Globe story doesn't really settle issue of how bad elderly drivers are
By adamg - 7/19/09 - 5:25 pm
Sure, the Globe discovered state statistics showing that drivers over 75 are responsible for a lower percentage of accidents than their percentage of the overall population.
But as Michael Graham (yes, that Michael Graham) points out, the Globe buried this nugget:
And on the basis of miles driven, which the state doesn't track, the GAO found that drivers age 75 or older are more likely than all other drivers to be involved in a fatal crash. The GAO report did not track nonfatal crashes.
So does that mean that when older drivers do drive they are more likely to be involved in a fatal crash? Sure sounds that way.
Comments
Stats
"There are lies, damned lies and statistics".
They buried it good
I didn't even see that graf when I skimmed the story this morning, but was struck by that lapse of logic implicit from the start.
They were talking about percentages as numbers of *licensed* drivers, not of *actual* drivers.
Licensed elderly drivers who are not actual drivers give us no direct information as to how safe actual elderly drivers overall are.
From the numbers given, I would make a wild guess that the accident rate for elderly actual drivers is likely at least twice that of non-elderly actual drivers, and possibly a lot higher.
This is classic "on the one
This is classic "on the one hand" writing. The author makes an editorial argument - against testing - with the "on the one hand" evidence, and then finishes the article with the "on the other hand" evidence, without ever resolving the two.
The indisputable fact is that as we get older, there comes a time when we simply cannot drive a care safely any more, any more than a drunk driver can drive safely even when "being careful." No one disputes that the correct metric is accident per miles driven. No one disputes that testing would successfully find many impared drivers and prevent serious accidents. Talk about younger drivers is a diversion. Younger drivers - past about a year or two of driving experience - dont' have accidents because they can't drive safely. Young drivers have accidents because they won't drive safely. If a brain scan could test for such irresponsibility, it might be a good idea to do so and take away licenses from such people. In any case, the matter is not relevent to the problems specific to elderly drivers.
The 85 age limit for the start of testing is ridiculous. By 85, most of us are dead. That's like saying that you'll only test for drunk driving when people can't get their car keys into their door locks. My father died at 69 in very poor health. He could not have driven safely at the time - his eyesight was very poor. He passed his last eye test by listening to the guy in front of him and repeating the letters he heard the guy say. Clever, no? My mother was driving him at the time. My mother died at 84, and I drove her everywhere for about the last five years of her life. She was alert and would have passed the eye test, but I would not have wanted her driving in most circumstances. Waiting until 85 is an attempt to sabotage the whole point of testing. Eighty at an absolute minimum, and 75 as a reasonable start is more like it.
Exactly
You've made a great case for why health care providers need to be way more involved in assessing whether people they see are able to drive.
You know how the routine physical exam form has checkboxes for "unrestricted participation in physical activity" and "unrestricted participation in work/school" along with a second checkbox for "participation with the following restrictions: _____________________"? Why not add "driving" onto that list? And require that the form be used for all encounters with a healthcare provider.
A provider who doesn't usually bring up driving during a visit could see that and be like, wait, this person has poor reflexes/vision/impulse control/whatever, and could either decide right there that the person isn't driving and would fill out the RMV physician form yanking the license, or would write that the person can't drive until s/he has had further vision testing or a neuro workup or whatever.
Initial licensing should also require the applicant to provide evidence of a recent physical including brief neuro assessment (reflexes, executive functioning, etc.) and a brief assessment of impulse control and judgment. They could also have people bring these in when they renew. Take the focus off of elders and require it for everyone.
http://1smootshort.blogspot.com
Fatal to whom?
Themselves or other drivers? Being older, and presumably frailer, tends to decrease the likelihood of surviving a serious crash, whether or not you caused it.
It's both
I remember this often being discussed when I worked for an insurance company. Elders statistically cause more severe accidents than other groups (based on damage to property and injuries to others), but also die more easily in accidents as you described.
http://1smootshort.blogspot.com
Safety + Sensitivity
For those who rely on their cars to get around, getting driving privileges yanked due to advancing infirmities is a huge, huge psychological blow. On the other hand, the (honest) stats about older drivers and accidents don't lie.
As the older Boomers head towards retirement, we need to find a sensitive, dignified, and safety conscious way out of this, including individual testing and provision of genuine transportation alternatives for those who can no longer drive. By addressing this now, we'll make our roads safer, and we'll make everyone's senior years richer and happier.
reckless driving vs. elderly driving.
A big part of bad driving is reckless aspect of the bad driver. Whats dangerous about the elderly driver that causes an accident is that they are more likely to do something that you wouldn't expect a driver to do.
If you are at a red light and it turns green, a good driver will still pause because its possible that someone might still run the red light. The same might go if you are in a rotary and you expect someone to yield. You simply keep your foot over the brake when you are in the rotary to prepare yourself for the driver that is entering the rotary but might not yield.
But these elderly drivers do things that you dont expect. The "foot on the gas instead of the brake" or the old "change lanes without looking at all" (because the elderly driver has no clue that there are two lanes).
But your average non-elderly driver gets into an accident because they are being reckless (run a red light, on phone and rear ends, forgets to look but knows they should).
I dunno, thats my own empirical view of the situation.
and dont forget..
a lot of people have a heart attack while driving and then crash their car. That probably counts as a crash with death....
Two of my former high school teachers....
... , both Christian Brothers, died while driving (stroke and heart attack), but thoughtfully pulled off to the side of the road and stopped their cars first.
tragedies all around
The most heartbreaking stories are those of older drivers who lost control -- e.g., stepping on the accelerator instead of the brake -- and killed one or more persons. Yes, it's horrible for the accident victims and their families. In addition, not infrequently the driver is someone who led a law abiding life without any major mishaps and who must now live out his/her years with this on the conscience.
you are right david..
there are also many elderly drivers with good driving records that end up causing one of these horrific accidents. Thats what really makes it tough to come up with answers.
Testing
As david_yamada said, I think testing is a big part of the solution.
One possible way to soften the potential insult of testing elderly drivers, and to simultaneously address the problem of non-elderly Masshole driving, as well as create gov't bureaucrat jobs: mandatory road re-testing of all drivers to maintain license.
Failure of road test would trigger license suspension til passing road test.
Drivers through some age (say, 65) need a new road test every 5 years. Then the frequency slowly increases as driver ages. Perhaps around 70, it's every 3 years, and by 80, every year.
A driver who just barely passes a test (due to aging or any other reason) might automatically be required to test again in a year. That might get the attention of lousy drivers, as well as monitor elderly whose driving skill might be declining rapidly.
Certain moving violations, or patterns of violations, could also trigger a new road test.
There might also be circumstances under which physicians are required to notify the state, eventually triggering road tests. That's more complicated.
And as we all get older...
...reliable public transportation MUST come into play, at least in cities. If you've ever known someone who waits forever for The Ride, you know what I mean.
In some cases, the difference between a lonely shut-in and an active participant in life is the ability to get from place to place even when driving is no longer an option. Family & friends are not always available to play chauffeur.
We need to change our whole mentality towards how we provide transportation options for the elderly. Eventually, it's about what options will be available to each of us.
Agreed
In addition to better conventional public transit, I'd like to see a city that is even more walkable and that has room for walking/jogging-speed motorized vehicles for use by people who cannot walk.
In my own neighborhood, we get elderly and disabled in wheelchairs and scooters, going into the street because the sidewalks are often not navigable or too much of a strain. A few times I've had to help people in wheelchairs who were stuck in the street, and I've seen others do it too. I've also seen daredevils on mobility scooters ride in heavy traffic with little more than a flag to make them visible to autos.
(Disclosure: I volunteer on pedestrian issues. I'm not currently involved on this specific topic.)
Sidewalks that Work
I have a colleague with a mild disability who was able to walk much further distances when we were in Portland, OR than she possibly can in Boston. Why? The sidewalks were well maintained: even and predictable, with well-placed ramps. She didn't constantly worry about tripping and falling.
The other thing: Boston and surrounding areas need to do a far better job of snow and ice removal from sidewalks. No excuses - Montreal does it, Boston can too!
Screening
It would be cheaper to use a simulator as a screen for the basic deficits. That would cut down the number of actual road tests required.
It would also be possible to put some in the waiting room that weren't linked to anything, and encourage people to "play" with one: do things like check their results with and without cel phone use, check their scores against other users, wear the "drunk" hat system to induce impairments, answer questions about road rules, and get used to the interface.
Failing a simulator test would trigger a road test.
Yeah, but they don't
Physicians are required to notify the RMV if they suspect that someone's driving might be impaired. There are two forms they can use, one that just notifies the RMV to do further follow up, and one that immediately pulls the license until the issue can be looked into further.
Physicians generally don't do this, except for a few ableist physicians I've encountered in my work, like the PCP who routinely pulls the licenses of people with completely controlled seizure disorders (who have neurologists who would pull it if they felt it was necessary) and the ER doc who pulls the license of anyone who lists any psychiatric disability in their medical history.
http://1smootshort.blogspot.com
My dad is 83 now
because the elderly driver has no clue that there are two lanes
It's not that he's not aware that there are two lanes, but that he can't turn his head far enough to see the second lane clearly. My dad has given up on driving on all but very long-haul trips (think Corpus Christi to Dallas) with my mother riding shotgun, and she chauffeurs him about town on other trips (she's a year or two younger than he). But having driven with him across the King Ranch as recently as 2006, I can say his chief problem is that he can't shoulder-check anymore.
Confusion of which pedal is where is secondary, and seems to stem from thinking he has moved his foot farther than he has sometimes when he aims for the brakes.
And yes, I know he's an accident waiting to happen. I've got no backing from mom or my sisters, so I do what I can to keep him from driving around town and pray.
Some don't even know the rules
I was rear-ended by an elder who swore up and down that three people got to go on a stop sign. It was all my fault because I stopped, you see. I keep a driver's manual handy and he STILL swore that it was the law when he learned to drive!
A stop sign was installed at an intersection in our city, and several older people complained that they got tickets for running it and it wasn't fair because they should have a couple of months (!) to "get used to it being there".
I have nearly been run down in a rotary by old people insisting that they can just barrel into a rotary (one of which made a nice smashup of our rear bumper when my husband bothered to yield).
A lot of older people walked into their town halls and said "I've driven 100 miles" and were never tested for rules or for proficiency. Even the current test is grossly inadequate by current standards - too short, not comprehensive, and the road test is "cop makes shit up" rather than a truly comprehensive survey of basic skills.
Put bluntly: we have a generation with epic senility levels, more miles on the road than ever, highest lifetime history of lead exposures and cigarette smoke exposures of any in modern times (both impact late life cognitive performance), and they have never been expected to even learn the rules or continue to learn new rules. This sounds like a recipe for disaster unless some screening is done - and I'd like that screening for all drivers given the very low bar for getting a license in MA in the first place.
Yep, test everyone
Hell, I wouldn't mind having to take the test yearly, if it meant not having to deal with as many people who don't know how four-way stops work, think it's safe to drive at dusk in a rainstorm without their lights on, don't know to move out of blind spots when driving on the highway, etc.
http://1smootshort.blogspot.com
Until the late 1970s,
it was legal under Massachusetts law for three cars in a row to go through a stop sign without each car having to come to a complete stop (provided of course it was safe to do so). I remember this well, because the law was changed just before I started drivers ed in 1978 and our instructors noted on several occasions during both classroom instruction and road practice of the change in the law.
Such subtle, but important, changes in the law are, IMO, a strong argument in favor of making periodic re-testing a requirement for all drivers regardless of age.
What's with the journalists?
I see this kind of thing too often in reporting - statistics are cited, a statement made, and often with just a little more digging the statistics could gain context and balance. To me it seems the journalist too often skims some surface, finds some press release, or some single source, and then it's off to the presses. Shoddy, and unfortunate.
How many newspaper reporters
How many newspaper reporters do you think have taken statistics classes?
there's a joke somewhere
there's a joke somewhere about journalists being inept at finance. After all, they paid thousands of dollars to go to school for journalism; a career that usually pays very little back in terms of cash compensation. Maybe we can say that of math and statistics in general?
Elderly drivers and fatalities
Not to defend that Globe story — I couldn't make heads or tails out of it. But as far back as 2001, the Washington Post reported that elderly drivers are involved in a disproportionately higher percentage of fatal accidents because they themselves are more likely to die.
elderly drivers
If you're going to try to restrict seniors' driving, the first step should be to provide adequate — no, make that superior — public transportation. If public transportation is more depedable, flexible and comfortable, who would want to drive?
Larz Neilson
East Boothbay ME