Published online by Cambridge University Press: 19 May 2010
“It's getting very hard for me to drive at night. I don't like to go out because I don't think it's safe. Is there something you can do to help me?”
“You have to talk to Dad about his driving when you go in. He almost hit someone the other day, and I don't feel like he can take the children out anymore.”
“My neck is so sore from that fender-bender. The emergency room said that I had to come in and see you if the pain didn't go away after a few days.”
Almost every health care practitioner who cares for older adults has heard a variation on one of these statements. Driving is an essential instrumental activity of daily living for young and old alike in this highly mobile society, but it becomes increasingly difficult to maintain with normal aging changes and potential comorbid medical conditions. Prevention, detection, and treatment of impaired driving ability is challenging in most health care settings for many reasons, including symptoms that do not fit typical medical paradigms, lack of familiarity with effective assessment techniques, and time constraints. Concerns about significant legal and ethical questions may also deter the health care provider from addressing the issue of driving. Early intervention is important, however, to prevent injury, unnecessary disability, and the potential loss of driving skills/privileges, with ensuing adverse effects on quality of life. With the rapid increase in the population of older adults, it is estimated that 25% of drivers will be older than age 65 by the year 2030.