Delegates at the Aging Driver Mobility Forum. Click image to enlarge

Articles and photos by Jil McIntosh

Toronto, Ontario – When he came back from the First World War, my grandfather bought a car. He pretty much just paid his money and received the keys; in Ontario, where he lived, driver’s licenses didn’t become mandatory until 1927.

They were definitely required when he was in his 80s, though, when a fender-bender determined to be his fault meant that his driving skills had to be assessed. He didn’t pass the test; I think the hardest day of his life was when he was told he could no longer get behind the wheel.

Getting older is an issue for all drivers, and it’s going to become an even more widespread concern as the huge postwar generation reaches a critical point. To that end, I recently attended a symposium in Toronto, the Aging Driver Mobility Forum. It was sponsored by the Insurance Bureau of Canada, the Ontario Ministry of Transportation, the Ontario Safety League and the Ontario Seniors’ Secretariat, but the issues went far beyond the province’s borders, and many speakers and attendees were from across Canada and the United States.

Ontario Minister of Transport, Jim Bradley. Click image to enlarge

The focus was not on how to take away licenses from older drivers, but on how to keep them mobile for as long as possible, with total restriction only as a final step. “We are still adults,” said Jim Bradley, Ontario’s Minister of Transportation, in his role as the forum’s opening speaker. “Nobody wants to be told what they can and cannot do, but personal mobility must be balanced with public safety, that of the safety of the driver and of others on the road. Ultimately, we want to keep senior drivers on the road for as long as they can safely drive. Driving is a privilege, but mobility is a right.”

Currently, of all the provinces and territories, Ontario has the strictest policies when it comes to senior drivers. Upon reaching the age of eighty, a driver must pass a vision test, a road knowledge test, and attend a group education session, all on the same day. Failure to pass the tests will result in the license not being renewed. This testing is required every two years. Doctors are also required by law to report any medical conditions that may prevent someone from driving safely; although it applies to drivers of all ages, seniors are far more likely to suffer conditions or illnesses that would be flagged.

The issue becomes more pressing when you look at the numbers. In the 1920s and 1930s, only five per cent of the Canadian population was over the age of 65; in the 1950s and 1960s, this age group accounted for eight per cent. But in 2005, 13.1 per cent of Canadians were over 65, and if current trends hold, it should increase to 24.5 per cent by 2036.

Statistics presented at the forum showed that in 2006, 13.2 per cent of all licensed drivers were 65 or older. This age group is also driving more, as well; drivers 55 to 64 years of age, and drivers 65 and older, were the only groups whose total number of kilometres driven increased between 2000 and 2004.

Overall, drivers between the ages of 55 and 70 years tally the lowest rate of collisions of any group in Canada. However, once over the age of 75, the collision rate per million kilometres driven is similar to that of young novice drivers. Seniors also accounted for the second-largest number of road deaths, behind only youth aged 15 to 24, but they may be overrepresented in this due to their frailty: senior drivers are more likely to be the fatality, while young drivers in a collision resulting in a fatality were more likely to kill a passenger, a pedestrian, or the occupant of another vehicle, rather than themselves.

Seniors are more likely to be involved in side-impact crashes, especially when turning left across the traffic flow or on right-hand turns around a corner, where they misjudge the speed of oncoming vehicles, and in crashes caused by a traffic violation, such as failure to yield the right-of-way, or disregarding traffic signals. Researchers speculate that this higher rate of side-impact crashes may partly be the result of seniors who stay off highways, and do most of their driving on secondary roads, where they are far more likely to encounter intersections and traffic lights.

So what can be done to keep people mobile? The general consensus – among government health and licensing bureaus, the police, the insurance industry, health care professionals, social workers and seniors’ groups – is that there isn’t a single solution, but rather, a network of measures and support that could and should be implemented in every jurisdiction in the country.

“Our roads must be not only safe, but open to all drivers, regardless of age,” said Mark Yakabuski, President and CEO of the Insurance Bureau of Canada. “A growing percentage of the population will have physical and cognitive problems. Let’s have a licensing (and) testing system that identifies medical conditions – not age, but medical conditions – when they begin to emerge. Any of us could be subject to medical conditions that prevent our ability to drive. We need to test earlier, not later, to detect these and help people with the issues.”

Yakabuski suggests a graduated system of licensing, similar to that which novice drivers face in many jurisdictions, which could include restrictions on night or highway driving. As well, those whose licenses must be fully restricted should not be left to fend for themselves, he said. “If we have to make a decision on full restriction, we have to look at the people who have to take these people places. We need to give these people more support. It’s time-consuming and expensive for them, but they are providing a service.”

Many speakers pointed out that identifying a problem is a major part of the issue. Self-analysis isn’t always possible, and for a number of reasons, including an ability to notice that driving skills are slipping. The word “dementia” is usually associated with debilitating instances such as late-stage Alzheimer’s, but the reality is that cognitive functions deteriorate to some extent in almost all people, with 70 per cent of those 85 and older exhibiting some form of dementia. Family, friends and doctors should be watching for signs of cognitive function deterioration and helping to take action before it’s too late.

“We need to plan a ‘transition strategy’,” said Jennifer Kroeker-Hall, Manager of Driving Licensing Policy for the Insurance Corporation of British Columbia (ICBC). “We need an infrastructure. It’s more than just licensing and de-licensing; we want to shape a system to accommodate drivers. That means building vehicles that can accommodate them. It means ‘walkability’, and communities must focus on this. We need better communications before the driver is at the point beyond getting help.

There’s an issue of mobility transit, which doesn’t always come at convenient times, and if a seniors’ group gets a volunteer driver, it’s often another senior. Licensing bureaus can’t do this on their own. They are part of a partnership of government, of stakeholders, of the police and seniors’ groups. This is more than just licensing.”

Some of the solution factors discussed include better police training, so they know what to do when faced with drivers who may not be in control of their vehicles; better communication between patients and doctors, and between doctors and licensing bodies; improved methods for testing senior drivers; more options for those who cannot drive, including a convenient transit system and community planning that makes amenities easily accessible even by walking; a focus on seniors in rural areas, where public transit does not exist; and easy access to information, including programs presented by seniors to their peers, which may be more acceptable than a session that might be considered a lecture when presented by a younger person.

Self-assessment was also discussed, including the importance of “use it or lose it” thinking. A common scenario, according to University of Alberta assistant professor Dr. Bonnie Dobbs, is that women tend to let their husbands do the bulk of the driving. “A male’s life expectancy is six to seven years past the point of driving, while a female is ten years,” she said. “She needs to start preparing for the day when her husband can’t drive anymore. If he loses his ability to drive, they will still be mobile.” She also stressed paying attention to health and activity overall, looking objectively at such things as night vision or detrimental habits, and a willingness to discuss potential problems with a doctor.

Of course, no one wants to admit difficulties to a doctor if that is going to result in immediate license seizure and a lack of mobility, and that’s why this needs to be an all-encompassing plan that takes every aspect of public safety and private mobility into consideration. It also goes beyond the age of drivers right now: we’re all getting older by the minute, and even younger drivers need to think about issues that will come into play in the future, whether it’s graduated licensing, better transit routes, or even if the big-box store planned for the neighbourhood should be more accessible to foot traffic.

“We know that the best driving comes from experience,” Mark Yakabuski said. “We need innovative solutions. We need to support the people who have given to our country, and our country must give back to them.”