Aging Population Requires New Safety Initiatives

Accident and injury prevention on our roads would be promoted by graduated curtailment of the driver's license of seniors as they age.  This to be based on a program of driver testing.  And if we are going to curtail automobile mobility, our communities have to be designed around other options for senior drivers.  Politicians and urban planners take note!

All this flows from an article in the Canadian Medical Association Journal.  The CBC interviewed the editor on March 17, 2010 and it speaks to these road safety issues so well I reproduce it.

Jeff Gilhooly:        Well if you're a senior and you enjoy the independence of driving your own car, listen up, an article in this week's edition of the Canadian Medical Association Journal suggests that many people turn a blind eye to elderly motorists who should not be driving.  It goes on to say that a government run driving retirement program is long overdue.  The editor and chief of this journal is Dr. Paul Hebert and he's on the line.  Good morning.

Dr. Paul Hebert:    How are you?

Mr. Gilhooly:        Good.  Why do you think a driving retirement program for seniors is long overdue?

Dr. Hebert:            Well I think right now we have what amounts to a bit of a haphazard approach to this.  We basically need clear standards and a clear approach.  At present what we have is a system where doctors are mandated to report dangerous drivers in most provinces if they think they have a medical reason not to drive.  So the difficulty we have is doctors are not in a position to judge whether someone can drive or not.  We are basically our patient's advocate, we're there to help them, diagnosis them, treat them.  We're not driving testers.  So what we're advocating for is that governments be the gatekeepers and, you know, decide when or not to drive, and the doctors be basically the people who notify.

Mr. Gilhooly:        Is there recent research to suggest that people who are driving over the age of 65, or driving over the age of 75, aren't doing as safe a job as they once did or what's the basis for this?

Dr. Hebert:            No.  Let me put it to you this way, at some point in your life you will be unsafe to drive, you're not going to be driving, you know, at the end of your life.  So it's something we're all going to have to face, right.  Now just to be clear, I'm not saying every single driver, in fact, I'm saying the opposite.  We're not saying every single driver over the age of 65 is dangerous, in fact, the evidence is to the contrary.  What we're saying though is that by the time we hit 75 and 80 your health is an issue and you ought to be evaluated on a more regular basis, and your risk of having accidents dramatically increases, almost as bad as being a teenager.

Mr. Gilhooly:        But you know how this is going to be received by some seniors, I mean, we are such a car-oriented society that their, almost their entire independence is based on being able to get from A to B in a vehicle.

Dr. Hebert:            I completely agree.  First and foremost public safety as we said.  Secondly we need, and that's the second part of our editorial.  The first part is let's standardize the approach, you know, let's get rules in place, standardize the approach, make sure doctors aren't the gatekeepers, because that's not our job.  And the second part of this whole thing is really we need to keep our seniors as independent as we can as long as we can.  This is something that governments haven't stepped up to the plate to do, right.

Mr. Gilhooly:        Well programs like what?

Dr. Hebert:            Well, for example, making sure that these communities have, let's say, school buses that are used to basically help people get to their groceries.  There are programs like that in, for example, in Ottawa.  We need to make sure that, as you pointed out, that urban planners mandate that seniors be considered when they build buildings and communities, right.  Communities aren't seniors friendly these days, as you pointed out, where we've got urban sprawl and our communities in general are not designed to basically walk to get your groceries.

Mr. Gilhooly:        Do you think there should be like financial incentives, even tax breaks?

Dr. Hebert:            Yeah.  Well I think what we need is governments to consider this and to start, you know, a consultation process to determine what we need in place to basically keep our seniors independent, but at the same time to have programs into place to help them retire from driving.  So when I get there, I want to make sure that I have choices.  My choices aren't to drive or not to drive, my choices are first I will go to a conditional license, some form of, you know, de-escalation, I won't be driving on the highways when I'm 90 years old and I won't be driving at night, I'll be driving to my doctor's appointments only, hopefully not on a highway, you know.

Mr. Gilhooly:        Don't drive in rush hour.

Dr. Hebert:            Yeah, so rush hour, or in unsafe conditions like during, you know, like St. John's has a lot of fog and snow.

Mr. Gilhooly:        I get a sense in talking to you that some of this is coming from the aging of our population in 5, 10, 15 years where the bulk of our drivers, or the age of the bulk of our drivers may be, is that what's pushing this to some degree?

Dr. Hebert:            Well actually if you're asking me why we came up with this, well we came up with this when we talking around our editorial group and at least a few of us were facing this very issue with our parents.  So that's where the idea came from and all of us realize that this is something that is going to affect more and more of us as our population ages.  So yes this is going to become a big problem.  It's a problem now because it's not standardized and we have, you know, we have issues, we have problems because our doctors are gatekeepers to licenses as opposed to our patient advocates, we have problems because we don't have a standardized, you know, approach to identifying patients when we need to, to send them off for evaluation, we have problems because we don't have appropriate testing procedures, like government to decide whether people need to be, you know, maintained on the road or not or have a restricted licence.  So all the way around there are issues and it's going to become a bigger and bigger one as our population ages.

Mr. Gilhooly:        Dr. Hebert thanks for this.

Dr. Hebert:            Thank you very much for having me.

Mr. Gilhooly:        Bye now.

Dr. Hebert:            Bye.

Mr. Gilhooly:        That's Dr. Paul Hebert, he's editor and chief of the Canadian Medical Association Journal.  You can read the article online at their website, www.cmaj.ca.