Automatic License Renewals in Ohio keep many unfit drivers on the road

Mike Blaisdell of Sylvania remembers the day he was convinced his grandmother should park her car for good.

A Michigan woman the same age as his grandmother-82-was eastbound on M-14 near I-275 on Christmas eve, 1990, when she suddenly turned her car around and headed westbound in the eastbound lane. Directly in her path was an eastbound car driven by Mr. Blaisdell's 37-year-old wife, Mary. The two cars collided head-on, sending Mrs. Blaisdell to the hospital with two broken wrists, a broken ankle, and cracked ribs.

Mrs. Blaisdell survived, as did teh elderly driver. But Mr. Blaisdell was now certain that his grandmother, Jenny Emmons of Kalamazoo, Mich., who suffered from cataracts and was legally blind, should no longer be driving.

"After what happened to my wife," he said, "I was thinking that if I didn't try to get my grandmother off the road and she hit and killed someone, I would feel guilty."
Mr. Blaisdell is not alone. Across this graying nation, children and grandchildren increasingly are confronted with the dilemma of what to do about their aging parents and grandparents, who, they believe, should not be driving for one health-related reason or another.
If you doubt the seriousness of the issue, consider that in the Toledo area in the last several weeks there have been four fatal accidents involving drivers over 80:

• On Aug.22, Michigan State Police said Argus Smith of Monroe crashed into the side of a tractor-trailer on South Dixie Highway in Erie Township, pinning his car beneath the trailer's rig. Mr. Smith, 82, and his 80-year-old wife, Fern Smith, were killed.
• On Aug. 26, Frank Lowery, 81, of Annapolis died after he drove through a stop sign at U.S. 6 near Bowling Green and collided with a truck, the Ohio Highway Patrol said.
• On Aug. 29, Bertha Peterson, 92, or Oregon pulled in front of a bus on Champlain Street and died a short time later in St. Vincent Medical Center, Toledo police said.
• On Sept. 6, Bruce Hillard, 83, of North Baltimore died after he pulled in front of a car on State Rt. 199 at Sugar Hill Road in Wood County, sheriff's deputies said.

Mr. Blaisdell, fearing such a calamity in his family, gently asked his grandmother if she would consider giving up her car.

She firmly refused.

Frustrated, Mr. Blaisdell called the Michigan State Police and the Ohio Highway Patrol seeking help. He was stunned by their response. "They said there was nothing they could do unless she commits an act or breaks a law," he said.

In fact, in Ohio, Michigan, and many other states, once you pass your first driving test you rarely need to take another. In Ohio, licenses are renewed every three or four years at any license bureau if you pass a simple eye test and acknowledge no serious medical problems. In Michigan, if you have a good driving record, you can renew by mail.

Three states-Illinois, Indiana, and New Hampshire-require road tests for drivers beginning at age 75.

One study found that Illinois and Indiana had 27 per cent lower fatal accident rates among senior drivers than Ohio and Michigan. However, legislation in those states requiring road tests for older drivers was passed years ago. Attempts to do so today would be political suicide, observers say, because of the clout of the seniors lobby-principally of the American Association for Retired Persons. The AARP is firmly opposed to any legislation that might restrict older drivers.

Drivers aged 15 to 24 have the nation's highest fatality rate. The next highest rate is among drivers 80 and older, according to the National Highway Traffic Safety Administration. Drivers aged 70-79 have a 33 percent higher fatality rate than those aged 40-49. Statistically, the latter group includes the best drivers in terms of fatal accidents.

There is at least one mechanism in place in Ohio that forces seniors to be re-examined, but few drivers appear to be affected. State troopers can issue re-examination requests to any driver involved in an accident or issued a traffic violation.

Contrary to Mr. Blaisdell's experience, family members also can register a complaint in person with Ohio and Michigan troopers that can trigger a re-examination request. Only 16 such requests, all as a result of accidents or traffic violations, have been issued in the past 20 months by the patrol's Toledo post, said Sgt. James Kertesz. Michigan has a similar policy, but state officials said they do not keep track of such information.

Ten of the 16 requests issued by the Toledo post involved drivers 78 or older.

Mr. Kertesz, however, believes that state's policy works just fine and that troopers have more important concerns. "There's a large number of them [the elderly]who drive OK," he said. "We have more of a problem with other drivers who neglect the law."

In 11 states-Ohio and Michigan excluded-doctors are required to report serious disabilities, such as dementia, schizophrenia, epilepsy, and diabetes to their department of motor vehicles. Elsewhere, doctors are encouraged to consider various disabilities that might impair driving, but they are under no legal obligation to do so and generally serve more as counselors than enforcers when confronted with situations involving unfit drivers.

Some are uncomfortable in this role.

"It's a difficult thing," said Toledo physician Dr. Harry Mayhew, professor and chairman of the Department of Family Medicine at the Medical College of Ohio. "I've literally lost patients over this."

Dr. Mayhew discussed two frequent scenarios. Sometimes patients ask him to sign insurance company forms, citing their good health, so they can have their auto policies renewed. Sometimes, believing their health is anything but good, he declines. Their reponse, said Dr. Mayhew: "If you don't sign it, I'll go somewhere else."

Worse, he said, are the calls from people who ask him-sometimes beg him-to stop their parents from driving but decline to get involved themselves.

Dr. Mayhew, genuinely disgusted at this notion, said:"I say to them,'Don't you think you ought to come in with Dad next time so he won't get mad at me?'"

Sheldon Suroff, of St. Louis, wishes Guy Lange's family would have done a better job at keeping him from driving. In July, 1993, Mr. Suroff's 21-year-old son, Jason, was westbound on I-70 en route to Kansas City when he was confronted by a confused Mr. Lange headed the wrong way in his lane. Jason Suroff swerved to avoid Mr. Lange, rolled his car, and died instantly of a broken neck. Mr. Lange, of Missouri, 91 at the time, drove on, unaware of what had occurred. Mr. Suroff and his wife, Karen, later discovered that Mr. Lange had been diagnosed with dementia and had no driver's license, and that his family had tried for years to get him off the road.

As a result of their son's death, the Suroffs launched Concerned Americans for Responsible Driving, Inc., known as CARD. Their goal, initially, was to persuade Missouri legislators to pass a bill requiring drivers age 75-79 to take a written and driving test every three years, and for drivers over 80 to be tested annually. The bill was shot down by angry seniors. Mr. Suroff, a novice politician, learned a valuable lesson: Lobby with your head, not your heart.

Now legislation is pending targeting impaired drivers, with age not a factor.

His current thinking: "[Some] elderly people are overmedicated, don't have good reactions, and may suffer from dementia. This group is going to grow 20 per cent a year. And they have more wrecks closer to home. Having said that, there is no way we're going after the elderly."

He'd better not. People like Dr. Ruth Morris of Toledo won't allow it. Dr. Morris, a retired optometrist, is assistant state coordinator of AARP's 55 Alive/Mature Driving program, which offers classroom refresher courses to seniors.

I can tell you, you're not going to pull them off the road," she said. "They would be up in arms."

Yet Dr. Morris, who's 76, admits that after age 50 physiological changes that alter vision, hearing, and reflexes affect one's driving ability.

"My hope," she said," is for a simple [driving] test that won't be costly to seniors. Perhaps we could talk them into voluntarily taking the test without the threat of taking their license away."

Such tests are being developed, said Dr. Harvey Sterns, director of the Institute for Life-Span Development and Gerontology at Akron University. He noted that three states-Maryland, Pennsylvania, and California-are experimenting with a sophisticated exam that measures useful field of view because one side effect of aging is that seniors suffer from deteriorating peripheral vision. That's one reason why elderly drivers have an abnormally high rate of accidents pulling out of driveways and at intersections, experts say.

"These tests are very important," he said. "We need to target people who are having difficulty."

That's how Lynne Chapman feels. As an occupational therapist at Medical College of Ohio's MCH Works program, she helps people who have suffered strokes, heart attackes, or other illnesses return to independent living. Included in the therapy is a driving assessment.

"We want to know if they have any difficulties that would [keep] them from driving." Ms. Chapman said. "Some people aren't aware that they have a problem."

About one-quarter of MCH patients are found unfit to drive, said Ms. Chapman, who informs the patient's doctor and the state's motor vehicle department. However, two-thirds of her problem drivers are not seniors but patients with brain injuries, severe diabetes and other infirmities, alcoholics, and drug addicts.

This supports AARP's and even Mr. Suroff's contention that there should be no age category for testing impaired drivers.

Further evidence can be found locally in the data released by Mr. Kertesz. Although 10 of the 16 people flagged for re-examination by Toledo troopers over the past 20 years were seniors, the other six were relatively youthful drivers who suffered diabetic reactions, seizures, or blackouts.

Still, most of the considerable national debate centers on senior drivers. With the population aging-the number of licensed drivers over 70 rose 118 per cent from 1975 to 1992-the issue promises to grow more volatile, Dr. Sterns said.

"In years past," he said, "we were more tolerant of driving and alcohol, but not any longer. I think it's the same thing with elderly drivers. Families do have a responsibility to their loved ones. They really should step in to limit their driving or stop it."

Yet, Ms. Chapman said, "I can't tell you how many people come in here and tell us driving is everything to them...especially the elderly. All they want to do is go to church and go to the store."

Listen to Mike Blaisdell's grandmother, Jenny Emmons, now 89 with 20/80 vision, whose daughter took her car away from her last month: "It's a real hard thing, not to be able to drive. Now I have to depend on others to take me. I feel able. But it's not for me to decide. There's nothing I can do about it."

Said Mr. Blaisdell, who understands but remains unyielding: "I asked her very frankly, 'If you hurt someone, how would you feel?'"