Older adults who enjoy driving and consider it a vital part of their continuing independence and sense of well-being nonetheless encounter physical changes that affect their driving experience as they age. There are lots of important issues involved in discussions about older adults continuing to drive. Here, we are going to focus on the physical and medical factors that come into play as we continue to drive and age, hopefully gracefully in both cases.

Physical Challenges

There can be some very basic, and predictable, physical changes that occur in the “mechanical” aspects of bodily function as a natural part of aging that can result in a profound impact on driving. A common one is stiffness in joints and weakness in muscles. Whether these occur in the lower part of your body (feet, ankles, knees), toward the midline of your body (arms, elbows, hands), or in the upper parts (shoulders, neck) doesn’t matter. The stiffness can still affect one’s driving. Don’t believe it? OK, let’s take a stroll out to your car or truck…

Did it take a little more time to get up out of your chair and into the vehicle because of the stiffness in your joints or weakness in your muscles?

Now that you are in and behind the wheel, pretend that you need to back up.

1. What did you have to do to safely do that? Reach around and put on the shoulder harness? Right. Feel a twinge in your shoulder while doing that? Then what?
2. Turn your neck and maybe your whole torso around in the seat to see out the back window to ensure that nobody was behind you? Right. Feel a twinge in your neck or shoulder(s) doing that? More than a twinge; actual pain?
3. If so, to avoid the pain maybe you’ve become used to relying on the rear-view mirror instead of turning around to get a full and safe view of what’s behind your car. The problem is that a rear-view mirror does not usually allow for a full view, and so you may be placing yourself and others in danger when backing up.

Now, while driving along, imagine a dog or child runs into the street. You want and intend to react fast, but that darn knee hurts when you move it, especially quickly. Or maybe the pain in your arms and shoulders prevent you from steering around them. Over time, you have become accustomed to not moving your arms or shoulders quickly to avoid the pain. Therefore, despite the need and your desire to move fast, slower movements have become part of your “repertoire.” Even if it isn’t pain as such, it just might be that weakened muscles inhibit the ability to slam on the brakes or steer around the dog or child.

Tips for Handling Physical Challenges

1. Be honest with yourself. If you perceive that stiffness or weakness issues get in the way of safe driving, take it upon yourself to handle it. Don’t be ashamed. Age is a part of life. Life is a lot better than the alternative. Call the doctor.
2. Be honest with the doctor. Tell him or her that whatever is going on with you may be interfering with your ability to safely drive. Odds are, stiffness and weakness (and resulting pain) can probably be managed. But if the management will involve medications, make sure that you discuss any side-effects and try the medication to see how it affects you before you drive.
3. Stay physically active and exercise. The joints will loosen, and the muscles will strengthen. But don’t make up the routine yourself; get help from someone who knows the ropes. Most communities have Senior Centers that recognize that Seniors need this kind of help. But, before starting anything like this, get an OK from your doctor that you are otherwise healthy enough to participate. If you aren’t he or she will have alternatives. This isn’t magic, but for many it is very doable.
4. Leave extra space between you and the car ahead by slowing down earlier.

Problems with Vision

For obvious reasons, this is a big factor and one that can be objectively diagnosed and measured by others. Your eyesight changes as you age. For example, it may be harder to see people, things, and movement outside of your direct line of sight. It may take you longer to read street or traffic signs or even to recognize familiar places. At night, the glare of oncoming headlights or streetlights, or by the sun during the day, can be blinding.

There are eye diseases that correlate with age, including:

1. Glaucoma. Glaucoma can affect both central and peripheral vision, both of which are needed for safe driving.While there are several kinds of glaucoma, according to the American Academy of Ophthalmology, typical symptoms may include: (1) Severe pain in the eye or forehead (2) Redness of the eye (3) Decreased or blurred vision (3) Vision rainbows or halos (4) Headache (5) Nausea (6) Vomiting. Do you have glaucoma? Only an eye care professional can tell for sure.
2. Macular Degeneration. This is a frequent age-related eye disease and is sometimes called age-related macular degeneration (AMD). It affects the macula, the part of the eye that allows you to see fine detail. It does not hurt, but it causes cells in the macula to die. There are two types: wet and dry. Wet AMD happens when abnormal blood vessels grow under the macula. These new blood vessels often leak blood and fluid. Wet AMD damages the macula quickly. Blurred vision is a common early symptom. Dry AMD happens when the light-sensitive cells in the macula slowly break down. You gradually lose your central vision. A common early symptom is that straight lines appear crooked. Do you have AMD? Only an eye care professional can tell for sure.
3. Also frequently age-related, a cataract is a clouding of the lens of the eye. The purpose of the lens is to help focus light or an image on the retina, which is located in the back of the eye. The lens must be clear so that it transmits a clear image to the retina. The image that the retina gets from the lens is in the form of light, and when the retina gets it, it is changed into nerve signals that are sent to the brain. Therefore, if a clear image is not received by the retina through the lens, the information that the brain gets is obscured, and vision is affected. Do you have cataracts? Only an eye care professional can tell for sure.

Tips for Handling Vision Challenges

1. Be honest with yourself. If you perceive that vision is declining and that it gets in the way of safe driving, if friends and relatives tell you that your driving appears off, or you have a collision resulting from it, recognize that something is wrong. Take it upon yourself to handle it. Don’t be ashamed to admit it. Age is a part of life. Life is better than the alternative. Yes, we said this before, but it bears repeating.
2. See an eye doctor at least every 2 years, but ideally every year.
3. If you have been prescribed glasses for driving, WEAR THEM. Get an extra pair that has been tinted for daytime driving. Many eyeglass stores offer 2-for-1 specials.

Hearing Problems

Diminishment of hearing often comes with age, but you may not have thought about it in the context of driving. Think again. Hearing loss can prevent you from being aware of horns and sirens, such as from emergency vehicles or other drivers from outside the car. It can also prevent hearing sounds coming from your car itself that may be signaling mechanical malfunction. Conversations within the car or truck or music playing can drown out important outside sounds. Do you have diminished hearing? C’mon, don’t just call it “selective perception.” Only a hearing professional can tell for sure.

Tips for Handling Diminished Hearing

1. Be honest with yourself. You know as well as anyone if the TV or radio has to be turned up to hear it well. You know as well as anyone if you are asking people to repeat themselves because you did not “catch it” the first time. You know as well as anyone if you didn’t hear the siren on the fire engine or ambulance coming from behind and were the only car not to pull over.
2. Get your hearing checked now to get a baseline measure. If you’re told that you are losing or have lost hearing on one or both sides, don’t minimize it. It won’t get better by itself. Ask the professional about alternatives. If one is a hearing aid, get it. Put the vanity aside because no one cares. Then, use them. Change the batteries as needed. Get your ears flushed (but take the hearing aids out first…).
3. Safely drive, if otherwise able to do so, knowing that you have done something good for yourself and the motoring public.

(This article was reviewed January 2024.)