Older Adult Drivers

Although most older drivers are very safe drivers, as we age, we may experience changes in vision, physical fitness, and slower reflexes which can cause safety concerns. The risk of being injured or killed in a traffic crash also increases as we age.

Examples of aging-related conditions that may cause physical and cognitive changes include:

• Stroke
• Diabetes
• Neuropathy
• Arthritis
• Parkinson’s disease
• Alzheimer's disease
• Heart/lung disease
• Glaucoma
• Macular degeneration
• Loss of peripheral / night vision

As we age, certain medications may also affect our ability to drive safely. Medications could include:

• Pain medications
• Sleeping pills
• Seizure medications
• Muscle relaxers
• Anti-nausea medications
• Eye Drops
• Blood pressure and heart medications
• Any medication that can cause drowsiness, dizziness, blurred vision, muscle relaxation

If you have questions or concerns about any of your medications, talk to your care provider or a pharmacist. 

The Centers for Disease Control (CDC) offers some steps that you can take to stay safe on the road:

• Always wear your seat belt and never drive impaired by alcohol, drugs, or medicines.
• Discuss any medical issues with your doctor to determine if they might affect your driving.
• Discuss stopping or changing your medicines with your pharmacist or doctor if you experience any side effects that could interfere with safe driving, such as blurry vision, dizziness, sleepiness, confusion, fatigue, and/or loss of consciousness.
• Have your eyes checked by an eye doctor at least once a year. Wear glasses and corrective lenses as directed.
• Plan your route before you drive.
• Drive during daylight and in good weather when possible.
• Consider potential alternatives to driving, such as riding with a friend, using public transit, or using ride share services.
• Download and use CDC’s MyMobility Plan for tips and resources on how to stay mobile and independent as you age.

Additional Resources for Older Drivers

• In the Driver’s Seat: A Guide to Vehicle Safety Technology - This guidebook, created by the Hartford, will help you understand and use vehicle safety technology while you are in the driver’s seat.
• Your Road Ahead: A Guide to Comprehensive Driving Evaluations -  This guidebook, created by the Hartford, describes the benefits of having a comprehensive driving evaluation from an occupational therapist with specialized driver evaluation training.
• Print this resources list for older drivers to refer to when needed.

As we age, and we are all aging, we need to:

• Be aware of how and when changes to driver safety occur.
• Identify at-risk drivers in our lives.
• Have hard conversations and share concerns with at-risk drivers.
• Willing to take action and provide resources to make the roads safer for all.

Recognize warning signs

• Multiple-vehicle crashes, "near misses," and/or new dents in the car
• Two or more traffic tickets or warnings within the last 2 years; increases in car insurance premiums because of driving issues
• Comments from neighbors or friends about driving
• Anxiety about driving at night
• Health issues that might affect driving ability, including problems with vision, hearing, and/or movement
• Complaints about the speed, sudden lane changes, or actions of other drivers
• Recommendations from a doctor to modify driving habits or quit driving entirely

Have conversations with older drivers

1. Collect Information

The first step requires family and friends to collect information about what is happening with the older driver. This takes time and may require gathering information from a variety of people who have opportunities to observe the older person’s driving.

A word of caution: It is not uncommon for families, caregivers, and friends to be wrong in their judgment of a driver’s risk or driving ability. A person’s driving performance – not age – is what determines fitness to drive.

2. Make a Plan

Once you have collected information, sit down and talk with the person to determine:

• Is the person driving safely within the acknowledged limits of his or her capabilities?
• If there is a problem, is it correctable?
• Do other transportation options need to be identified?

3. Having "The Talk" about driving

• Avoid confrontation. Use "I" messages rather than "You" messages.
  Example: You might say, "I am concerned about your safety when you are driving," rather than, "You're no longer a safe driver.“
• Stick to the issue. Discuss the driver's skills, not his or her age.
• Focus on safety and maintaining independence. Be clear that the goal is for the older driver to continue the activities he or she currently enjoys while staying safe. Offer to help the person stay independent.
  Example: You might say, "I'll help you figure out how to get where you want to go if driving isn't possible.“
• Be positive and supportive. Recognize the importance of a driver's license to the older person. Understand that he or she may become defensive, angry, hurt, or withdrawn.
  Example: You might say, "I understand that this may be upsetting" or "We'll work together to find a solution."

Interested in learning more? Take AARP's We Need To Talk Seminar online.

4. Follow through on plan

Older adult drivers should be deeply involved in every step of their transportation planning and implementation process.

Doing so demonstrates that family members respect the older person’s opinions and needs, are genuinely concerned about the older person’s safety, and have given the issue significant thought, time, and attention.

Be sure to review the plan periodically.

5. Provide resources

Learn about local services to help someone who can no longer drive. Identify the person's transportation needs for errands, health care, social events, and others. A printable list of resources for older drivers can be found online. 

For more information, watch our webinar recording from the "Road to Mobility" Webinar Series focused on how caregivers and loved ones can support the older drivers in their lives. 

Additional Resources

• We Need to Talk Course – AARP
• How to Understand and Influence Older Drivers – National Highway Traffic Safety Administration
• Talking to Older Drivers about Safety Concerns – National Institute on Aging
• Family Conversations with Older Drivers – The Hartford
  • We Need to Talk… Family Conversations with Older Drivers Guidebook – The Hartford
• Dementia and Driving – The Hartford
  • At the Crossroads: Family Conversations about Alzheimer’s Disease, Dementia, and Driving Guidebook – The Hartford
• Family Caregiver Support Groups & Resources: Family caregivers are critical to the success of seniors and people with disabilities living in the community. If you need support as a caregiver, learn more from the Vermont Department of Disabilities, Aging, and Independent Living, contact your local Area Agency on Aging, or dial 2-1-1 to be connected with resources.
• A print-friendly resources guide for caregivers and loved ones is available online.

An important part of keeping older adults safe on the roads is a strong provider-patient relationship. Discussing driving can be a difficult topic to address if there is risk of damaging this relationship, violating patient confidentially, or losing patients.

However, health care professionals need to be able to recognize the age-related conditions that can influence an older adult’s driving ability and be familiar with resources that can help older adults maintain their driving skills and keep older drivers safe.

By exploring the many resources and becoming knowledgeable in these areas, health care professionals can contribute to the safety of both older drivers and the public.

• As a health care professional, there are some legal and ethical duties relevant to the issue of driving. More information on legal and ethical duties are available through the National Highway Traffic Safety Administration.
• Additionally, being aware of medication reactions is essential. The American Geriatrics Society 2019 Updated Beers Criteria^®, updated from 2015, are designed to reduce older adults' drug-related problems including, but not limited to exposure to potentially inappropriate medications, drug-disease interactions, and medications that warrant extra caution in the older adult population. 
• The Centers for Disease Control offers Timed Up and Go tests to help test patients' mobility. 
• If you are concerned, you can refer your patients to Drivers' Rehab Programs or be re-tested through the Vermont Department of Motor Vehicles. Drivers' Rehab Programs are available through Rutland Regional Medical Center, Adaptive Driving Associates, and UVM Medical Center. 
• Refer to this print-friendly resources guide for health care staff, caseworkers, and caregivers.

Print-friendly Resources for Patients

• Download and print the CDC’s MyMobility Tool for tips and resources for older patients to stay mobile and independent as they age.
• Provide your patients with the Health Department's Older Driver Resources list.

In 2020, the Centers for Disease Control estimated that there were almost 48 million licensed drivers ages 65 and older in the United States. This is a 68% increase since 2000, and this number is expected to increase more in the coming years. Law enforcement officers must understand and address the needs of the older driver population, provide resources, and interact efficiently and appropriately to respond to challenges to highway safety.

It can be challenging for law enforcement to cite or refer drivers because you may not want to take away an older driver's mobility and independence. We can, however, work together to make the roadways safer for all. 

Roadside information

• Learn more about tools you can use for roadside screening. The Driver Orientation Screen for Cognitive Impairment offers one example.
• If you are concerned about an older driver at a roadside stop, you can refer drivers to be re-tested through the Department of Motor Vehicles. 
• You may also wish to print out this red-flag reporting card for medically at-risk drivers to have handy in your patrol vehicle.

Additional Resources

• The Clearinghouse for Older Road User Safety has additional resources and information for law enforcement officials. 
• Find more resources for older drivers in the print-friendly Older Driver Resources Guide from the Health Department.
• For more resources, check out the resources guide for law enforcement and public safety officials

Vermont is one of the fastest aging states in the nation. Local leaders must proactively prepare for the unique needs and challenges of an aging population. Preparing our communities for an aging population is particularly true in our rural areas where over 65.3% of older Vermonters reside. This is the highest percent of older people living in rural areas in the U.S. (2012-2016 American Community Survey (ACS) data). 

Older Vermonters living in rural Vermont have difficulty accessing health services and emergency care, are more likely to face loneliness and social isolation, and lack access to alternative transportation options including safe places to walk — in fact, from 2011-2020, 51% of pedestrians killed on our roadways were over 60 years old.

Dementia-friendly communities

Additionally, according to the Vermont Alzheimer's Association, upwards of 13,000 Vermonters have Alzheimer's disease or another form of dementia, and more than 25,000 friends and family are providing care. Most people living with a form of dementia currently live in their community homes and community leaders need to prepare for the unique needs and challenges faced by people living with dementia.

One way for local leaders, businesses, faith organizations, and community groups to become more accessible to people with dementia is to become a Dementia Friendly Community. A Dementia Friendly Community is informed, safe and respectful of individuals with the disease, their families and caregivers and provides supportive options that foster quality of life. Learn more about how you can make your community dementia-friendly.

Accessible design

Accessible design is necessary for some people and useful for all people. Streets with curb cuts and ramps that are accessible to people using a wheelchair are also useful for people pushing strollers. Communities that are designed for older adults also tend to be safer for younger children. Some requirements under the Americans with Disabilities Act (ADA) include curb ramps, truncated domes (detectable warnings), and minimum widths for sidewalks. All new or reconstructed sidewalks or shared paths open to public travel by pedestrians must meet standards for accessibility. Find more information about pedestrian standards from the Agency of Transportation.

Livable communities

To support older people, we need to create communities that are safe, accessible, and walkable, with age-friendly transportation and housing options where older people can easily get to grocery stores, doctor’s appointments, and other essential services and fun activities. Learn more about how you can create Livable Communities from AARP.

Additional Resources

• Resources guide for local leaders and decision-makers containing information and grant opportunities across Vermont and national
• VTrans ADA Program Resources & Useful Links
• Handbook for Designing Roadways for the Aging Population
• AARP’s Livable Lingo: A Livability Glossary
• AARP’s 7 Ways to Make Communities More Livable for People With Vision or Hearing Impairments
• Universal Design

This video series demonstrates some considerations for designing sidewalks for all members of your community.

• Accessible Sidewalks: Pedestrians who use Wheelchairs
• Accessible Sidewalks: Pedestrians with Ambulatory Impairments
• Accessible Sidewalks: Pedestrians with Low Vision
• Accessible Sidewalks: Pedestrians who are Blind

If you are interested in having training offerings related to older driver safety or improving accessibility for your business, health care office, municipality, community, and/or organization, please get in touch with the Older Driver Program Director: Andrea Spinale

Road to Mobility Webinar Series Recordings (2022)

The Road to Mobility Webinar Series: Keeping Older Drivers Safe, Mobile, and Independent

This free webinar series that ran from April - June 2022 – sponsored by AARP Vermont, Vermont Highway Safety Alliance, University of Vermont Medical Center, Vermont Department of State's Attorneys & Sheriffs, Rutland County Sherriff's Department, Vermont Criminal Justice Council, Vermont Department of Motor Vehicles, Vermont Department of Disabilities, Aging, and Independent Living, Vermont Agency of Transportation, and Vermont Department of Health –  explored how we can all play a role and take action in keeping older Vermonters safe, mobile, and independent while also ensuring our roadways are safe and our communities are accessible and livable for all. Watch the recordings at the links below:

• Watch the recording from the first session for Caregivers and Loved Ones.
• Watch the recording from the second session on Law Enforcement's Role in Older Driver Safety.
• Watch the final recording on Policymakers and Local Leaders: Creating Safe and Livable Communities. 

PowerPoint slides are available by request. 

Driver rehab programs

• UVM Medical Center - Driver Rehab Program, Burlington: The University of Vermont Medical Center occupational therapists who are specially trained as driver educators can help you get back on the road again. Call: 802-847-3140
• Central Vermont Medical Center - Clinical Driver Assessments, Berlin: The Clinical Driving Assessment program offered by CVMC Rehabilitation Therapy services, in collaboration with the Driver Rehabilitation program at The University of Vermont Medical Center, is a comprehensive clinical assessment for those who may be at a high risk for an automobile crash. Call: 802-847-3140
• Rutland Regional Driver Assessment Program, Rutland: Specially trained therapists provide screening services to ensure you have the ability to drive safely. RRMC evaluates your vision function, visual perception, cognitive function, strength, range of motion, reaction time, on-the-road abilities and the need for adaptive equipment. Call: 802-772-2490
• Adaptive Driving Associates, White River Junction: Certified driver rehabilitation. Call: 802-296-2004

Safe driving programs

• Vermont DMV: Mature Drivers, Statewide: The Vermont Department of Motor Vehicles strives to keep mature drivers on the road as long as possible with a primary concern of safety to all. Whether you are a neighbor, family member, or concerned friend, you have an important opportunity to make the roads of Vermont a safer place to drive. Call: 888-970-0357
• AARP Smart Driver Course: The AARP Smart Driver course is the nation’s first refresher course specifically designed for drivers age 50 and older. In many states, drivers may benefit from a discount on their auto insurance premium upon completing the course. And you will learn something new along the way. www.aarp.org/auto/driver-safety/driving-assessment
• AAA RoadWise Driver Program: a senior defensive driving program is an online course designed to positively affect driving behavior and help you learn about and adjust to age-related physical changes. AAA’s driver improvement courses may be offered through the classroom, online or both.
• Vermont Safe Driver Program - Community Justice Centers of Vermont: Safe driving is a community responsibility and the Safe Driver Program allows participants to engage in exercises that illustrate the financial, personal and emotional impact of unsafe driving on the driver, their family, and on others who have been harmed by or lost a loved one during a crash. State attorneys and Diversion Staff can refer people to this program as part of a Civil DLS Diversion Program. You can also contact your local Community Justice Center to enroll. 

If driving is no longer an option for you or a loved one, there are many alternative transportation options in Vermont to help older people stay mobile and independent. 

• Rides In Sight provides information about senior transportation options in local communities throughout the United States. ITNAmerica researched communities nationwide to build a database of senior transportation options.
• The Vermont Public Transportation Association provides mobility choices for seniors (60+) and people with disabilities through various funding programs. These programs help Vermonters remain independent and active within their community.
• The Vermont 211 database contains detailed descriptions of programs and services available to Vermonters that are provided by local community groups, social service and health-related agencies, government organizations, and others.
• Comprehensive Guide on Transportation for Older Adults: This guide from SeniorLiving.org has useful resources & apps for getting around and covers plenty of ways for older people to travel locally, nationally, and internationally.

• Vermont Areas Agencies on Aging: These agencies offer information and help to Vermonters age 60+ and their families. Call 1-800-642-5119 to connect to your local agency.
• Vermont 211: a database that contains detailed descriptions of programs and services available to Vermonters that are provided by local community groups, social service and health-related agencies, government organizations, and others. Call: 2-1-1
• Vermont Department of Disabilities, Aging, and Independent Living (DAIL): The Adult Services Division (ASD) is responsible for the management and oversight of a full array of long-term services and supports for older Vermonters and adults with physical disabilities. The ASD supports Vermonters to live as they choose, pursuing their individual goals and preferences within their chosen communities. Call: 802-241-0294
• Vermont Center for Independent Living (VCIL): VCIL works to promote the dignity, independence and civil rights of Vermonters with disabilities. Like other independent living centers across the country, VCIL is committed to: services for all disabilities; promotion of active citizenship; and working with others to create services that support free-choice and full participation in community life.

• Older Drivers: Stay Safe Behind the Wheel – Centers for Disease Control and Prevention (CDC)
  • CDC MyMobility Plan: This mobility planning tool can guide you to take action today to help keep yourself—or your loved ones—safe, mobile, and independent today and in the future. 
• Older Driver Safety Page - National Highway Traffic Safety Administration
• Older Drivers – National Institute on Aging