing keys, dropping things or a loss of sensation in the feet or hands.
Loss of one’s ability to drive can often lead to depression, anger or frustration. When the time comes, Fierra suggests family members report their concerns to a family physician, and let he or she phone the DMV to have their loved one’s driving abilities tested. “It removes the family from being the target of the upset and anger,” Fierra said.
Garza said family members can also report a loved one to the DMV anonymously. “We call them in and we can (test) them,” he said. “We keep the peace at home without telling them anything else.”
If the news is not good, Garza said, “We tell them right there at the office after the test (is administered). You try to explain it the best you can. We have to be understanding of the driver, their need to be mobile and the need to have that independence. When you take that away, it can be very emotional.”
For some, Garza said, revocation isn’t the only option. Sometimes a senior’s license may merely require a restriction placed on it, stating they are only allowed to drive during daylight hours or on familiar streets.
Hill said many conditions that impair driving can be treated, allowing a senior to remain mobile.
“Vision can be corrected; it might be that simple,” she said. “It might be that physical therapy will help arthritis; it might be that lowering (the dosage of) a drug will help reduce drowsiness and confusion. It’s important to recognize there’s a problem, so you can look for solutions.”
However, Hill noted that about a quarter of people over age 80 have visual impairments that cannot be corrected.
“When you’re younger you can usually correct it with glasses or contacts, but as we age we get nasty things like macular degeneration or glaucoma that are hard to treat,” she said. “Similarly, starting at about 65, half of older adults are taking five or more medications in any given week for a variety of things. Even when taken correctly, there can be drug interactions or individual reactions that can cause disorientation, sleepiness or poor coordination that can interfere with driving. Just being frail, just having less muscle mass and less bone (density) puts people at risk for a crash. You can’t turn your head as well if you don’t have the strength.”
In addition, an average 70-year-old involved in a crash is four times as likely to die of their injuries than an average 20-year-old in the same crash, Hill said. She recommends those who suspect a senior loved one may have a medical condition that is interfering with their ability to drive get in the car and take a test drive with them through the neighborhood or on a calm street.
“Go for a drive with them first and see if that’s an issue,” she said. “The other thing is to look at their car and see if there’s a lot of scratches and dents, because that will be another clue.”
For those unwilling to gracefully retire from the road or who do not agree that they are no longer fit to drive, Hill suggests family members contact a driving rehab specialist (typically an occupational therapist) that can take a test drive with their loved one to provide an impartial assessment.
Garza said the DMV also has its Senior Ombudsman Program, in which seniors work with other seniors to help them through the aging process as motorists, and offer valuable information. “They go out and they talk at senior centers, community centers and basically provide the guidance that they need,” he said.