The Raleigh News, NC
Sunday, August 3, 2003 7:23AM EDT

How old is too old to drive?
The debate about driving limits revs up after an 86-year-old kills 10 people

By BONNIE ROCHMAN, Staff Writer

It might come as a surprise to hear that Bob Morgenroth thinks older drivers such as himself -- he's 88 -- should get
more scrutiny than those half his age. But he knows his limits, and he tends not to fight reality, which, as it turns
out, has the retired professor of foreign languages from Chapel Hill nodding off in front of the television.

"I thought that could happen in front of a car," said Morgenroth, who favors annual renewal of licenses for older
drivers -- say those older than 70 or so. "We really don't see so well and think so fast, and our muscles aren't as
quick."

Which is why on a recent Thursday he was at an AARP class designed to perk up driving skills and help people determine
when they should hang up their keys for good. Morgenroth, who can be spotted behind the wheel of a Toyota Camry or
Acura Integra, has taken the class three or four times.

Less than three weeks after a driver two years younger than Morgenroth killed 10 people at a Santa Monica, Calif.,
farmers market, the debate about whether older drivers should face restrictions has once again revved up.

Here in the Triangle, in 2000, an 84-year-old woman accidentally reversed a van into a group of children at a middle
school in Smithfield, killing an 11-year-old honor student. Two weeks ago, a 78-year-old Raleigh woman drove her car
through the window of a dry cleaner.

Few advocate revoking the right to drive at any particular age, a move that would curtail the independence of a growing
segment of society. Far less clear is how to ensure that older drivers are safe drivers. A Gallup poll taken days after
the California market tragedy revealed that about nine of 10 Americans favor requiring older drivers to take vision and
road tests every few years to renew their licenses.

"Things do start declining at a certain age, but at what time does it affect driving? That's the big question. People
age so differently that you really can't say," said Jane Stutts, associate director of the University of North Carolina
Highway Safety Research Center . She advocates more frequent renewals for people older than 70 or so.

That is why the AARP, an organization that lobbies on behalf of people 50 and older, opposes driving limits linked only
to age.

"That's one of the challenges -- to not cut off by age but by condition," said Bob Jackson , AARP state director.

Studies -- and there are many -- show that older drivers are safer drivers than teenagers, aged 16 to 19. But after
drivers reach 75, their crash rates per mile driven begin to increase along with their incidences of fatal accidents,
largely because of their increased fragility.

Between 1991 and 2001, there was a 27 percent increase in the number of drivers 70 and older who were killed in
crashes, from 2,494 to 3,164 . Overall crash fatalities increased less than 1 percent during the period , according to
The Road Information Program , a national nonprofit transportation research group.

Older drivers are also spending 28 percent more time on the road -- 37 minutes per day compared with 29 in 1995, the
study showed . And the number of older drivers keeps increasing .

In North Carolina, people 65 and older make up 12 percent of the population and 14 percent of drivers, state officials
say. Projections for 2030 call for the 65-and-older bracket to make up 18 percent of the state's population, according
to the N.C. Division of Aging.

About 20 states have special requirements for older drivers, but North Carolina is not among them. Some states renew
older drivers' licenses more frequently than younger drivers'. Others require vision tests more often. New Hampshire
and Illinois require drivers 75 and older to take a road test.

The N.C. Division of Motor Vehicles renews drivers licenses every five years. Every applicant, regardless of age, must
pass vision and road signs tests. Examiners are trained to spot drivers who seem unsteady or confused and are
authorized to administer driving exams on the spot or refer questionable drivers to the DMV's medical review program.

That program assesses drivers of any age to see whether restrictions are warranted. Family members, physicians or law
enforcement officers responding to an accident scene may also refer a driver for evaluation.

Last year, the state performed 37,312 medical reviews. Slightly more than half the drivers evaluated were 65 or older .
Officials denied licenses to 4,259 people, but Wayne Hurder , director of drivers license certification for DMV, said
he didn't know how many were senior citizens .

Several years ago, the DMV considered proposing to the General Assembly that drivers older than 75 should renew their
licenses every three years. In 1999, a bill failed -- largely because of AARP opposition -- that would have stretched
renewal time for most drivers to 10 years but would have condensed renewal time to three years for those 80 and older .
North Carolina has more than a handful of over-80 drivers: DMV records show 9,068 drivers between 90 and 95, 478
between 96 and 100, and 21 over the age of 100.

But Hurder says it is time to take another look.

A recent federal study posted on the National Highway Transportation Safety Administration's Web site indicates that
between the ages of 70 and 75, fragility increases and driving problems begin to emerge.

"It tells us now is the time we need to re-evaluate our standards," Hurder said. "Based on the latest studies by the
federal government, it's a reasonable conclusion that older people should be seen more frequently."

In addition, Hurder said, DMV officials will focus on developing better and faster ways to assess drivers' mental
sharpness -- counting to 10 and back quickly, for example.

Phyllis Stewart , a transportation consultant for the N.C. Division of Aging, said efforts are under way nationally to
develop screening tests to identify drivers at increased risk of crashing while not denying licenses to older drivers
who are not likely to.

Compensating for age

There is also evidence, at least anecdotal, that older people compensate for their declining skills by avoiding busy
highways or driving only during daylight, Stewart said. Researchers at the Massachusetts Institute of Technology's
AgeLab reported that two-thirds of drivers they studied older than 50 said they "self-regulated," curtailing driving in
bad weather, on interstates, in heavy traffic, during rush hour.

Polly Williams, a retired English professor from Raleigh who will turn 80 next month, said she rarely drives at night
because she doesn't see well in the dark. Nor is it unusual for her to choose a longer yet less-complicated driving
route. But she says she is not about to voluntarily give up her license.

"It's very humiliating to have to acknowledge you can't drive anymore," she said.

Michele Murphy, a facilitator for the Triangle Caregivers support group, knows how difficult it is to broach the
subject with a family member. She tried for years to persuade her mother to stop driving, but until the 76-year-old hit
a stone wall, she refused to listen.

"This time it was a stone wall," she and other relatives told her mother. "Next time it might be a person."

Murphy's mother acquiesced, but grudgingly, and sold her Ford Escort.

"This was a woman who raised five kids and worked until she was 72," Murphy said. "She was used to going where she
wanted when she wanted to go. People that have been independent all their lives find that an unacceptable way to live.
It makes them very unhappy."

Murphy said she supports more frequent vision tests for seniors starting at age 70 and license renewal every two years.
More frequent follow-ups might have caught her mother's inability to drive safely sooner, she said.

The larger problem

It is crucial to remember, says the AARP's Jackson, that there is no absolute age at which a person's driving becomes
dangerous.

"Those aren't seniors having accidents every single day out there," he said. "Those are working folks who are
tailgating, talking on cell phones and putting on makeup and -- bam! -- every single morning. We've got to do a whole
lot of work on general driver safety."

Another challenge is finding tools to improve driver safety and identify at-risk drivers. One avenue, Jackson said , is
the development of better tests. Another is more emphasis on physician involvement. The American Medical Association
has released new guidelines to help doctors assess which patients should no longer be driving and to assist others in
getting help.

Yet another is the AARP's driver safety program, an eight-hour refresher course offered 300 times a year across the
state.

Joe Mangum directs the program, a daylong primer geared toward people who learned to drive when "superhighway" meant
two lanes. Instructors teach students to stay three seconds behind the car they are following, to count to three when a
light turns green so a red-light runner won't broadside them, and to eliminate left turns -- the most complicated turns
because they involve crossing lanes.

"We go over when it's time to give up driving," said Mangum, who thinks restrictions should be based on need, not age.
"Some people say yes, we think we've reached that place. We create the thought."

But others won't entertain the notion. Nor should they, said the Division of Aging's Stewart, whose octogenarian
father's agility, strength and reflexes rival her own.

He recently moved from Southport, on the coast, to Person County to be nearer to family. During the move, he made the
more-than-four-hour trip back and forth at least five times in his Lincoln Town Car. "I don't worry about him driving,"
she said.

"I'm 55 and in good health," she said. "He's 83 and in good health. He has better eyesight than I do. There's a high
probability he will continue to be a very good driver for years until and unless his health changes."

Staff writer Bonnie Rochman can be reached at 829-4871 or [log in to unmask]

SOURCE: The Raleigh News, NC
http://newsobserver.com/news/story/2747111p-2546686c.html

Reference:

READ: "Assessing and Counseling Older Drivers," posted last week on the American Medical Association Web site.
http://www.ama-assn.org/ ama/pub/category/10791.html

IS AN ELDERLY LOVED ONE AT RISK ON THE ROAD?
Use this checklist from occupational therapist Jenny Womack of the University of North Carolina at Chapel Hill to find
out:

* Is the driver overwhelmed or unsure in unfamiliar or crowded driving situations?

* Does he or she miss signs or get lost?

* Does the driver seem unusually tired after driving what would be a normal distance for him or her?

* Has the driver had a recent change in visual ability or eyewear prescription?

* Has his or her general mobility changed? (Such as reduced range of motion or increased falling)

* Does the driver take any medications that cause drowsiness?

* Does he or she have trouble judging dimensions of parking spaces and how to get into them?

* Is the driver unable to concentrate on driving and carry on a conversation in the car?

* Does he or she "hide" driving times and routes from loved ones?

* Has the driver had an increase in minor moving violations or accidents?

* Does he or she drive at inappropriate speeds or accidentally use brake or gas pedals?

* Does the driver use signals incorrectly?

* Does they driver become agitated behind the wheel?

Confronting someone about their driving is tricky. Womack suggests offering to drive more often on trips you take
together; suggesting public transportation alternatives; and encouraging the driver to consult a physician. Some
driving difficulties are because of temporary, treatable conditions.

She recommends the booklet "Driving Safely While Aging Gracefully," published in 2000 by the USAA Educational
Foundation, AARP and National Highway Transportation Safety Association. Geared to the driver, it asks specific
questions about vision, physical fitness, reaction time and attention. Read "Driving Safely While Aging Gracefully" on-
line.
http://www.nhtsa.dot.gov/people/injury/olddrive/booklet.html

CONCERNED ABOUT A RELATIVE'S DRIVING SKILLS? This is the address to report people who family members or physicians
think should be reviewed by state officials: Division of Motor Vehicles, Medical Review Branch, 3112 Mail Service
Center, Raleigh, N.C. 27699. The division accepts only written, signed correspondence. Those with questions can call
861-3809.

TAKE A MULTIPLE-CHOICE TEST of your driving knowledge, find answers to some of the questions most often asked by older
drivers and, if you are 50 or older, get information on safe-driving courses from the AARP http://www.aarp.org/55alive

CALL AAA CAROLINAS for referrals to driving programs in North Carolina. (800) 888-3262, ext. 7883.

WATCH INSTRUCTIONAL VIDEOS at SeniorDrivers.org , the AAA Foundation for Traffic Safety's Senior Driver Web site. Go to
http://www.seniordrivers.org/home/index.cfm and click "Videos."

* * *

----------------------------------------------------------------------
To sign-off Parkinsn send a message to: mailto:[log in to unmask]
In the body of the message put: signoff parkinsn