As the years pass, the number of motor vehicle drivers over the age of 65 steadily increases. Although there is no specific age at which drivers licences are suspended, drivers are required to complete a medical examination starting at 80 years of age, and every 2 years after 80, in order to maintain a valid licence.
Based on the medical exam, the Office of the Superintendent of Motor Vehicles (OSMV) may require the driver to undergo further assessments, such as an ICBC road test, to better determine the impact of their medical condition on their ability to drive.
With normal aging there is a decrease in both cognitive and physical functioning, and with illness the changes are often more pronounced. The elderly are more likely to have impairments or disabilities that adversely affect driving performance.
There may not be one single medical contraindication to driving, but the accumulation of a number of mild changes or chronic conditions may place the person in an unsafe situation.
Mature drivers workshops
Many local communities have mature drivers workshops open to older drivers. These are usually advertised in seniors’ centres and in the 55+ section of night school brochures. These workshops are led by volunteer seniors who help other seniors become more aware of changes they may be experiencing and how these changes may affect their driving, particularly those changes that have an adverse effect on safe driving ability.
Tips and strategies are provided in a peer group environment. The information and insights gained may be important factors in keeping a person driving safely longer than may have been possible without the workshops. On the other hand, it may lead to voluntary limitation on driving.
More information on these workshops and the program developed by the BCAA Traffic Safety Foundation is available at www.MatureDrivers.ca.
Drivers’ medical examinations
Physicians in active practice, particularly general practitioners, are presented frequently with the need to perform a driver’s medical examination and provide an opinion to the OSMV regarding a patient’s medical fitness to drive safely. As a guideline, the BCMA has produced the Guide for Physicians in Determining Fitness to Drive a Motor Vehicle, which is available at www.drivesafe.com/guidecontent.html#_Toc534602090.
Two other helpful references are the seventh edition of Determining Medical Fitness to Operate Motor Vehicles, the Canadian Medical Association (CMA) Driver’s Guide available to CMA members, and the Physician’s Guide to Assessing and Counselling Older Drivers by the American Medical Association (www.ama-assn.org).
In some cases the decision to declare a person unfit to drive safely may be a difficult one for the physician because it restricts the person’s mobility. It may limit the patient’s ability to attend medical appointments, socialize, obtain groceries, and so forth.
This is more of a problem in rural communities where the availability of public transportation, HandyDART, and taxi service may be limited or nonexistent. Nevertheless, in determining medical fitness to drive the welfare of those exposed to the patient’s driving must be considered as well as the interests of the patient being examined.
The form for the driver’s medical examination provides the opportunity to recommend an assessment by a specialist for a medical condition, a practical road test by a Motor Vehicle Branch driver examiner, or both. These options are helpful in the situations where there are considerations but not actual contraindications to safe driving.
The road test is remarkably good at assessing driving skills and may be an eye-opener for the person who insists he or she drives “just fine, Doc.”
The final determination of a person’s fitness to drive rests with the OSMV, which places significant weight on the information and recommendations in our reports.
Conditional and restricted licences
It is possible that the OSMV may decline full licensing but allow a restricted or conditional licence. These partial licences include restrictions to driving in daylight hours, on known streets, under a certain speed limit, and so forth. It may be that a person can negotiate the few blocks to the grocery store in daylight but cannot cope with the multiple inputs of traffic congestions at speed on the freeway.
There will be future articles on senior drivers. In the meantime, if you have any questions, comments, or suggestions for future columns, please contact me at DrLaura.Jensen@ICBC.com.
—Laura Jensen, MD
ICBC Medical Community Liaison
The opinions expressed in this article are those of the author and do not necessarily represent the position of the Insurance Corporation of British Columbia.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org