Driven to keep driving

Slipping into the driver’s seat of her Dodge Spirit, Diana Ingalls buckles up and carefully reverses the car out her driveway in Nepean, Ont. Before long, the soft-spoken 84-year-old with closely cropped grey hair is cruising confidently along at 100 kilometres an hour, keeping pace with the cars around her in the city’s west end. Today’s destination is Ralph & Son’s Diner on Carling Avenue in Ottawa, her favourite spot to grab a bite to eat and chat to the waitresses who know her by name.

Having spent nearly 70 years behind the wheel of a car, Ingalls has difficulty imagining life without a driver’s licence. To her and 3.4 million other Canadians over the age of 65 who grew up with cars, independence comes with being able to drive. “There’s a feeling of freedom when you get into the car and take off,” Ingalls says. Yet, she knows the day will probably come when she will have to park her car for the final time. “I’d be devastated, but if I knew it was necessary, I’d have to come to terms with it,” she says.

But what if there was a way to keep seniors like Ingalls driving longer and driving safely? As various jurisdictions acrossNorth America have demonstrated, solutions exist. Restrictive licensing and senior-friendly road design have emerged as a way to strike a balance between keeping seniors mobile and roads safe. The alternative is for seniors to hang up the keys as their driving ability begins to wane. However, experts caution against unnecessarily stripping seniors of their licence. According to Dr. Shawn Marshall, a researcher at the Canadian Driving Research Initiative for Vehicular Safety in the Elderly, for some seniors it can lead to isolation, depression, loss of function and a tremendous blow to their self-esteem. “I have patients who are devastated,” he says. “For some of us like myself, driving isn’t important, but many people get their sense of who they are in driving.” For rural seniors, who often have no access to public transportation, driving cessation can also mean having to relocate, often leaving behind the family homestead. Becoming dependent is also a major concern among the elderly. Not surprisingly then, a driver’s licence is an emblem of independence to seniors.

An avid driver, Ingalls relies on her car on a day-to-day basis. It gets her to fitness classes, allows her to visit friends and ensures her basic needs, such as getting groceries, are met. For years, it was also a necessity in the care of her ailing husband, Ross, who has Alzheimer’s. Now that he has moved into a long-term care facility, she depends on her car to stay connected with him. While she acknowledges that she could get by without driving, relying instead on family, taxis and public transit, she says she would miss the convenience, flexibility and spontaneity that a licence provides. “I wouldn’t have the freedom to just get up and take off the way I do,” she says. “My life would change considerably.”

But in other provinces, seniors don’t necessarily have to be relegated to the passenger seat. Restrictive licensing, also known as de-graduated and conditional licensing, is in place in every province across the country except Ontario.

Based not on age, but rather on medical and functional condition, restrictive licensing allows people to continue to drive when health impairments would have prevented them from holding a regular licence. Although the type of restrictions can vary from place to place, according to licensing bodies across Canada, common conditions placed upon senior drivers include things such as daylight driving only and restricted areas, which allows a senior to drive a limited distance from home.

While the Ontario Ministry of Transportation prides itself on having some of the safest roads in North America, not everyone praises its approach to senior drivers. Raynald Marchand, traffic safety and training manager at the Canada Safety Council, calls the current licensing system an all-or-nothing approach. “In Ontario … you can drive in downtown Toronto or on (Hwy.) 401 and around the GTA or you can’t drive at all,” he says. An advocate for restrictive licensing, he wants to see it brought to Ontario. “It may be restrictions such as daytime hours. Many seniors would be fine with that. They can do their groceries, they can go to the doctor, they can visit their friends,” he says. “They retain some mobility as opposed to ‘Sorry, if you can’t drive in the GTA, you can’t drive at all.’ ”

Whether the Ontario Ministry of Transportation will ever implement such a system remains unknown, although spokesperson Bob Nichols says the effectiveness of conditional licensing programs is being evaluated. While little research has been done on the topic, a 2002 study co-written by Marshall suggests it works. The study compared the crash rate of Saskatchewan’s drivers who have restricted licences to the province’s general driving population and found that restricted licences significantly decreased crash rates and traffic violations. “We aren’t sure why it works, but it does seem to work,” Marshall explains. “As a physician, I’m fully in favour of it because I think bringing your driving environment in line with your abilities makes good sense.”

But should seniors even be allowed to continue driving when age-associated health problems can negatively affect their safety and that of others on the road?

Statistically, on a per capita basis, seniors are not high-risk drivers. However, measuring accidents per kilometre driven, older drivers – along with young drivers – are more likely than other age groups to be involved in collisions. According to the Canadian Council of Motor Transport Administrators, common mistakes among senior drivers are failing to yield the right of way, misunderstanding signs or traffic signals and miscalculating the speed of other vehicles. It says problem situations for older drivers include changing lanes and night driving.

Intersections in particular prove to be dangerous for seniors. According to a 1999 literature review by the Canadian Council of Motor Transport Administrators, half of fatal crashes involving drivers over the age of 80 occur at intersections, compared to 23 per cent for drivers 50 years and under. These findings, along with Statistics Canada’s prediction that one in five Canadians will be over age 65 by 2026, have left policy-makers wondering about the future of Canadian roads.

Across the border, age-related health impairments are being compensated for through road design. Although several states have recently begun to adopt senior-friendly engineering solutions, Florida has been leading the way since 1992 with its Elder Road User Program. Among the changes made there, advanced street name and warning signs have been added, and the width of lane marking has been increased. Reflective markers on the centre line have also been re-spaced. Lettering on signs has been increased in size to accommodate 20/70 visual acuity, where once it was designed for 20/40 vision.

While no studies have been done yet to determine whether Florida’s approach is working, motorists’ reactions to the changes, which were studied in the early 1990s, suggest they find the improvements helpful. While parts of the United States are making headway in the quest to make roads senior-friendly, Canada hasn’t followed suit. Eric Hildebrand, a professor of civil engineering at the University of New Brunswick, attributes Canada’s slow response to out-of-date national road design standards. He says the guidelines put in place in the 1950s were based on the “middle-of-the-road person” and failed to take into account the number of elderly drivers of the future. But he says even if Canada’s provinces and territories started updating roads tomorrow, it wouldn’t necessarily solve the problem – at least not immediately. “There are very few brand new roads being built these days so it would take a very, very long time for things like horizontal curvature and vertical curvature to be changed for seniors,” he says.

Ingalls says she would certainly welcome engineering changes that would help her navigate. Although she’s still a very capable driver, she admits her reaction time is slower than it once was and that she has to get closer to signs to read them. But whether policy-makers will adapt Canada’s roads and licensing practices for senior drivers in the coming decades remains somewhat of a mystery for now. For the time being, Ingalls isn’t worried about it. She recently passed the mandatory licence renewal process for senior drivers in Ontario and still considers herself to be a very capable driver. “There’s no use worrying about something that hasn’t happened,” she says philosophically. When the time does arrive, she says she hopes there are options like restrictive licensing available to enable her to keep driving. In fact, she says she’d even volunteer as a test subject. “If it means I can still drive, I’m prepared to be a guinea pig,” she laughs.