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Experts Offer New Insights into Senior Driving Safety

Experts Offer New Insights into Senior Driving Safety

The AAA Foundation for Traffic Safety is a not-for-profit organization whose mission is to prevent traffic deaths and injuries through research and education. The foundation has conducted many studies on older drivers, with the two-fold mission of extending the driving years of older adults, while ensuring they are safe drivers during those years.

The emphasis on safety is important. According to the foundation, 42 million senior drivers are on the road. Many are dealing with health conditions that make driving less safe, such as mental and physical impairments, vision and hearing problems and sleep disturbances. 200,000 drivers age 65 and older are involved in crashes each year, with 3,500 fatalities among them.

Extending driving abilities is also important. The foundation’s executive director, Dr. David Yang, says that when seniors can no longer drive, they frequently become less socially and physically active. “Older adults who give up the keys are more likely to suffer from depression than those who remain behind the wheel,” said Yang. “It is important that we find ways to keep older drivers in good physical health in order to extend their mobility.”

Here are some of the foundation’s most recent tips for senior drivers.

Exercise for driving safety

Arthritis, range-of-motion limitations, back pain and other health conditions that are more common as we grow older can make it unsafe to drive. Fortunately, many of these conditions can be improved, managed and even delayed by regular exercise. And the AAA experts says that exercise can improve driving safety even for seniors who are living with health challenges. Regular physical activity that includes muscle strength building and stretching exercises improves safety when steering, braking, parking, looking to the side and rear and putting on one’s seat belt.

“Exercise doesn’t have to be strenuous to produce positive results,” said AAA director of traffic safety advocacy and research Jake Nelson. “Simple steps to keep active can keep you driving safely for longer.”

The role of medications

A study from AAA, Columbia University and the University of California, San Diego, took a look at the relationship between driving safety and the medications seniors take. The findings? Many seniors take medications that could make it unsafe to drive, causing blurred vision, fatigue, confusion—and this can increase the risk of a crash by 300%!

The researchers urge seniors to talk to their doctors about their medications, noting, “Nearly 20% of older drivers are using medications that generally should be avoided because they have very limited therapeutic benefit, pose excess harm, or both.” Said Nelson, “Ask your doctor and pharmacist as many questions as necessary to ensure you understand why you need the medications prescribed to you, and how they can affect your driving, especially if taking multiple medications.” Afraid to bring up the topic? Nelson provides reassurance: “Don’t be afraid to question healthcare providers. It’s their job to help you. And the answers may just save your life.”

About those high-tech dashboards…

Some of the features of today’s cars, such as backup cameras and lane departure warning signals, have improved safety for seniors. But some haven’t, reports the foundation: “New in-vehicle infotainment technology has the potential to increase comfort and extend mobility for older drivers—but first, it has to stop distracting them!”

Taking our eyes off the road for even two seconds to make a call, tune in the radio or program navigation doubles the risk of a crash—and older adults take their eyes off the road a big longer to do it. Voice commands could potentially help, but, says Yang, “Unfortunately, the complexity and poor design of some of these systems could cause more harm for older drivers, in particular, instead of helping them.”

This goes for drivers of every age. “This is a design problem, not an age problem,” says Nelson. “Designing systems to meet the safety and comfort needs of aging drivers would benefit all of us today, and for years to come.”

Until that time comes, AAA has a few suggestions for drivers whose vehicles are equipped with in-vehicle infotainment systems:

  • Don’t use dashboard technologies while you’re actually driving, unless it’s an emergency.
  • To become proficient in using your touch screen and voice command functions, practice ahead of time when you’re not driving.
  • Avoid using center console controllers—the AAA says those are especially dangerous.

Time to talk about it

Here’s one more bit of advice from the AAA. Well before you think you might have to give up driving—“driving retirement,” they call it—talk to your family members and your doctor about your driving safety abilities, and alternatives to driving. The AAA says that 83% of older drivers fail to have those conversations, which makes it a lot harder when they do need to stop driving—and also raises the risk of a crash. Why take the risk? Start the conversation now!

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Extreme Heat is the most deadly.

Did you know that the Centers for Disease Control and Prevention (CDC) lists extreme heat as the most deadly of all natural disasters in the U.S.? Heat waves take the lives of more people than all other natural disasters combined.

This is the time of year when our attention turns to natural disasters. The U.S. has already experienced our first hurricane this year. Summer brings tornadoes throughout the nation’s midsection. And a series of earthquakes recently struck the West. Time to make our emergency preparation kit and plan our evacuation route, just in case!

Just about anywhere in the world, it’s getting hotter. Even Alaska recently experienced record-breaking hot temperatures, and while we don’t think of northern Europe as a torrid zone, England, Germany and France just experienced the hottest temperatures on record. Worldwide, public health experts are urging everyone to make a plan for days when the temperatures are dangerous. Are you planning ahead?

These experts also warn that older adults are at highest risk of death during heatwaves, not only from heat-related illnesses such as heatstroke, but also due to an increase in heart attacks and respiratory problems.

Why is the risk greater for seniors?

As we grow older, decreased blood circulation and a less efficient perspiration mechanism make it harder for our bodies to regulate temperature. Common health conditions such as cardiovascular disease, kidney or lung problems and an unhealthy body weight are also factors. Seniors are also more likely to take certain prescription medications that hinder the body’s ability to cool itself. And our thirst mechanism is less sensitive as we grow older, so it’s easier to become dehydrated.

Dr. Raquel Nunes of the University of Warwick in the UK has been researching the plight of seniors in a warming climate. She says that beyond the health reasons mentioned above, a number of social factors also put seniors at greater risk: elders may not realize the danger of high temperatures, their homes may not be designed for warmer temperatures; they may not know how to keep the interior cool, and they may be socially isolated. Dr. Nunes says that just as social agencies and neighbors, families and friends would look in on an elder during a hurricane or blizzard, they should also check up during heatwaves, and help seniors make a plan to be safe.

Extreme heat is the most deadly of all natural disasters, here’s how family caregivers and friends can help senior loved ones be safe during periods of heat:

  1. Your loved one’s home has air conditioning, be sure it is in good working order. If it is an older model, check out newer, more efficient models.
  2. Is your loved one worried about energy costs? Contact the local area agency on aging to find out about federal, state and local assistance programs.
  3. If the home is not air conditioned, help your loved one open windows during early morning and evening hours to let in cooler air. Close drapes to block the sun, and use fans to circulate air.
  4. Is the home still uncomfortably warm? Help your loved one get to a place with air-conditioning—perhaps your own home or that of a friend, or to the mall or to a movie. Many communities offer daytime cooling centers, located in community centers, libraries, senior centers or schools. Locate a shelter ahead of time. If your loved one has a pet, find out if there are pet-friendly centers in the area.
  5. Encourage your loved one to drink plenty of fluids, even if they don’t seem thirsty. Fresh fruit also is a good source of fluids. Avoid caffeine and alcohol, which can increase dehydration. (People who are on a fluid-restricted diet should consult their physician before changing their fluid intake.)
  6. Encourage your loved one to dress in lightweight, light-colored, loose-fitting clothes. Natural fabrics, such as cotton and linen, are coolest. Many synthetic fabrics trap heat and perspiration against the body.
  7. Be aware of the signs of heat-related illness, such as dizziness, weakness, nausea and heavy perspiration. If ignored, these symptoms can progress to a dangerous condition called heatstroke. The symptoms of heatstroke are:
    • Body temperature over 104°
    • Confusion, staggering
    • Dry, flushed skin with no sweating
    • Strong, rapid pulse
    • Headache
    • Unconsciousness

Heat stroke is a medical emergency. Call 9-1-1 right away. While waiting for help to arrive, move the person to a cooler place. Remove or loosen tight clothing, and apply cool, wet cloths or towels to the skin.

Looking for more information on why extreme heat is the most deadly? The CDC shares more details: https://www.cdc.gov/disasters/extremeheat/older-adults-heat.html

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If a Loved One Is Diagnosed with Alzheimer’s Disease, Can Family Talk to the Doctor?

In the earliest stages of Alzheimer’s disease, a senior and their family may be in denial, chalking up memory lapses and personality changes to “just getting older.” A recent study from Johns Hopkins Medicine revealed that over half of people with dementia have never been diagnosed, or told about their diagnosis! But we shouldn’t bury our head in the sand. The earlier that Alzheimer’s disease is diagnosed, the more time the person and family have to begin putting financial, legal and care planning in place.
It’s usually best for the person with dementia to have the full support of family. But it’s not always simple, as many family caregivers will tell you. Seniors in the early stage may fiercely protect their independence. It’s important to overcome this hesitance, because the support of family will become all the more important as the disease progresses.
One question that often arises is whether family members and other caregivers will be permitted to talk to the person’s doctor. An important consideration is that the Health Insurance Portability and Accountability Act (HIPAA) sets boundaries on releasing an individual’s health information. In broad terms, the law gives patients greater control over their medical information and with whom it may be discussed. This law affects whether family members are able to talk to their loved one’s doctor.
If you have a loved one who has just been diagnosed, here are steps to take to make sure you have access to the information you need in supporting your loved one.
The importance of naming a healthcare representative
In the early stages of Alzheimer’s, if your loved one allows you to accompany them to doctor’s appointments, permission to participate in the discussion and the exchange of information with the person’s physician is implied. The doctor may ask your loved one for verbal or written permission before releasing information to you.
In later stages, when your loved one can no longer make their own decisions, informal permission may no longer be enough. A solution is for your loved one to appoint a trusted friend or relative to serve as their health care representative. An advance directive like this is often called a “durable power of attorney for health care” or “health care proxy.” This document names someone to make healthcare decisions if a person is unable to. And, it gives permission for that person to step into the patient’s shoes with respect to confidential health care information and discussions. This gives the person’s representative access to the information they need in order to understand the person’s care options and make wise, informed decisions on the patient’s behalf.
What if your loved one won’t sign a healthcare appointment?
An Alzheimer’s Association spokesperson suggests that if your loved one won’t sign a healthcare appointment, it can be helpful to enlist the help of a trusted third party to encourage them to sign one, perhaps by explaining that it’s beneficial for all concerned. You might ask your loved one’s physician, a member of the clergy, a lawyer, trusted friend, or an Aging Life Care Professional (geriatric care manager). Bringing in a third party can help overcome family barriers that may exist and may be viewed by your loved one as having the benefit of an “expert” opinion.
The Alzheimer’s Association also suggests that if a third party is unable to help, it’s important to inform the physician. Ultimately, the physician will need to determine the capacity of your loved one to make decisions. Capacity is not always clear cut, so the unfortunate reality is that without a health appointment, there may be a time when the doctor is not at liberty to talk to you.
What about filing for guardianship?
Guardianship is an option when a person with Alzheimer’s reaches the point where they cannot take care of themselves, are deemed incompetent to make decisions, and haven’t completed an advance directive naming a health care representative. The Alzheimer Association notes that the process can be time consuming, emotionally draining, and expensive, but is sometimes necessary in order to protect individuals with dementia who do not understand they need help. Guardianship laws differ from state to state, so if your family thinks they need to consider this, consult with an elder care attorney.
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From Sitting to Moving … Make the Switch!

Most of us know that exercise is a top factor in keeping us healthy as we grow older. Yet many well-intentioned, health-conscious older adults are unaware that even if they work out regularly, their health can still be harmed if they spend the rest of the day sitting around, whether it’s surfing the web while moving nothing but our wrist all evening, a day of couch potato mode in front of the TV, or knitting for hours. Or maybe you’re one of the increasing number of seniors who have put off retirement—good for your financial health and social life, but perhaps trapping you behind a desk all day?

Multiple studies over the past decade have confirmed the dangers of prolonged sitting. Sitting down most of the day has been linked to heart disease, diabetes, joint problems, stroke, even dementia.

But there’s good news, as well! Other research shows that we can lessen the damage by breaking up those seated hours, even in small doses of time. Of course, many of those studies relied on data from questionnaires—and as you might guess, most of us tend to exaggerate the level of activity we get. But a January 2019 study, this one from Columbia University Irving Medical Center, provided even more convincing data when the research team equipped 8,000 middle-aged and older adults with activity monitors over the course of four years, and compared their health with their exercise level—both the amount and intensity.

The study results, published in the American Journal of Epidemiology, found that replacing just 30 minutes of sitting with low-intensity physical activity each day lowered the test subjects’ risk of early death by 17 percent. Increase the activity level to moderate to vigorous activities, and the risk was cut by 35 percent!

Not so long ago, the common wisdom was that we need to exercise for a prolonged period of time to get the best benefit. An hour-long session at the gym, a long run, an aerobics class, a fifteen-mile bike ride … we were advised to do this several times a week to get the recommended 150 minutes per week of moderate intensity physical activity.

These power workouts yield maximum fitness results. But recent studies show that we can also benefit from a number of shorter periods of activity, spread out through the day, to neutralize the dangers of sitting. The Columbia researchers said that for the people in their study, “Even short bursts of activity—of just a minute or two—provided a health benefit.”

How can we add more movement to our lives? Hide the TV remote so you have to get up to change the channel. Better yet, lift weights or walk on a treadmill while you watch. Or listen to music or a podcast while you walk around the block (remaining alert for tripping hazards, of course). Plant a garden this year. Take a dance class. Walk to the store rather than drive, if you can. Or take a bus halfway there! Go window shopping. Walk a dog. Do a little extra housework. Meet a friend for a walk instead of a trip to the doughnut shop. Talking on the phone? Stand up during that chat! If you have mobility challenges, there are plenty of chair exercises that can provide a good workout.

The first step to taking more steps is to put movement at the top of your mind. Set a timer so you’ll stretch and walk around every half hour or so. Once you overcome the habit of inertia, your body will start reminding you to take a motion break!

And remember, before you make a big change in your exercise regimen, ask your doctor for an exercise “prescription” that is safe and beneficial for you.

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Expanding the Life Space of Older Adults

Expanding the Life Space of Older Adults

Some of the changes that age brings can tempt us to spend more time at home. Visual impairment, hearing loss, mobility challenges and memory problems can make it unsafe for us to drive. We might feel less confident when we’re out and about, fearing that we will fall or get lost. Gradually we develop a frame of mind where going on an outing seems like just too much trouble!

When this happens, the world of an older adult becomes smaller, with a diminished sense of independence and connection in the community. The term that is sometimes used for homebound seniors—“shut-in”—really isn’t far off the mark. The inability to get out can make seniors feel isolated and trapped, soon leading to depression and inactivity.

It’s important to help seniors get back into the community. A study conducted by Chicago’s Rush Alzheimer’s Disease Center found that seniors with a “constricted life space” were at greater risk of memory loss. The study authors defined “life space” as “the extent to which we move through our environments as we carry out our daily lives—from home to garden to workplace and beyond.”

The study, headed by epidemiologist Bryan James, Ph.D., looked at the lives of a group of seniors over the course of eight years. The researchers asked the seniors to record how far from home they typically ventured—outside of their city, outside their neighborhood, or no farther than their own yard or front porch. They found that the seniors with “constricted life space” were almost twice as likely to develop Alzheimer’s disease.

Is this a matter of cause and effect? “The reasons why a constricted life space is associated with an increased risk of Alzheimer’s disease is not clear,” James said. “Certain disease processes in the brain may affect how far we move through the world years before they affect our memory and thinking. Or perhaps life space is an indicator of how much we are actively engaging and challenging our cognitive abilities.”

Whatever the case, says James, “As we continue to search for the answer, we recommend that people—particularly older adults—get out as much as possible and enjoy the world beyond their front doors.”

How can we help seniors get out and about?

Find the right activities. A trip out need not be elaborate, strenuous, or planned far in advance. Lunching with friends, attending one’s faith community, walking in a local park or garden or visiting a gallery can provide a mood boost. Seniors with memory loss continue to benefit from outings, and these days there are more dementia-friendly programs through museums, parks and recreation departments and senior centers. Even shopping provides physical and emotional benefits. A study from The Journal of Epidemiology and Community Health showed that “retail therapy” is a real thing! This makes sense when you consider that since the beginning of civilization, people have congregated in the marketplace. According to the study, there is more good news: You don’t even have to buy anything to benefit from a shopping outing.

Learn about transportation options. Sometimes seniors can extend their driving years with a senior driving class and modifications to the car, such as mirrors and pedal extenders, or a newer car with backup cameras and other updated safety features. But if driving is no longer safe, family and friends might be willing to schedule rides. Check into public transportation and senior transportation programs. Many public transit agencies offer training and orientation classes for senior passengers to build their confidence. Taxi cabs might be an option, and today more older adults are using ride hailing services, such as Uber and Lyft. If a senior uses home care, the caregivers can provide transportation and assistance.

Consider a senior living community. One of the advantages of living in a retirement community, assisted living community or other senior living environment is the transportation they provide. They feature regularly scheduled shopping trips, special events, and transportation to the doctor and other appointments. Seniors in assisted living or memory care feel more confidence with supportive staff along for the adventure. And what a great way to make friends and spend quality time with other residents! Life space mobility and a wider living environment can do wonders for an older adult’s sense of well-being.