Missouri law takes on issue of elderly drivers' abilities

KANSAS CITY, Mo.-Evelyn White, 84, had driven her car for 68 years without an accident-until one chilly day last December when she hit a pickup truck.

It was only a minor fender bender. But the crash jolted her into reassessing her driving skills.

"I realized I couldn't hear so good anymore; and, well, little things are going wrong with my body," she said. "It's time for me to stop driving."

She won't renew her license when it expires next month.

Although White decided to stop driving on her own, many of this country's aging drivers stay behind the wheel long after it's safe.

To deal with the problem, Missouri enacted a law in January that is being hailed as a national model for how to tackle this sensitive issue. The law, which relies on impairment rather than age, has won support from advocates for the elderly, from the AARP to the Alzheimer's Association. Other states, which might have been reluctant to yank the licenses of impaired drivers whose skills have deteriorated over the years, have contacted Missouri about its new law.

Under the law, anyone can confidentially report an impaired driver and the state will determine whether he or she should keep driving. Those who file reports are also granted immunity from prosecution, and the law provides penalties for fraudulent reports.

Since January, 293 Missourians have filled out forms, now available at all driver's license offices. Once a claim is filed, the state can require the driver to retake the driver's license exam, including the road test. Drivers who fail the test can opt to retake it later.

In Kansas, residents can write the state a letter about an impaired driver; then a doctor must determine whether a person is competent to drive. But doctors are sometimes loath to report a patient because they are not shielded from prosecution, according to some advocates for the elderly.

More older drivers ahead

Getting unsafe older drivers to give up their licenses has long been a delicate subject. And the ranks of older drivers will only grow in coming years. Within the next two decades, the number of licensed drivers age 75 and older will zoom to 50 million from 17 million, according to the National Highway Traffic Safety Administration.

Nationally, traffic fatalities increase sharply after age 70, and drivers 75 and older are involved in more fatal crashes per mile driven than any other age group except teens, according to a 1996 study by the traffic safety administration.

As persons age, their vision and hearing often dim. Reflexes slow. Arthritis can make looking over the shoulder a painful experience. The rate of metabolism decreases, extending the effects of many medications. All of these problems can make driving more precarious.

Some senior drivers aren't aware of the physical changes. Some suffer dementia and other mental illnesses that affect their judgment. For those people, driving could be a death sentence for themselves or anyone they encounter.

Until recently, family members could do little except take away the car keys from a loved one or dismantle the car itself. Just bringing up the topic to a spouse, a parent or grandparent can be painful for families.

"Driving is often people's last bit of independence," said Kim Collins, executive director of the Alzheimer's Association Heartland Chapter in Kansas City. "It's especially hard for a man to give up his license. Families don't want to be evil or mean, but they go through torture worrying about what could happen, and what they should do about it."

Accident was impetus

Sheldon and Karen Suroff pushed for the Missouri law after their son died in a 1993 wreck caused by a 91-year-old man with senile dementia.

The man had driven the wrong way on I-70. When police caught up with him 250 miles later, he and his wife were sitting on the road side, with no memory of the accident.

The Missouri law has won support from the American Association of Retired Persons because people can't lose driving privileges based on age. Advocates for the elderly praise the law for giving people the chance to regain their licenses if their medical condition improves or if they learn how to compensate for it.

For example, at the Rehabilitation Institute in Kansas City, therapists find adaptive driving devices such as left-foot accelerator pedals or a hand control on a steering wheel to help people with visual, physical, or cognitive impairments.

"Sometimes as people age, they start having more medical complications like strokes or amputations, but that doesn't mean they have to stop driving," said Mary Schwartz, an occupational therapist at the institute.

States lack proper tests

The real difficulty with curbing any at-risk driver is that states do not have adequate driving tests, said Audrey Straight of the AARP.

"For example, on the vision tests, people with 200 eyesight won't pass; but if they have some sort of problem with peripheral vision or depth perception, the tests won't necessarily pick that up," she said.

And fewer states do on-the-road testing for renewals, she said, to save money and shorten lines in the license bureaus. In Missouri, people renew their licenses every three years-and the state might decide to extend that to every six years. Kansans renew their licenses every six years.

(This past December, Indiana's Bureau of Motor Vehicles discovered there was no law of rule on the books requiring testing of older drivers. So the bureau suspended a long-standing requirement that drivers 75 and older take a driving test every three years.)

Seniors can learn to compensate for diminishing abilities through driving refresher courses, like the AARP's "55 Alive/Mature Driving" program. The class costs $8 and can earn graduates a lower rate from their insurance company.

"There's a lot of things we did in our younger years that's not logical to attempt today," driving instructor Ed Moran said. "But you can still keep driving if you know your limits.

"Someday there will be a time when you'll decide it's time to quit." he continued. "Start making plans now, so you'll be ready."

That's what Evelyn White did. She gathered information on bus routes and carpools and talked to her family about it.

"I know it's a hard decision to stop, and I'm sure that I'm going to miss it, "she admitted. "But I'm doing it before I actually have to, so that my son won't have to go through that worry."