The Misfits: Helping to tell whether it's time for elderly drivers to yield

Gradually, almost imperceptibly, Tom Harrison began to lose flexibility in his neck and trunk. He was in his early 80s. There are worse things at that age, right?

Then a test offered by Greenspring, a community for older people in Springfield, where Harrison lives, revealed that the stiffness limited his view while driving. Harrison couldn't turn well enough in his seat to identify an object on a computer screen behind him, which meant he would have trouble doing the same thing behind the wheel.

Harrison, a retired Air Force navigator, hit the gym at Greenspring and soon regained the flexibility he needs to safely pilot 2,000 pounds of steel on the roads.

"Those kind of muscles, it just takes a little bit of exercise to get them back into shape," said Harrison, now 86.

When the sensitive issue of taking the keys from an elderly driver comes up, we usually think of visual and cognitive deficits. Rightfully so. As we age, there is little doubt that we have more trouble with overall visual acuity, seeing in low light or rain and processing information quickly.

But there are also physical fitness factors that tend to receive less attention: hand-eye coordination, head-neck flexibility, leg strength and balance.

"It is a fitness issue," said Lisa Boorom, who runs the Viva wellness center at Greenspring. "A lot of people don't realize how much balance is a part of leg strength. . . . Torso flexibility is something they lose over time, and they don't realize it."

(I took the test myself and, at age 51, had no trouble with the physical aspects. But it did show that I have a mild deficit in "visualizing missing information." Remember those standardized tests that asked you to envision what a figure would look like when it is unfolded? I never could do those and apparently still can't.)

The Viva program offers the test to anyone, regardless of age. Beyond driving skills, it offers a battery of physical, social and psychological tests. You don't have to live at Greenspring, either. Boorom has tested firefighters, for example. The price is $99 for a first-time participant.

According to the American Automobile Association, 37 million people will be 65 or older in 2020, and 90 percent will have driver's licenses. After teenagers, seniors have the highest death rate from crashes, according to the National Highway Traffic Safety Administration.

It's not that older drivers are more reckless or less able, AAA says. In fact, research shows that older drivers tend to know their limitations, drive less, use seat belts more, speed and drive drunk less often, and kill fewer pedestrians and motorists than other adults. But they are more susceptible to injury and death when they are in accidents.

States have imposed a variety of requirements for people who seek to renew their driver's licenses, beginning at age 65, but most cover visual deficiencies, renewal dates and road tests. The District appears to be the only U.S. jurisdiction that requires a doctor to attest that a person over 70 who renews a license is competent to drive.

It may be difficult for a healthy adult or a teen driver to imagine lacking the leg strength to smoothly work a vehicle's pedals or respond quickly in an emergency, to see well enough to parallel park or check a blind spot. For seniors, these matters are all too real and hold potentially terrible consequences. Few moments mark the end of independent living as starkly as losing the ability to drive safely. The world shrinks overnight, literally and figuratively.

"It's a big loss," said Boorom. "It's treated almost like a grieving process."

Her program has no power to deprive anyone of the right to drive, she stressed, and all information is confidential. But when there are clear problems, she may advise that seniors talk to their doctors or children.

"It's usually not a surprise [to them] when they have a lot of deficits," she said.

Long before any action is taken, however, older folks can access programs sponsored by groups such as AAA and AARP that are designed to keep them on the road. These include exercises to increase flexibility, balance and leg strength. AAA, for example, publishes a brochure on flexibility training for older drivers. The same difficulties can be addressed at a gym or with a trainer, as Harrison did at Greenspring.

Other programs help by assuring that seats and mirrors are adjusted properly to compensate for physical changes. CarFit, which is sponsored by AAA, AARP and the American Occupational Therapy Association, is one. And devices that help older folks, for example, reach foot pedals without sitting too close to the wheel are also available. The Association for Driver Rehabilitation Specialists offers a wide variety of such services.