A national study shows that licensing policies for older drivers vary widely in Canada, raising issues for the coming increase in seniors.
Requirements for licence renewal, reporting practices, appeals processes and options for restricted licences largely depend on where one lives, according to researchers Brenda Vrkljan of McMaster University, Anita Myers of the University of Waterloo and Shawn Marshall of the University of Ottawa.
The study, funded by the Ontario Neurotrauma Foundation and Transport Canada, found little agreement between the provinces and territories on the best ways to identify and regulate older drivers who may present a risk to themselves and others on the road.
Transport Canada data shows that in 2009 there were 3.25 million licensed drivers aged 65 and older, representing 14 per cent of the total driving population. The volume of senior drivers is expected to more than double in the next decade, as the oldest baby boomers turn 65 this year.
Vrkljan, associate professor in the School of Rehabilitation Science and an occupational therapist saw the implications of an aging population first-hand when she worked at a hospital in Chatham, Ont.
"Being able to drive was a key health issue for our patients, particularly our older patients who lived in rural areas where alternative transportation is nearly non- existent," she said.
For many seniors, driving is crucial for maintaining mobility and freedom. Surveys show that most would rather have restricted licences (such as no night or highway driving) rather than lose their driving privileges altogether. Licensing authorities are under pressure to expand restricted licences for older drivers, comparable to graduated licences for novice drivers.
But as drivers age, they are more likely to develop vision and other health problems that may compromise driving safety. In some provinces drivers are subjected to medical review once they turn 70, 75 or 80. Mass screening, however, is costly and apart from in-person renewal, has shown minimal impact on fatalities.
According to the researchers, although older drivers are involved in proportionately fewer collisions than younger drivers, they are more likely to be seriously injured or die as a result. They also said the rate of fatal collisions starts to rise at age 70 and continues to increase for drivers in their 80's and 90's.
The experts agree that the focus should be on identifying potentially medically at-risk drivers regardless of age and thoroughly assessing each person's capabilities for continued safe driving. In most provinces, physicians are required to report patients they suspect are medically unfit to drive. This puts pressure on doctors who have increasing numbers of older patients with chronic conditions and lack valid tools to determine fitness to drive.
Access to driver assessment centres, wait times and costs to drivers themselves, as well as the qualifications of those who conduct assessments vary widely from province to province, according to the study. In Ontario, for example, Vrkljan noted that an occupational therapist must be involved in the evaluation of a medically at-risk driver when the Ministry of Transportation determines such an assessment is required. Other provinces have different stipulations.
To make this information more widely available, the researchers partnered with the AAA Foundation for Traffic Safety to produce a comprehensive website on current practices and promising approaches regarding medically at-risk and older drivers.
"The public has a right to know what is being done in various parts of the country, while policy makers need these data to make informed decisions based on best practices," said Kent Bassett-Spiers, CEO of the Ontario Neurotrauma Foundation. "This research is the first step in unifying policies and setting strategic priorities."
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