Making a decision about when it’s time for a loved one to stop driving can be difficult, especially because there’s no set age that tells you when it’s no longer safe. However, a new online tool – also known as a driving decision aid (DDA) – is meant to support an individual’s values and help them make an informed decision about driving with confidence.
According to a recent randomized clinical trial published in the Journal of the American Geriatrics Society, 301 participants with an average age of 77 without cognitive impairment who viewed and used the online tool, had less internal conflict about their driving decision—and made one based on what felt right to them.
The tool presents key information, including options (with risks and benefits of each) that helps a person clarify their own feelings or values, Marian Betz, MD, MPH, professor of emergency medicine and epidemiology at the University of Colorado Anschutz Medical Campus and corresponding author of the trial, told Seasons.
The online tool is split into six sections: “Get the Facts,” “Compare Options,” “Your Feelings,” “Your Decision,” “Quiz Yourself,” and “Your Summary.” Some statements users could address throughout the online tool include: “I’m worried about getting into an accident,” “I feel sure of myself when I drive,” “I feel nervous and scared when I drive,” and “I’m afraid my driving might lead to someone else getting hurt.”
“It’s a ‘decision aid,’ which is a type of tool commonly used for decisions like choosing cancer treatment,” Betz said. “It doesn’t tell a person if they need to stop driving or not; rather, it helps the person make the decision that feels right to them.”
It doesn’t tell a person if they need to stop driving or not; rather, it helps the person make the decision that feels right to them.
Mary Winners, BSBA, CPG, a gerontologist and founder of About Seniors Solutions, who was not part of the clinical trial, said participants were given a Decision Conflict Scale score, which measures personal perceptions in making a decision by providing information that gives more certainty to that decision.
“The process [used in the clinical trial] is value-based and assists in allowing a person to feel they made the best decision for them personally,” Winners said. “From what I understand, it is a series of questions to support decision-making in regard to an individual’s ability to drive or not.”
The researchers noted the sample they studied was intentionally older drivers who were generally healthy and wanted to keep driving. They will be following participants for up to two years to see how things change over time, including whether the decision aid is associated with actual decisions to drop driving, Betz said.
Benefits of using the Driving Decision Aid tool
Research shows driving is extremely important for older adults because it gives them a sense of independence, mobility and freedom. Additionally, stopping driving can be frightening for most seniors and in some cases lead to negative outcomes like depression or isolation, according to Betz. However, she said having access to a tool like DDA can have some benefits.
“Older adults want to make the decision themselves when possible and have time to prepare. A tool like this can help a person make an informed decision that’s in line with their own preferences,” she said. “Hopefully, that kind of ‘good’ decision (i.e., that feels good to the person) would be associated with less depression or anxiety.”
Winners added using the DDA tool can educate older adults about driving awareness, help them find additional support to improve their driving skills, and support their decision on whether or not driving remains safe for them.
“Some older adults surrender their keys willingly, while others lack insight into their driving capacity or fear the results of becoming landlocked, dependent, isolated or neglected,” Winners said. “This tool could help physicians, other professionals and families start the conversation about driving safety.”
How caregivers and older adults can make a driving decision
Caregivers and older adults should start thinking ahead to the future and make a plan regarding driving and transportation, particularly because most older adults outlive their safe driving ability by about seven to 10 years, Metz said. It’s also important to address driving if loved ones are showing warning signs.
Some questions to consider when you start the conversation about driving include: Who would they trust to help them decide? And what are other transportation options for getting to the places they need to go, like the grocery store, doctor’s office, religious services or community gatherings?
“When the time comes for the transition, caregivers and family members can help put that plan in place and provide emotional support because ‘hanging up the keys’ can be a sad, stressful event,” Metz said.
Other tools beyond the DDA tool are also available that can help caregivers and older adults make driving decisions:
- Driver 65 Plus: Check Your Performance: This is an online booklet designed by the American Automobile Association (AAA) on self-assessing your driving skills due to your concern or the urging of family and friends.
- Online driving programs: Similar to teenage driving programs, there are driving classes and training programs for seniors. If you take any classes, make sure they are approved by the Department of Motor Vehicles (DMV).
- American Association of Retired Persons: AARP offers resources for testing driving safety and can help families have those critical conversations.
- Support programs from universities: Some universities offer training and support programs for seniors and others affected by medical conditions or accidents to regain the functionality to drive.
- DMV: The DMV in your state should also provide guides and programs to seniors on driving safety.
Caregivers and adults of all ages should additionally ask about or look out for vision, strength, reflex, thinking and hearing impairments that can all affect driving ability, Metz said. Many conditions are treatable and occupational therapists can help with adjustments to vehicles (like bigger mirrors) so people can keep driving safely.
“If a senior truly should not drive, a plan to get essentials, maintain socialization, and go to important appointments should be created,” Winners said. “Community transportation and support from family and friends are essential to support independence, physical and emotional well-being of the seniors who may lose their license to drive.”