Robert Abel, Jr., MD
Robert Abel, Jr., MD, ophthalmologist, Christiana Care Health System, Wilmington, Delaware, and former professor of ophthalmology at Thomas Jefferson University, Philadelphia. He is author of The Eye Care Revolution.
Driving may be the most hazardous thing that most of us do each day, but simply growing older—or having a chronic medical condition, no matter what your age, that affects your vision, thought process or physical abilities—doesn’t mean that you can’t continue to be independent.
To drive safely as long as possible: It’s crucial to proactively avoid problems that can limit your car-handling competence. Here’s how…
Beyond commonsense imperatives such as getting regular medical, vision and hearing checkups, a few simple steps will help ensure that your driving abilities are intact.
At your checkup with your primary care doctor, have a candid talk to discuss any medical conditions you may have that could affect your driving now or in the future.
For example, a stroke may result in lingering visual or movement problems…diabetes might be causing neuropathy in your feet, making it difficult to feel the gas or brake pedals…and cataracts, macular degeneration or glaucoma may limit vision if it’s not carefully treated. A conversation with your doctor can help you minimize these issues and prevent them from becoming a bigger problem down the road. Also…
Some prescription or over-the-counter medications can impair your ability to drive by triggering drowsiness, cutting concentration, inducing shakiness or uncoordinated movements, or increasing your reaction time. Taking multiple drugs—a common practice among older adults and those coping with chronic medical problems—can make matters even worse by amplifying medication side effects. Certain dietary supplements, such as melatonin or valerian, may also have an effect.
What to find out: Show your doctor or pharmacist a list of all the medications (prescription and over-the-counter) and dietary supplements you take, and ask how they interact and may affect your driving abilities. Also: Ask if the timing of when you take any drugs or supplements that may affect cognition or coordination can be altered—for example, taken before bedtime instead of in the morning.
Important: If you are on painkillers or narcotics, also ask your spouse or a trusted friend if the medication makes you “loopy”—an effect that you may not notice but is perhaps obvious to another person.
Age can compromise your eyesight and bring physical changes that make it more difficult to see the road while driving—for example, many people lose one to three inches of height due to bone loss and spinal compression. Or a stroke or an eye condition (such as cataracts) may affect your peripheral vision, interfering with your ability to spot traffic alongside your car. To address these changes, it helps to customize your car. Here’s how…
• Set power seats at the highest level. Also, consider adding a firm cushion (such as the durable type used for outdoor furniture) to the driver’s seat so that your chin is at least three inches higher than the top of the steering wheel.
• Use extra (or bigger) mirrors inside and/or outside your car to increase your field of vision. For example, you can get a mirror that attaches to your rearview mirror to expand your view to the rear. Or you can get bigger mirrors or extra mirrors that can be bolted onto existing side mirrors or the side of the car itself. Check with your car dealer for details for your make and model.
• Keep your headlights clean. Also, consider replacing the bulbs—even before they burn out. The bulbs get dimmer before they’ve completely burned out.
• Opt for automatic. If you’re buying a new car, be sure to get one with automatic transmission, power steering and power brakes, which don’t require as much strength to operate. Also, consider a car with backup alert sensors, which detect objects in your blind spots.
A driving refresher course (ideally taken every three to five years) will keep you up to date on the newest traffic rules and can reduce road mishaps.
Good news: Some car insurance companies even lower premium rates if you take one of these courses, which usually lasts four to eight hours. Good choice: A course such as those offered by AAA or AARP is likely to have an instructor who is well-versed in issues facing older adults—as well as classmates who are true peers. If you are interested in taking a driver course because of a medical condition, consult The Association for Driver Rehabilitation Specialists (click on “CDRS Provider Search” under “Directory & Services”) to find a program near you.
When it comes to hitting the gas and brake, what’s on our feet can be just as important as our ability to see and react. Consider these important footwear-related issues…
• Choose the right sneaker. Running-style sneakers with soles that are thick, chunky and/or beveled can catch on pedals as you move your foot, so opt for a flat sole, such as a tennis-style or walking sneaker.
• Go for thin soles. People with diabetic neuropathy or limited foot sensation should wear thinner-soled shoes while driving. Thin soles, which don’t have much padding between the bottom of the feet and the car pedals, give you a better sense of how hard you are pushing the brake and accelerator.
Important: Be sure to choose a car that “fits” you well—with good sight lines to the sides and rear…controls that are easy to reach…and a model that is easy for you to get in and out of.