Older drivers’ dilemma: when is it time to quit?

For many seniors, their independence – and even their self-worth – is linked to having a driving licence.

Getting a licence in the first place is often seen as a coming-of-age event, so taking that licence away can be equated with taking away a person’s identity.

As we age, deciding – or having the decision made for us – that we are too old to drive is an emotional issue that has practical everyday ramifications for older drivers, their families, and the broader community.

With the proportion of Australians over 65 expected to reach 23% by 2050, many more seniors will face the prospect of losing their ability to drive.

In some states, drivers aged 75 and older must complete a medical assessment to determine whether are safe to drive. Surprisingly, there is no standardised diagnostic tool for GPs to use. 

A recent crash on the Gold Coast has again raised community questions about older drivers potentially endangering the lives of others.

A five-year-old girl suffered serious head injuries and a pedestrian was injured when a car, with an 87-year-old behind the wheel, mounted the kerb in reverse.

In 2018, six-year-old Indie Armstrong died on the Sunshine Coast after a car driven by an 86-year-old reversed into her family at a shopping centre.

University of Queensland emeritus professor and general practitioner Geoff Mitchell said doctors relied on “blunt instruments” such as basic memory tests when determining a person’s fitness to hold a driver’s licence.

He said a memory test is good at picking severely unwell people, but it's not very good at testing judgement.

“You have to make a call based on their physical appearance – how quickly they walk into the surgery and how sharp they are," he said.

About 472,000 Australians are living with dementia, but Dr Mitchell said many older drivers who have trouble with memory and judgement are capable of controlling a vehicle.

The Navigating Fitness to Drive program, developed by the University of Queensland, could provide a standardised way of assessing a driver’s ability.

The program uses dashcam videos of real-life situations to assess the reaction times of people with dementia.

If a driver's reaction times are too long, it provides evidence for GPs to recommend against them having a driver’s licence.

The requirements for older drivers vary in different states and territories.

Victoria, Tasmania, South Australia, and the Northern Territory are the only jurisdictions that do not mandate medical checks for drivers, regardless of age. SA drivers from age 75 are mailed an annual self-assessment to evaluate their driving ability to drive.

Drivers aged over 75 in New South Wales and the Australian Capital Territory must get an annual fitness-to-drive approval from a doctor, while in Western Australia, that applies from the age of 80.

In Queensland, drivers over 75 need to carry a GP-signed Medical Certificate for Motor Vehicle Driver Form, which remains valid for one year.

Regardless of age, doctors and drivers must report medical conditions that can affect a person’s ability to drive, including dementia, stroke, seizures, epilepsy, vision problems, heart disease, and some psychiatric and sleep disorders.

Health professionals can also impose conditions restricting people’s ability to drive on highways, at night, or outside a 10-kilometre radius of their home. This applies to people undergoing medical treatments and for those with chronic conditions.

Experts are split on the effectiveness of mandatory testing. UQ psychology professor Nancy Pachana said age does not equate to a poorer driving standard.

She told ABC News that healthy, older motorists have the advantage of their experience, making them “among the safest drivers”.

Dr Mitchell said it was not a feasible long-term solution to impose mandatory practical tests on each licence renewal.

He said it was important for families to have sensitive conversations with their older loved ones about their driving.

"You don’t just drop it on them,” Dr Mitchell said. “Get them thinking about it so that, when the day comes, it’s not coming completely out of the blue.”

Professor Pachana encourages older drivers to keep in mind that a shift from driving their own car opens up other options such as public transport and ride-sharing.

“This is a major transition, but needn’t be framed as a loss of independence,” she said.

Professor Pachana said driving independence doesn’t just affect those in the later stages of life.

“As a society, we need to better support the entire range of people needing better public transportation – people with disabilities, people who for whatever reason cannot drive or maintain a private vehicle.” 

Related reading: UQ, ABC