Aging drivers face tough choices

PORTLAND — From the time Nellie Hobson first got behind the wheel of a car at 16, she could go where she wanted, when she wanted. Even 66 years later, Hobson gets around.

But the 82-year-old Salem woman has cut back on driving considerably: weekly trips to the grocery store, church on Sundays and to see her family who live nearby.

Hobson has no feeling in her legs, a result of a progressive anemia diagnosed 32 years ago. She began modifying her cars 20 years ago with a handbrake in order to continue driving. Safety has always been a priority.

"I just drive in town where I'm familiar with everything," she says. "I will not drive to the coast. I don't feel that's secure anymore."

Hobson belongs to the growing ranks of drivers over 65 keeping their car keys longer. Today, 30 million licensed drivers fit this bill. As baby boomers age, that number will swell. Oregon drivers over 65 get into wrecks at a similar rate to teenage drivers. Nationally, wrecks are the leading cause of injury-related deaths in people over 65.

It's the often-delicate conversation that starts at the family dinner table and extends to health care providers, engineers, legislators and transportation officials. Next week the National Transportation Safety Board for the first time will discuss technologies and strategies to prevent accidents and reduce injuries and fatalities in drivers over 65.

Policymakers have to careful about age discrimination, so impairment is the focus — a 50-year-old with a medical condition might be unfit to drive while an 80-year-old is OK.

But the topic is complicated — and emotional. Location or resources often play a role: Rural Oregonians with few public transportation options may be hampered and left isolated without driving. Children who want their parents to stop driving must maneuver a tricky discussion about safety and independence.

Hobson and her husband, who died in 2004, never had children. But she's heard from neighbors in her retirement community about children taking away their parents' keys and cars.

"When the time comes, it comes, and you realize it," she says. "And you give up."

High-profile crashes involving older drivers spotlight the problem.

Last week, an 82-year-old California woman driving a car on Highway 20 near Toledo drove into the path of a Freightliner truck, causing a three-car crash that killed a state wildlife biologist.

In 2007, an 80-year-old Wilsonville woman left her home for a doctor's appointment but never showed up. Her body was found inside her car submerged in the Willamette River four months later. The night before she was last seen, police cited her for failure to drive on the right side. Her daughter learned later that 97 calls to 9-1-1 that day cited her mother's erratic driving.

In 2003, an 86-year-old man plowed into a California farmer's market, killing 10 people and drawing international notoriety to aging drivers.

Age isn't the sole indicator of ability, skills necessary for safe driving — vision, reflexes, hearing and flexibility — generally begin to deteriorate at about 55. And crash statistics make many experts want to speed up the conversation about aging drivers.

"I don't think we're as prepared as we should be to handle the whole variety of traffic safety matters with association to the aging population," says Peter Kissinger, executive director of the AAA Foundation for Traffic Safety.

A 2004 Oregon law requires certain medical care providers to submit a confidential form to Driver and Motor Vehicle Services if they detect potential driving impairment. DMV then decides to suspend a license or require additional tests.

"There's no law that says you have this disease you can't drive, or you're at this age, you can't drive," DMV spokesman David House says. "It was a result of the question of older drivers, but it ended up focusing on impairment."

To get a license, Oregon requires a knowledge test, behind-the-wheel driving test and vision screening. Drivers over 50 have vision screened to renew their license. Some states require a road test and more frequent renewals for older drivers. But Oregon only requires the knowledge and drive re-test if a license is expired for a year or more or if there's an impairment referral.

In 2009 DMV received 1,525 mandatory impairment referrals. More than half of the immediate suspensions were to drivers over 70. The most common reasons: judgment, memory, reaction time and attention.

For the last 83 years, Verland Reavis has operated a car. He lives on his own in Lakeside, a town of about 1,300 in Coos County, and turns 99 later in November.

Recently, Reavis began looking into whether the DMV would test his driving. He tries to avoid night driving, and recently completed an AARP driver's safety course. But he wants someone to observe him behind the wheel for "any suggestions about what I am doing and not doing."

DMV will retest people who volunteer for the driving exam. If they fail, they must pass all three DMV tests within 60 days to avoid a suspension.

In some cases, drivers give up their keys on their own. But, online tests and surveys, community classes or physician consultations can help people like Reavis either improve their driving skills or get unbiased and unemotional assessments.

At one such program, occupational therapist Joan Knapp evaluates drivers' vision, cognition and physical ability offered at Providence Gateway Rehabilitation in Northeast Portland. Insurance does not cover the two-hour $250 assessment.

Knapp reviews medication, living situations, medical issues and how people get around in their community. In one hands-on test, drivers step up to a board and hit blinking red buttons as she observes hand-eye coordination, reaction time, peripheral vision and balance. Drivers must press at least 50 buttons in a minute to pass. Knapp says some only manage eight.

"I just feel so badly for them even though you know they shouldn't be on the road," she says. "Mobility and independence in this country are big. We assume it's our right to drive."

Knapp recommends planning for the day you stop driving — just like planning for retirement. That way the life-altering event does not sneak up on them.

Reavis, whose license is good until 2013, says he is still healthy enough to drive. He lives in a small town where there's little congestion. When he does stop driving, he has friends or his housekeeper to drive him around town. Otherwise, he would need taxis since there is no public transportation.

"You have to look out for the other person as well as yourself," he says.

One day, Hobson will need alternate ways to get around Salem. She uses transportation at her retirement community to make some trips.

Her driving record in 66 years is virtually spotless, she says. She has been cited twice by police — once for an illegal left turn about 20 years ago and one for failing to give the right of way seven years ago. In April, Hobson rear-ended a car at about four miles per hour as both cars exited a parking lot. She doesn't know when to relinquish her driver's license, but Hobson cites her 101-year-old neighbor who still cruises around town, accident free.

Hobson knows her driving days are numbered.

"I hate to think about it. Ever since I was 16, I have driven and have been very independent."

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