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Independence and Safe Mobility: Keys to Health and Wellbeing for Seniors

Blue Shield’s Chief Health Officer Seth Glickman, M.D., offers tips and information for seniors and their families to stay vibrant in their independence and ensure safe mobility.

Independence and safe mobility are important aspects of health and wellness for seniors. That's why Blue Shield of California is collaborating with AAA Northern California to offer members help in maintaining their independence with a new innovative supplemental benefit package. These resources help support seniors with safe driving advice and education, computer-based simulation programs to help sharpen their driving skills, and roadside assistance. We asked Blue Shield Chief Health Officer Seth Glickman, M.D., for tips and information for seniors and their families to stay vibrant in their independence and ensure safe mobility.

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Dr. Seth Glickman

When should seniors consider a clinical driving assessment to prevent unsafe driving and/or getting into an accident?

It is important to feel awake, alert and aware of your surroundings when driving. Also, hand-eye coordination, reflexes and eyesight are critical. Certain chronic diseases (and the treatment for them) can interfere with one’s mental state, reflexes, and even eyesight.

Here are some conditions that may warrant a clinical driving assessment:

  • Some heart conditions, including rhythm problems, congestive heart failure, coronary artery disease, and more
  • Diabetes mellitus
  • Chronic lung disorders
  • Some clotting conditions, such as a history of clots in the leg (deep venous thrombosis), lung (pulmonary embolus) or brain (stroke)
  • Hardening of the arteries of the legs (peripheral vascular disease)
  • Problems with memory or cognitive ability, including Alzheimer’s
  • Cancer, especially if undergoing treatment
  • Some psychological conditions, such as anxiety or untreated depression
  • History of loss of consciousness, including fainting or syncope

Some medications that may lead to safety concerns include:

  • Any use of sedatives, such as sleeping medications taken other than just prior to bedtime (such as benzodiazepines), sedating antihistamines such as Benadryl and others
  • Certain antidepressants such as those in the Tricyclic class
  • Certain medications used to treat Parkinson’s (the anticholinergic class)
  • Some muscle relaxants
  • Some medications used to treat psychiatric disorders
  • Certain pain medications, such as narcotics
  • A small number of medications used to treat hypertension, such as methyldopa or clonidine
  • Any drug that appears to be associated with drowsiness, dizziness, slowed reaction time and movement, fainting, blurred vision, excitability, and inability to focus

Lastly, if a senior finds himself or herself driving in an unsafe manner, including:

  • Drifting into other lanes
  • Making sudden unnecessary lane changes or sudden stopping
  • Driving through stop signs or red lights
  • Becoming confused while driving
  • Experiencing close calls, near misses etc.
  • Experiencing denting or scraping of the car due to driving too close to objects

For family members who may observe these things, how should they talk to their loved ones about it?

There is no universal cut-off age when seniors should stop driving. However, if you begin observing any of the above warning signs, it is time to address the situation. Don’t wait for an accident to occur.

It’s important to be understanding of your loved one’s feelings, as most elders consider losing the ability to drive a major event that represents a loss of independence and self-sufficiency. Rather than forcibly taking away the car keys, suggest a driving test to evaluate an elder’s ability to operate a car safely and responsibly. Driving assessments are available at local Department of Motor Vehicles (DMV) offices. If your loved one fails the assessment, then it is time to forfeit driving privileges.

Please remember the following tips as you communicate with your family member:

  • Be respectful. Driving is often an integral part of independence. At the same time, don’t be intimidated or back down if you have a true concern.
  • Give specific examples. Instead of generalizations like “You can’t drive safely anymore,” outline specific concerns that you’ve noticed. For example: “You have a harder time turning your head than you used to,” or “You braked suddenly at stop signs three times the last time we drove.”
  • Find strength in numbers. If more than one family member or close friend has noticed, it’s less likely to be taken as nagging. A loved one may also listen to a more impartial party, such as a doctor or driving specialist.
  • Help find alternatives. The person may be so used to driving she or he has never considered alternatives. You can offer concrete help, such as researching transportation options or offering rides when possible.
  • Understand the difficulty of the transition. Your loved one may experience a profound sense of loss. Giving up the keys and not being able to drive can lead to isolation and depression. Try to help with the transition as much as possible. If it is safe, try slowly transitioning your senior out of driving to give him or her time to adjust. For example, your loved one may begin the transition by no longer driving at night or on the freeways, or by using a shuttle service to specific meetings, such as doctor appointments.

How can seniors prepare or continue to sharpen their driving skills for safe mobility?

In some cases, enrolling in a mature-driving course can help seniors brush up on their driving skills. Even the most experienced drivers can benefit from a driver-safety course. In these courses, elders will learn the current rules of the road, defensive-driving techniques, and how to operate a vehicle more safely in today’s increasingly challenging driving environment. Instructors can also make recommendations for managing and accommodating age-related changes in vision, hearing and reaction time.

Does it matter how many years of driving experience a senior has? And once they stop driving, does it affect their mental health since they no longer have this independence?

Researchers advise that intervention programs ensuring mobility and social functions may be needed to mitigate the potential adverse effects of driving cessation on health and well‐being in older adults.  

This is why Blue Shield is teaming up with AAA Northern California to help our Medicare members remain mobile and independent by continuing to drive, thereby contributing to better quality of life.