Mary G., 72, was the primary caretaker and chauffeur for her 78-year-old husband who suffered from declining vision and heart problems. Although Mary was in excellent physical and mental health, she started having small fender-benders on a fairly regular basis.

Mary's family soon noticed the dents and scratches on her car and suggested she have her reflexes tested. When the tests showed some decline in responses, they discussed how she might get along without a car. Mary and her husband decided to sell their suburban house and take an apartment in the city, which offered more public transportation options. It turned out to be a wise decision. Mary's family worked downtown and they even came to visit Mary and her husband more frequently.

"Giving up driving for a senior citizen is a major event, almost like when a person first gets a license," says Scott Spier, MD, chief of the Division of Psychiatry at Mercy Medical Center in Baltimore, Maryland. It represents a loss of mobility, which leads to a sense that independence, competence, and well-being are compromised.

Knowing When to Hang Up the Keys

According to Barbara L. Spreitzer-Berent, gerontologist and president of Quest Learning Resources in Detroit, Michigan, senior citizens and their families can tell if an older person should start thinking about giving up his or her driver's license by answering the following questions:

  • Has there been a pattern of close calls, violations, or minor collisions?
  • Do you have trouble spotting pedestrians, signs, or other objects?
  • Are you surprised by passing cars or do you brake harder than normal for hazards, stop signs, or stopped traffic?
  • Have you gone through red lights or stop signs? Have you backed into or over things or run into curbs?
  • Are you having trouble coordinating hand and foot movements?
  • Is the glare of oncoming headlights causing more discomfort?
  • Do you have trouble turning your head, neck, and shoulders as you back up?
  • Are you more nervous behind the wheel?
  • Do you experience increased anger or frustration while in the car?
  • Are you quickly fatigued from driving?
  • Do you lose your way, even in your own neighborhood?
  • Do you get lost or make poor or slow decisions in traffic?
  • Have you ever hit the accelerator instead of the brake?
  • Are other drivers honking, tailgating, or passing you aggressively?
  • Do you take medication for a medical condition which may impair your driving? These conditions often include multiple sclerosis , Parkinson's disease , amyotrophic lateral sclerosis (ALS), seizure or sleep disorders , or uncontrolled diabetes .

Too many "yes" answers could mean an older person may not be able to handle the vehicle in an emergency situation. Experts also say it's not a good idea to rely solely on the state testing agency that tests drivers and issues driver's licenses. People who have reflex problems can squeak by and still pass the test.

Testing Driving Ability

To get a better idea of an older person's driving skills, rehabilitation centers and insurance companies offer tests that objectively rate driving ability. Moreover, some senior centers, hospitals, retirement communities, and civic organizations offer driver improvement programs for seniors who never really learned good motoring habits—but are perfectly capable of doing so.

Starting the Discussion

Many family members rely on the older driver's doctor to let him or her know it might be time to think about giving up the car. The physician considers muscle strength, eye sight, reflexes and general overall health, along with questions about close calls in traffic.

"When a relative notices the senior's car is chronically bumped and dented, it may be a good time to gently inquire about his or her driving skills," Dr. Spier says. But the best way to approach the topic, according to Spreitzer-Berent, is tactfully.

Don't just blurt out: "You're 87 years old, Dad. You're just too old to drive anymore!"

Instead, try: "Dad, I'm a little worried. I noticed a lot of new dents and scratches on your car. What's been happening?" You may even find that Dad is relieved to talk about it.

If early symptoms of Alzheimer's disease or dementia become evident, Dr. Spier suggests it may be kinder to hide the car keys or even disconnect the battery so the car can't start. Because these early symptoms are accompanied by a fair degree of frustration, hiding the keys might cause a tantrum or outburst, but it will pass quickly.

Getting Around Without a Car

Buses, taxis, and vans operated by senior citizen centers, hospitals, municipal transportation systems, and retirement centers are very helpful. Many seniors also count on family and friends for rides. Dena S., a woman who stopped driving about two years ago has a standing "date" with her 25-year-old granddaughter.

"She picks me up on Saturday mornings and I have a list of errands that I need to do. We finish up around noon and I take her to lunch. It gives us an opportunity to catch up on family gossip, her life, and makes me feel young again."

For seniors on a fixed income, giving up the car is also cost effective. "When you add up all the costs associated with owning your own car, it is usually much more cost-effective to take a taxi," says Dr. Spier.

It may not be necessary to give up driving altogether. If poor vision becomes a problem, an older relative can plan to drive only during the day. If a senior motorist tires easily or gets disoriented in new places, he or she can concentrate on doing errands that are closer to home.

Many Seniors Drive Just Fine

It is not true that all seniors should stop driving.

"Numerous national studies paint a more positive picture of mature drivers than many expect," says Spreitzer-Berent. "Reports show that mature motorists are not involved in a disproportionate number of car crashes."

And in fact, insurance rates reflect this fact. In most states, drivers under age 25 pay higher premiums than drivers over age 65.

Stress and fatigue may cause some fender-benders among older drivers. The Visiting Nurses Association of Westchester County has compiled the following exercises to relieve aches, pains, and tension. These can be done in a parked car.

  • Chin Extension Exercise
  • Keep head facing forward. Bend your head forward, touching chin on chest and hold for five seconds.
  • Bring head back to center. Tilt head backwards as far as comfortable and hold for five seconds.
  • Neck Rotation Exercise
  • Turn neck as far right as comfortable and hold five seconds.
  • Turn neck as far left as comfortable and hold five seconds.
  • Look straight ahead and bend head to left as though trying to touch your ear to your left shoulder. Hold five seconds.
  • Face center and bend head to right as though trying to touch your ear to your right shoulder. Hold five seconds.
  • Don't do these exercises if you feel discomfort. Use your judgment. The important thing is to recognize your individual needs as muscles, reflexes, and attention span gradually slow down with the aging process.