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The Elderly and Driving: When Is It Time to Hit the Brakes?

Prince Philip, 97, was involved in a car accident outside London. For families everywhere, the incident raises all-too-familiar questions.

Prince Philip talking with Queen Elizabeth II at Windsor in May. He was involved in a car accident on Thursday, raising questions in Britain about when seniors should stop driving. Credit: Steve Parsons/Press Association, via Associated Press

Prince Philip, the 97-year-old husband of Queen Elizabeth II of Britain, overturned his Land Rover on Thursday in a car crash on a rural road north of London. He was unhurt; two women in an oncoming minivan suffered scrapes and a broken wrist.

It’s not known exactly what happened or who was at fault. The prince told police officers at the scene that he was momentarily blinded by the sun while pulling onto the main thoroughfare.

The incident has prompted some reflection in Britain about when an aging driver ought to consider surrendering the car keys. Sound familiar? The question has long tormented families everywhere.

Over the years, reporters at The Times have written extensively about the thorny issues involved. Here are a few articles about a controversy that won’t be going away anytime soon.

The Car Key Conversation

Now I learn that the “car key conversation” is the one that caregivers dread most. Thirty-six percent of adult children polled by the website and the National Safety Council said that talking to their parents about the need to stop driving would be harder than discussing funeral plans (29 percent) or selling the family home (18 percent).

Should Doctors Stop Patients From Driving?

Alas, among the takeaways of the guidebook are the great difficulties physicians have at this fraught moment, and how much easier it would be for them if the decision did not involve them. As it is, physicians must wrestle with laws that vary by state on a variety of issues: if and how elderly drivers are assessed differently than younger ones; whether it is mandatory or optional for doctors to report their concerns; how they are supposed to go about it and strike the right balance between confidentiality and safety; and whether they risk legal liability if, on the one hand, they alert the state authorities or, on the other hand, they keep silent and a subsequent accident occurs.

Elderly Drivers Fail a Test

True or false? Most older drivers drive as safely as anyone else. It’s just that a few bad apples, particularly those behind the wheel despite poor vision or dementia, make mistakes and produce the statistics showing that per mile driven, drivers over age 75 are almost as dangerous as teenagers.

I want this to be true, given how dependent Americans of all ages are on automobiles. But researchers in Australia, using a novel method to gauge how well people drive, have concluded that serious errors are alarmingly commonplace. “We are seeing a ubiquitous increase in driver errors with age,” said Kaarin Anstey, a psychologist at Australian National University and lead author of the report, just published in the journal Neuropsychology.

My Solution to the Driving Problem: Vandalism

Sneaking into my mother’s garage to disable the engine of her 1997 Honda Accord was not something I ever imagined doing in my role as daughter and caregiver of a parent in failing health.

I had every possible legal authority to secure her health and safety, including medical and legal powers of attorney that enabled me to unravel paperwork problems, manage home repairs and participate in medical decisions. But messing with her right to drive, I discovered, was a huge, neon-lighted, statutory no-no in New York State.

A Contract to Stop Driving

I’m intrigued by the idea of a family driving agreement, by which an older person who may now be a perfectly fine driver acknowledges that with age-related changes, “there may come a day when the advantages of my continuing to drive are outweighed by the safety risk I pose not only to myself, but also to other motorists.”

With this document, the driver designates a trusted relative or friend to notify him when he should either stop driving or continue only with certain restrictions. He pledges to listen and accept that person’s recommendation. Then the driver, his designated adviser, and a witness, or several, affix their signatures.

Driving While Demented

Take the question of whether people with mild dementia — not just older drivers in general — should be behind the wheel at all. “Clinicians may present patients and their caregivers with the data showing that, as a group, patients with mild dementia … are at a substantially higher risk for unsafe driving, and thus should strongly consider discontinuing driving,” a new report suggested.

Yet it also noted that several studies had shown that a considerable number of those with mild dementia — 41 percent to 76 percent, depending on the study — could pass an on-road driving test. Given that, in many parts of the country, not being able to drive can lead to isolation and a host of other real problems, should those people have to give up their cars?

Safer Cars Help Keep Older Drivers on the Road

After years of advising others on how to get older drivers to relinquish the car keys, which often resulted in lost independence, isolation and depression (as well as family disputes), driving experts now focus on helping the elderly select vehicles that can accommodate their physical disabilities and certain sensory or cognitive losses.

An Alternative to Giving Up the Car Keys

While that is a scary thought for some people, the common perception, that the only real choice is between ignoring the difficulties faced by elderly drivers and taking away the car keys, is wrong. “We’re evolving in our thinking,” said Jodi Olshevski, a gerontologist and executive director of the Hartford insurance company’s Center for Mature Market Excellence. “We’re not just looking at the transition from driver to passenger, but how we can empower drivers to extend their driving as long as possible.”