At what age is it time to turn in the car keys for good?

Eleven years ago this week, my best friend from grade school lost her son. He and his best friend were killed by an 84 year-old driver who probably should not have been behind the wheel.  

I have told patients in our ophthalmology office, on more occasions than I care to mention, that their visual acuity measures below the legal vision guidelines of the New York State Department of Motor Vehicles.  I have actually had my car hit in our office's parking lot, and wondered if it was someone with whom I had just had this uncomfortable conversation. Believe me, I am not judging, as I have had to go through this with my mother-in-law a few years ago.  

Recently it was all over the news that Prince Phillip was in a car accident.  When the news broke, I asked myself,  "How in the world is the 97 year-old husband of the Queen of England still driving? "  The answer that I hear from the adult children of these elderly people more than I would care to is, "If my Mom/Dad could no longer drive, it would kill them."

New York State formerly required driver vision tests every three years. Due to government costs reductions, they now only require renewals every eight years. To be a full legal driver in New York, a driver must have 20/40 visual acuity, with or without eyeglasses, in at least one eye. 

Imagine the difference between a 75 year-old driver and an 83 year-old driver! 

New York State also does not require testing for mental ability, reflexes, and other essential abilities to drive a two-ton vehicle.  Many other states require approval from their physician, and some even require repeat road testing in order to renew licenses above a certain age.

Prince Phillip finally gave up his license, but it took nearly killing a young family and him having to climb out from his flipped Land Rover to do so. According to British news reports, he gave up driving unwillingly. 

Some elderly patients have visual acuity that is only slightly below the legal 20/40 mandate. But it is not unusual for patients with macular degeneration, diabetic retinopathy or glaucoma to be driving with 20/400 vision, or for patients to be driving who are hobbling with walkers and necks bent over that they can't possibly see more than an inch over the dashboard. 

And yet, I continue to hear the adult children protest, "If my Mom/Dad could no longer drive, it would kill them."

My response is always the same: "If your Mom/Dad continue to drive, it could kill someone else". 

This post is in honor of Graeme and Kevin.