2010 Florida Driving Fatalities. The Facts. In 2010, 571 older Floridians were killed in traffic crashes, nearly 23 percent of all fatalities.

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3 Introduction During a lifetime, a person will spend thousands of hours driving, walking, biking, or riding. The Florida Safe Mobility for Life Coalition is working to make sure each of those trips whether in a car, on a bus, bicycle, motorcycle, or by foot is as safe as possible, particularly for Florida s growing number of aging road users. 1

4 The Facts Florida leads the nation with 18 percent of its population age 65 and older. By the year 2030, over 27 percent will be over age 65, and onehalf of them will be 75 or older. Mirroring this growth, an increasing proportion of licensed drivers in Florida are getting older. In January 2011, 25 percent of all licensed drivers in Florida were age 60 and older, a small but steady increase from 23.7 percent in Furthermore, today s aging road users are driving longer and driving more miles per year than in the past. In fact, aging road users can expect to outlive their ability to safely drive by 7 to 10 years. 23% In 2010, 571 older Floridians were killed in traffic crashes, nearly 23 percent of all fatalities. 77% 2010 Florida Driving Fatalities 2

5 Safe Mobility for Life Nationally, from 2007 to 2009, adults age 65 and older made up an increasing percent of fatalities from crashes over the three years. According to the 2007 to 2009 Fatality Facts published by the Insurance Institute for Highway Safety, the motor vehicle crash death rate among aging road users for the U.S. overall also declined from 2007 to 2009 and was lower than Florida s rate in each year (15.66 versus in 2007, versus in 2008, and versus in 2009). 3

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7 Safe Mobility for Life This section provides information on how aging road users can stay safe and mobile even when driving is no longer a safe option. Florida Safe Mobility for Life Coalition To prepare and meet the challenges of Florida s aging population, the Florida Department of Transportation (FDOT), along with the Pepper Institute on Aging and Public Policy, reached out to other agencies and organizations to join together to form a statewide coalition to improve the safety, access, and mobility of Florida s aging road user ultimately reducing injuries and crashes among this vulnerable population. To date, coalition membership includes the following: AAA Auto Club South; AARP; Area Agency on Aging for North Florida, Inc.; Area Agency on Aging of Pasco-Pinellas, Inc.; Carlin Rogers Consulting; Commission for the Transportation Disadvantaged; Community Traffic Safety Teams Coalition; Department of Community Affairs; Department of Elder Affairs; Department of Health; Department of Highway Safety and Motor Vehicles; Department of Transportation; Federal Highway Administration Florida Division; Florida Association of Area Agencies on Aging; Florida Association of Senior Centers; Florida Highway Patrol; Florida International University; Florida Public Transportation Association; 5

8 Florida State University College of Medicine; Lee County Sheriff s Office; Metropolitan Planning Organization Advisory Council; National Highway Traffic Safety Administration (Ex-Officio Member); Pepper Institute on Aging and Public Policy; StarMetro; Tallahassee Senior Center; The University of Central Florida; and The University of Florida Institute for Mobility, Activity, and Participation. Aging Road User Strategic Safety Strategic Plan With the overall goal to reduce injuries and crashes among Florida s aging road users, the Safe Mobility for Life Coalition developed and is implementing a comprehensive safety plan. The plan focuses on the following key emphasis areas: 6 Advocacy and Policy; Aging in Place; Assessment, Remediation, and Rehabilitation; Data Collection and Analysis; Licensing and Enforcement; Other Road Users (pedestrians, transit riders, bicyclists, and other non-motorized vehicles); Outreach and Education; Prevention and Early Recognition; Program Management, Evaluation, and Resources; and Transitioning from Driving. To obtain a copy of the plan, contact Gail Holley, Safe Mobility for Life Program and Research Manager, Florida Department of Transportation, State Traffic Engineering and Operations Office, 605 Suwannee Street, M.S. 36, Tallahassee, Florida ; Phone: ; Fax: ;

9 Outreach Materials Outreach materials available from the Safe Mobility for Life Coalition include tip cards that explain how to navigate a roundabout, use countdown pedestrian signals, and the purpose of advance street name signs. A Safe Mobility for Life Fact Sheet is also available and provides details on the elements and resources of the Safe Mobility for Life Coalition. The Coalition, through the Pepper Institute on Aging and Public Policy, is developing an Aging Road User Resource Center where these materials can be accessed. Individuals may also want to sign up for the Safe Mobility for Life electronic mailing list to stay informed. FDOT has developed and maintains a comprehensive website, Safe and Mobile Seniors (www.safeandmobileseniors.org), which is a virtual one stop shop for transportation safety and mobility information for drivers and pedestrians 65 years and older living in Florida. The site also includes information for families and caregivers, law enforcement officers, and engineers and planners who are involved with aging road users. The Coalition will be using this site to provide Floridians easy access to information and resources in an effort to improve the safety, access, and mobility of Florida s growing aging road user population. 7

10 Roadway Improvements The Florida Department of Transportation began implementing roadway improvements in 1991 on the State Highway System and within two years of implementation were standards on the system. The improvements include the following: Improved intersection safety with roundabouts; Increased visibility through the following:» Increased lane and edge line pavement marking widths to six inches;» Retro-reflective back plates on traffic signals;» Increased placement of reflective pavement markers (RPM); and» Larger lettering on guide signs. Improved pedestrian features at intersections, including the following:» Countdown pedestrian signals;» Refuge islands;» High-emphasis crosswalks; and» Slower walk speeds. Providing advance notification through the following:» Advance street name signs; and» Advance warning signs (stop, yield, and signal ahead). Licensing Requirements Beginning January 1, 2010, Florida has new documentation requirements for residents renewing or obtaining a new driver license or identification card. For office visits, the individual must bring original documents that prove the person s identity, social security number, and residential address. Office visits are required under the following circumstances: 8 If the person is applying for a first driver license or identification card;

11 When the person s current credential expires and they have already used the one-time convenience renewal option; or If the person legally changes their name (e.g., by marriage or divorce). Vision Requirements for Drivers Age 80 and Older Effective January 1, 2004, all drivers who are 80 years of age or older and who are in the process of renewing their driver license are required to pass a vision test. The test, which is ONLY required if the individual is renewing their license, can be taken in the following ways: Have a Florida licensed doctor administer the test and submit a Mature Driver Vision Test Form (HSMV 72119). The licensed doctor must be a medical doctor, osteopathic physician, or an optometrist. Once the individual passes the vision test, they can complete the license renewal process. If the test reveals a problem, however, then the individual must have an eye specialist licensed in the State of Florida complete a Report of Eye Examination (HSMV 72010) and submit it to the department prior to renewing your license. The form requires more information and asks the eye specialist to provide information on any restrictions they feel are necessary such as daylight driving only. To reinstate a license revoked for inadequate vision, the individual must submit a report of eye exam to a Florida Driver License office and may be licensed if minimum vision standards are met. If record states Inadequate/ Field of Vision, then a vision report, including a Field of Vision Chart must be mailed to: The Bureau of Motorist Compliance Vision Section 2900 Apalachee Parkway, MS 87 Tallahassee, FL Medical Review Process Florida is one of 36 states that have a Medical Advisory Board whose purpose is to assist DHSMV in dealing with potentially unsafe drivers. 9

12 The board also advises DHSMV on medical criteria and vision standards relating to the licensing of drivers. The Medical Board will review the information on unsafe drivers, advise the Department, and the Department will advise the individual. For more information on the license renewal process, including the vision requirements, contact the DHSMV Customer Service Center at Reporting Unsafe Drivers Florida law allows any physician, person, or agency (including law enforcement) having knowledge of any licensed driver s or applicant s mental or physical disability to drive, is authorized to report such knowledge to DHSMV. The person making the report does not need to know the driver s diagnosis to report them as a possible unsafe driver. It is important, however, to write what they observed and provide any useful examples. The reports are confidential and no civil or criminal action may be brought against the individual submitting the information. When requesting a medical review, individuals must submit a Medical Reporting Form describing the person s physical and mental handicap and send it to DHSMV at: DHSMV, Medical Review Section Neil Kirkman Building, Room A227 Tallahassee, FL Or fax it to the Medical Review Section at An individual may also call the Medical Review Section at A re-examination consists of a vision test, written test, and driving exam. Road User Rules Not all aging road users are drivers. Many individuals walk or ride motorcycles and bicycles. It is important to learn to share the road with all road users. The Highway Research Center at the University of North Carolina provided the following list of tips for drivers and pedestrians. 10

13 Tips for Drivers Drivers can encounter pedestrians anytime and anywhere even in places where they are not supposed to be found. Pedestrians can be very hard to see especially in bad weather or at night. Drivers must keep a lookout and slow down if they cannot see clearly. When entering a crosswalk area, drive slowly and be prepared to stop. Stop for pedestrians who are in a crosswalk, even if it is not marked. When stopping for a pedestrian in a crosswalk, stop well back so that drivers in the other lanes can also see the pedestrian in time to stop. Do not overtake and pass other vehicles stopped for pedestrians. When turning, drivers often have to wait for a gap in traffic. Beware that during that period, pedestrians may have moved into the driver s intended path. Be especially attentive around schools and in neighborhoods where children are active. Impact on Driving Tips for Pedestrians Be predictable. Stay off freeways and restricted zones. Use sidewalks where provided. Cross or enter streets where it is legal to do so. Where there are no sidewalks, it is usually safer to walk facing road traffic. Make it easy for drivers to see the pedestrian by dressing in light colors and wearing retro-reflective material. It might be wise to carry a flashlight in very dark areas. Be wary. Most drivers are nice people, but pedestrians should not count on them paying attention. Watch out make eye contact to be sure drivers see you! Alcohol and drugs can impair the ability to walk safely, just as they do a person s ability to drive. Use extra caution when crossing multiple-lane, higher speed streets. 11

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15 The Impact of Aging on Driving For most people there is a steady decline in certain skills that are important for safe driving as they get older. Beginning at around age 55, there is a gradual decrease in the ability to process information, to remember, and to make judgments in traffic situations such as determining the distance and approach of oncoming traffic. Functional decline related to aging does not affect all drivers at the same rate or in the same way. Although specific abilities needed to drive safely such as vision, memory, physical strength, reaction time, and flexibility decline as people age, the rate of change varies greatly across the older adult population. The chart shows how aging affects various skills necessary for safe driving. Function Skills Effect on Driving Vision Near and far vision, depth perception, visual attention, peripheral vision, light and dark sensitivity, and the affect of glare. Ability to see other vehicles, traffic signals, signs, lane markings, road conditions, and pedestrians. Ability to see equipment and controls on own vehicle. Cognition Memory, attention, recognition, speed of decisions, and judgment. Ability to recognize traffic conditions and locations/destinations, process the information, and make appropriate decisions. Ability to recognize and understand operation of own vehicle. Ability to judge the speed and distance of oncoming vehicles. Physical Function Strength, flexibility, and reaction time. Ability to perform physical movement to control own vehicle. 13

16 Vision Vision is the primary sense used in driving. Visual declines represent the most significant losses for older drivers who need more light to distinguish features along the roadway and must be closer to read signs and follow other traffic cues. Older eyes also need more time to recover from the glare of bright headlights at night. In Florida vision tests are required for all drivers renewing their license if they have already used the one time convenience renewal option and if they are 80 years and older. The test is to make sure the driver has at least 20/40 vision in at least one eye, with or without corrective lenses. Visual acuity readings worse than 20/40 are referred to an eye specialist. Color blindness will not cause any special condition for licensing. Because it is so important to safe driving that you see well, individuals should have their eyes checked every year or two by an eye specialist. If the road user wears glasses or contact lenses for driving, they should remember to: Always wear them when they drive, even if they are only going a short distance. If the driver s license indicates the person must wear corrective lenses and they do not, they could get a ticket if stopped by a law enforcement officer. Try to keep an extra pair of glasses in the vehicle in case the regular glasses get broken or lost. This also can be helpful if the person does not always wear glasses and they forget to take them when they drive. Do not wear dark glasses or tinted contact lenses at night, even if it is to help with glare. The problem is that they shut out too much light, which is necessary to see clearly. Cognition Cognition involves perception, attention, learning, memory, thought, visual processing, reading, and problem-solving. Driving is a complex activity that requires a number of these skills. Drivers must remember how to operate their vehicle, what the signs and signals mean, to know their destination and how to get there all of which 14

17 occurs while processing other information. Problems related to cognition may result in the following driver safety problems: Distraction or disorientation while driving; Difficulty maintaining control of a vehicle for prolonged distances; Delay in timely response to traffic control devices or directives; to changes in traffic conditions, traffic hazards,and emergencies; and in observing and responding to the position of other vehicles that are changing lanes, are in the oncoming lane of traffic, or entering the roadway; Difficulty in recognizing and responding to the presence of pedestrians and bicyclists; Inability to simultaneously manipulate vehicle controls and watch the roadway; Improper or delayed signal to other drivers that the vehicle is turning, changing lanes, or stopping; Difficulty planning and safely maneuvering a driving route; and Frequently becoming lost, confused, and unable to find the way from one location to another while driving resulting in panic and sudden irrational changes in direction or loss of control of the vehicle. 15

18 Dementia According to the National Highway Traffic Safety Administration (NHTSA), dementia affects a number of critical abilities needed for safe driving, including perception and visual processing, an ability to maintain attention and respond to multiple stimuli, an ability to make correct decisions, and to act appropriately in difficult traffic situations. Individuals in the early stage of the disease may be able to operate a vehicle under normal circumstances, but have difficulty with changing circumstances and may often become lost. NHTSA s Driver Fitness Medical Guidelines provide these indicators that can help determine if the person needs an evaluation for possible adverse affects due to dementia: The person s age is 80 years or older; There is a history of a recent crash or moving violation; The patient uses psychoactive medications such as benzodiazepines, neuroleptics, antidepressants, or use of medications for Alzheimer s disease; There is a history of falls; and Scores from simple screening tools indicate the possibility of a cognitive deficit. Physical Capabilities As a person ages there is also a decline in muscle mass and bone strength making older drivers at greater risk of a serious injury or death in the event of a crash. According to the research, drivers 65 and older have four times the odds of sustaining serious injuries compared to young drivers younger than 24 years old. Aging can also result in sensory impairments such as a tingling, numbness, and loss of position sense in extremities that affects the ability to feel, grasp, manipulate, or release objects. Loss of strength results in an inability to maintain a firm grip on objects or to apply consistent pressure to objects with legs and feet. 16

19 Flexibility is impacted resulting in rigidity and/or limited range of mobility in neck, torso, arms, legs, or joints. Motor planning and coordination is impacted resulting in difficulty and slowness in initiating movement. Vertigo, dizziness, loss of balance or other motor planning conditions can be occur along with involuntary muscle movements, or loss of muscle control. Common Driver Errors As motor skills and vision deteriorate with age, older drivers commonly make errors when: Making left turns; Driving at night; Merging into traffic, i.e., right-of-way; Changing lanes; Yielding to traffic; Following traffic signals; and Driving impaired (prescription and over the counter medication). Safe to Drive? 17

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21 Am I Safe to Drive? For most Americans, a driver s license is the first outward and visible step toward becoming an adult. Today, many of us see cars as physical extensions of ourselves transporting us wherever we want, whenever we want, like a high-speed second pair of legs. However, there comes a time when driving may no longer be an option. The decision to stop driving is never easy for the driver, his or her family members, or caregivers. The key for a positive transition to giving up the car keys is PLANNING. Warning Signs AARP provides a helpful list of warning signs that indicate it may be necessary to limit or stop driving. Following are some warning signs: Feeling uncomfortable and nervous or fearful while driving; Dents and scrapes on the car or on fences, mailboxes, garage doors, curbs, etc.; Difficulty staying in the lane of travel; Getting lost; Trouble paying attention to signals, road signs, and pavement markings; Slower response to unexpected situations; Medical conditions or medications that may be affecting the ability to handle the car safely; Frequent close calls (i.e., almost crashing); Trouble judging gaps in traffic at intersections and on highway entrance/exit ramps; Other drivers honking at you and instances when you are angry at other drivers; Friends or relatives not wanting to drive with you; Difficulty seeing the sides of the road when looking straight ahead; Easily distracted or having a hard time concentrating while driving; 19

22 Having a hard time turning around to check over your shoulder while backing up or changing lanes; and Frequent traffic tickets or warnings by traffic or law enforcement officers in the last year or two. AARP recommends that if you notice one or more of these warning signs you may want to have your driving assessed by a professional or attend a driver refresher class. They also indicate it may be a good idea to consult with a doctor if you are having unusual concentration or memory problems, or other physical symptoms that may be affecting your ability to drive. 20

23 Self-Assessment AARP has also developed a short quiz to help individuals assess their own driving ability. Take the quiz to judge your driving ability. A = Always F = Frequently O = Occasionally N = Never Question A F O N I notice that other drivers seem to be honking at me. I find gaps in traffic hard to judge. I find that cars suddenly appear from nowhere. I find drivers are stopping suddenly in front of me. I have trouble looking over my shoulder to back or change lanes. I have trouble remembering to look left and right to check traffic at intersections. I have trouble driving through intersections. I get nervous making left turns. I lack confidence that I am able to drive in heavy traffic and at high speeds. I feel overwhelmed by too many road signs, signals, pavement markings, pedestrians, other vehicles, etc. I have trouble moving my foot from the gas pedal to the brake pedal or turning the steering wheel. I get lost on roads that are familiar to me. I feel nervous, agitated, or irritated while driving. I have had several fender benders in the last three years. Total... Never = 0 Occasionally = 1 Frequently = 2 Always = 3 Grand Score You should 0 to 5 Do not be concerned at this time 6 to 15 Take additional self assessments 16 or above Consider a more formal assessment 21

24 Family Members and Caregivers Families, partners, and friends play a large role in aging road user safety. Research indicates that discussions between older drivers and families and friends can be effective in helping the aging road user with the issues of aging and safe driving. In a survey conducted by The Hartford/MIT AgeLab of 7,200 adults aged 50 and older, more than one-half followed the suggestions made in conversations about driving. Even when family members, friends, and providers are willing to tackle these difficult conversations, research shows they want more information with which to begin the discussion. Families can be better prepared for the discussion by having: A list of signs and symptoms indicating driving problems (see warning signs); Tips on observing the older driver s driving abilities; Assistance in understanding the meaning of driving from the loved one s perspective; Suggestions on how to begin the driving discussion; Ideas on how best to talk about appropriate driving choices and ways to travel around the community; A list of community resources for driving evaluation and remediation; Strategies for driving reduction or retirement; and Checking out local transportation alternatives. Tips on Observing Driver Behavior As a family member or caregiver, you may know there is a problem if: 22 The older road user is often forgetful or confused; Uses bad judgment when driving; Fails to follow the rules of the road; There is inability to see where they are going; Aggressive driving; Driving well below the speed limit; There is a rash of crashes or new dents or dings on the car; Family members may notice crashes; or Neighbors, friends, police, or others indicate there is a problem.

25 Some reasons conversations are not brought up: Apprehension about the older person s response; Fear of seeming disrespectful; The family may not want to deal with their role in meeting transportation needs; The decision to stop driving may isolate the older person if they are the only person in the household; The older driver may not want to burden others for rides; and The discussion is postponed until a crisis has occurred a poor time for developing a transportation plan. Caregivers and Medical Professionals Given their unique role in society and their knowledge and expertise, physicians and health care providers are important partners with their patients and can assist them in making good decisions about driving. Physicians and other medical professionals can help patients stay healthy by being aware of how medical conditions impact driving ability. Any medical condition that affects physical or mental functioning may affect driving fitness. When the physical or mental effects of the condition are progressive in nature, periodic evaluations are required. According to NHTSA s Driver Fitness Medical Guidelines, medical conditions that affect driving fall into three categories: Conditions that create functional limitations (chronic compromise); Conditions that involve a possible loss of consciousness (acute compromise); and Use of substances (alcohol, drugs, and medications) judged to be incompatible with safe driving. The Guidelines note men can expect to cease driving about 6 years before their death and for women the figure is about 11 years, which means health professionals can expect to be confronted by mobility problems as their patients age. This does not mean the health professional withdraws or suspends driving privileges; only the DMV has the authority to make that decision. The health professional s role is to provide the DMV with the information it requires to make the appropriate decision about the ability to drive safely in the light of the driver s state of health. 23 Staying Safe

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27 Staying Safe While Driving CarFit CarFit is an educational program created by the American Society on Aging and developed in collaboration with American Automobile Association (AAA), AARP, and the American Occupational Therapy Association. The goals of the program are to help older drivers improve the fit of their vehicle for their safety and comfort, promote conversations among aging road users and families about driving safety, and link these users with relevant local resources that can help them drive safer longer. CarFit checkups include 12 items reviewed by trained volunteers. Items such as: Clear line of sight over the steering wheel; Adequate distance from the front airbag; Proper positioning of seat, usage of foot pedals and all mirrors; and Proper safety belt use and fit. Through a safety grant funded by the FDOT, CarFit has been adapted to Florida and training events for event coordinators, technicians, and seniors are held across the State. On May 4, 2011 Florida CarFit celebrated its 100 th community event at the Orlando Senior Expo at the Central Florida Fairgrounds. To find out a schedule for upcoming CarFit events, call. Driver Safety Courses If you have a Florida Driver s License and are 55 years of age or older, you are now eligible to complete a motor vehicle accident prevention course that will allow you to receive a mandatory reduction on your insurance rate for three years. DHSMV approved courses include the following: Florida Educational Driving School FEDS Senior Driving Course 5079 Northwest 66 th Lane Coral Springs, FL

28 American Safety Institute Senior Driving Course 9009 Mahan Drive, Suite 501 Tallahassee, FL Cheap Mature Driver (on-line) I Drive Safely (on-line mature driver course) mature.idrivesafely.com National Safety Council Coaching the Mature Driver 700 Lake Elinor Drive, Suite 120 Orlando, FL American Safety Council MatureDriverClass.com 5125 Adanson Street, Suite 500 Orlando, FL or AAA-Safe Driving for Mature Operators Consult your local phone book The AARP Driver Safety Program, which is also an approved DHSMV training program, is the nation s first and largest refresher course for drivers age 50 and older that has helped millions of drivers sharpen their driving skills. Classes are $15.95 for AARP members and $19.95 for nonmembers. For more information, call toll-free, 888-AARP-NOW ( ). Florida Safety Council is an approved insurance discount course and is offered in either a classroom or on-line. To register for a classroom course, which costs $14.95, call

29 Driving Skills Assessment A skills assessment helps you determine whether it is wise for you to continue driving. There are a number of skills assessment tools, including evaluation by professionals or self-assessment forms that can help aging road users make good decisions about driving. Occupational therapy practitioners with specialized training in driver rehabilitation help individuals remain mobile and independent, and ensure people s meaningful participation in the community. These practitioners may administer comprehensive driving evaluations that include in office and in vehicle sessions so they can assess the physical, visual, and mental abilities of the driver. A driver rehabilitation specialist (DRS) is someone who plans, develops, coordinates, and implements driving services for individuals with disabilities. A DRS evaluates a person s driving skills, recommends rehabilitation as needed, and can suggest vehicle and/or route modifications (e.g., such as avoiding left hand turns) to enable the person to resume or continue driving safely. Based on their assessment the DRS will recommend the individual return to driving with or without adaptive equipment, can recommend the person limit driving or attend a remedial driving course, obtain adaptive equipment, or stop driving. Following is a list of driving specialists in Florida as of October 2011 from the American Occupational Therapy Association or the Association for Driver Rehabilitation Specialists: Adaptive Mobility Services, Inc South Delaney Ave. Orlando, FL Advanced Driver Rehabilitation, Inc Ives Dairy Road, Suite 228 North Miami Beach, FL

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