Too Old To Drive? When It’s Time To Surrender The Keys

BOSTON — Genevieve Priest is 89-years-old and still has her driver’s license, but says she has mostly given up driving. She travels with a tank of oxygen connected to a tube in her nose, and she does not feel as strong as she used to.

“Well, I have a breathing problem, I don’t have the energy I had before, and my eyes are not as good as they used to be,” Priest says. “I would drive today if I had to, but I prefer not to.”

httpv://www.youtube.com/watch?v=YlXLuo0wjUw

She still comes, though, to this weekly quilting group at the Belmont Senior Center. She usually gets dropped off by her husband, who is still driving at age 91.

“He’s been a tremendous good driver,” Priest says, “but lately we’re getting a little nervous about him driving because he doesn’t seem to have the confidence.”

A handful of recent high-profile car accidents involving elderly drivers has state lawmakers considering legislation that would require extra testing for older drivers. Supporters of the proposed new laws say people over a certain age are unsafe behind the wheel.

Priest says she realizes there are older drivers on the road who should not be. That is why she supports more frequent driving tests — but for young and old alike. “There are a lot of older people — they’re just not good on the road, myself included,” she says. “But they’re driving, and I think that’s very unsafe.”

During a quilting group at the Belmont Senior Center, Eleanor Pinnone (left), 80, and Liz Malsky, 72, talk about proposed new laws that would require more testing for elderly drivers. (Sacha Pfeiffer/WBUR)

Liz Malsky is 72 and considers herself confident behind the wheel, although she avoids nighttime driving. Like Genevieve Priest, she thinks there should be periodic testing of all drivers. She says it is the younger ones who are a bigger menace on the roads.

“The young women who are driving now — talk on the phone, they comb their hair, they put on eyebrow pencil or whatever they’re doing while they’re driving,” Malsky says. “And they’re the ones who cause accidents. The number of seniors who cause accidents are really very small.”

Malsky has a point. Statistics from the National Highway Traffic Safety Administration show that 16- to 19-year-olds cause the most car crashes and that people get in fewer accidents as they get older. But that is in part because elderly people do not drive as much. When they do get behind the wheel, people 85 and older are almost three times as likely as teenagers to be involved in fatal accidents.

Dr. Bob Stern at the Boston University School of Medicine studies why that is. He specializes in what happens to the brain as it ages, and specifically in how aging affects driving.

“People always say, ‘I’ve been driving for 60 years! As long as I’m just driving to the grocery store or down to the library, I’m fine. I know the route,’ ” says Stern. “Well, that rote kind of driving is fine. But that’s not what driving is.”

He says driving is a deer suddenly dashing in front of your car on the highway. It is a small child darting into a road to chase a rolling ball. It is a ladder falling off the pickup truck ahead of you. Those scenarios require quick thinking, quick reaction time and multitasking. And that, Stern says, is what people lose as they age. That cognitive decline usually begins around age 60 or 65.

“What happens in maybe the not-routine drive down the country road?” says Stern. “Or the very complex city street where there’s cars coming right and left, the ambulance is coming behind you, and the kid is walking out of on the sidewalk?”

But Stern says even when elderly drivers realize it is time to give up their licenses, they often cannot bring themselves to do it. “I can’t tell you how many patients have sat in my office when we discuss potentially not driving and they say, ‘I’d rather die,’ ” Stern says.

WBUR's Sacha Pfeiffer went for a quick drive wearing Liberty Mutual's "Senior Simulator." It wasn't exactly a smooth ride.

So, what is it like to be an elderly driver behind the wheel? Liberty Mutual, the insurance company, has designed a full-body suit that it says replicates the effect of aging on driving ability. The company claims that wearing the bulky suit, called the Senior Simulator, is like going through an instant aging process. I decided to try it out.

Sitting in the driver’s seat of a 2010 Toyota Camry with driving instructor Kevin Stromski, a neck brace prevents me from turning my head to look behind me, and a knee brace makes it tough to move my legs. A spinal strap creates a small hunch in my back. I’m also wearing vision-impairing glasses and thick gloves that make it hard to maneuver the key.

“Now your seatbelt,” Stromski says. “You can’t reach it, huh?”

It is hard. I have to move my whole body to do what I can usually do with just my neck.

“It’s tough, huh?” says Stromski. “Took you three tries to find the ignition.”

We are in a big parking lot lined with pylons. Stromski leads me through a series of exercises including three-point turns, quick braking and reversing using my side mirrors. Physically, I feel stiff and restricted, and my immobilized neck means it is hard to see the pylons behind and beside the car. When I put the car in reverse, I hold my breath and inch backwards, barely touching the gas.

I feel like what I’m doing is just going as slowly as possible, so that if I hit something the damage will be minimal.

“I haven’t even seen the speedometer move,” Stromski says.

I do not end up hitting any pylons, but there are several close calls — especially when I am wearing the glasses that make me feel as though I’m looking through an ice-covered windshield.

“We’re way off again,” Stromsky says. “There’s no way we’re going to make this turn now.”

I barely miss the cones. I do hit them during a quick-braking exercise, though. So how did I do?

“If I were trying to teach you how to do this in our class,” Stromski tells me, “I would not have passed you.”

Afterward, I call Bob Stern at the BU School of Medicine again. I want to know what he thinks of the suit. Stern says the neck brace and glasses are the most realistic part of it. But overall he thinks the Senior Simulator is a gimmick.

“One can simulate having problems moving, or the silly strap that gives you artificial osteoporosis,” Stern says, “but those things are not really what gets in the way of driving.”

Stern says slowed reflexes and other cognitive declines are the major difficulties many elder drivers struggle with. And he says a costume cannot replicate that. “Don’t try this at home,” Stern cautions, “but probably the best way to simulate the cognitive impairment would be to have a few drinks so that your brain is overall slowed, so that your reaction times are slowed, that you’re unable to multitask as well.”

That effect is why Stern thinks driving tests should be given every few years beginning when drivers are relatively young — say, 45 or 50 — and perhaps more frequently as they get older. Because, he says, while some elderly people still drive quite well, it is better to discover driving problems at the registry than on the road.