2012/02: Should greater restrictions be placed on elderly drivers?
What they said...
'Age itself is not an indicator of driving ability, but it is generally accepted that as we get older our reflexes and reaction times are slower'
Queensland MP, Peter Lawlor, whose daughter lost a leg in a car park accident when an 88-year-old driver pinned her between two cars
'Research by the Government in 2006 indicated that older drivers were not disproportionately represented in crash statistics'
West Australian Transport minister, Troy Buswell
The issue at a glance
On August 26, 2011, the Tasmanian government announced that as of October 2011, drivers over 85 would no longer face a compulsory competence test.
On September 25, 2011, the West Australian government announced that drivers in that state aged 75 to 78 will no longer require a medical assessment to renew their licence. The change in West Australian regulations is expected to be in place within six months.
Each of these relaxations of regulations has been justified on the supposed absence of research data that would warrant such blanket testing of elderly drivers. The West Australian Transport Minister, Troy Buswell, noted that age per se was not a marker of reduced driving competence.
However, negative attention has recently been attracted to elderly drivers in Queensland and Victoria by five incidents in which they were involved.
In May, 2011, a 37-year-old Queensland woman was involved in an accident which resulted in her leg being amputated. She and her four-year-old son were struck by a car driven by an 88-year-old motorist in a shopping centre car park.
In June, 2011, a 90-year-old Queensland woman died after being crushed by a reversing car in Brisbane's west. The woman and two others were hit by an 80-year-old driver who had lost control of her reversing car in a car park.
In January, 2012, a 93-year old man died in Ivanhoe when he hit the accelerator instead of the brakes, while a 74-year-old woman was hospitalised and her passenger died after she hit a bridge railing near Echuca.
In February, 2012, a disoriented elderly motorist drove across the West Gate Bridge and through the Domain Tunnel in the wrong direction.
Though no serious accidents occurred as a result, the most recent incident has led to a variety of calls for greater restrictions on elderly drivers.
Background
(Some of the following background information is drawn from the New South Wales Transport Roads and Marine Services Internet page. The full information can be accessed at http://www.rta.nsw.gov.au/licensing/olderdriver_changes.html Other information has been drawn from http://www.rta.nsw.gov.au/licensing/olderdriver_changes.htmlhttp://abcdiamond.com.au/annual-driving-tests-for-the-elderly/ and from a New South Wales parliamentary review of laws relating to elderly drivers accessed at http://www.rta.nsw.gov.au/licensing/olderdriver_changes.htmlhttp://abcdiamond.com.au/annual-driving-tests-for-the-elderly/http://www.parliament.nsw.gov.au/prod/parlment/publications.nsf/0/EFE9D4AB5C456905CA257376000D7777/$File/Older%20drivers%20final%20&%20INDEX.pdf)
As of May 2012, the following requirements will apply in the different Australian states and territories.
A medical test can be applied where there is considered to be cause (irrespective of the driver's age) in both Victoria and the Northern Territory. Where there is considered cause, a driving test can be required (irrespective of the driver's age) in Victoria, Queensland, the Australian Capital Territory and the Northern Territory.
Elderly drivers in Victoria may have restricted licences imposed upon them if they come to the attention of the authorities either as the result of an accident or traffic violation or the notification of someone else. Drivers over 75 are issued with a maximum three-year licence before they have to apply again for renewal.
In South Australia, a compulsory medical test is applied to all drivers over 70. This test is then applied annually.
In New South Wales, the Australian Capital Territory, Queensland and Tasmania a compulsory medical test is applied to all drivers over 75. In New South Wales this is applied annually. In Queensland the test is valid for five years. The Tasmanian test will no longer be given after 2014.
In Western Australia a compulsory medical test is applied to all drivers over 85. (The former compulsory tests at 75 and 78 are in the process of being abolished.)
In New South Wales and Western Australia all drivers over 85 undergo a driving test. In New South Wales these tests are applied every two years. For a charge, New South Wales drivers may complete this test in their own homes.
In New South Wales, drivers over 85 may also request a modified licence, for example, they may wish to be exempted from driving over long distances or driving at night. No test is required for a modified licence and the driver is then exempted from subsequent driving tests.
Internet information
In 1994 a team of Yale University School of Medicine researchers undertook a wide-ranging data analysis survey with follow-up study to determine the physiological conditions which seemed to be predictors of motor vehicle accidents among the elderly. Their study can be read in full at http://www.annals.org/content/121/11/842.full.pdf+html
In 1997, the Medical Journal of Australia published a study by Peter Lipski titled, 'Driving and dementia; a cause for concern'. Dr Lipski is part of the Central Coast Area Health Service, Gosford, New South Wales and is a Staff Specialist Geriatrician.
The study details the effects of dementia on driving competence and details the inadequate screening and regulatory practices that operate in Australia. It makes some recommendations for reform. The full text of this study can be found at http://www.mja.com.au/public/issues/oct20/lipski/lipski.html#suba1
In April 2004, the ABC carried a report of the discriminatory treatment many elderly drivers believe they receive. A full text of this report can be found at http://www.abc.net.au/stateline/vic/content/2003/s1080118.htm
In 2006, Monash University's Accident Research Centre released a report titled, 'The Elderly and Mobility: A Review of the Literature'. The review looks at the impacts of reduced mobility on the elderly. The full text of this review can be found at http://www.monash.edu.au/miri/research/reports/muarc255.pdf
In 2008, Ingrid Larkin, Josephine Previte and Edwina Luck produced a media analysis titled, 'Get off our roads Magoo: Are elderly drivers entitled to drive on our roads?' It was published in 'Proceedings Australian and New Zealand Marketing Academic Conference (ANZMAC) 2008, Sydney, Australia.'
The study concludes that the Australian media typically depicts elderly drivers in a negative manner.
The full text of the study can be found at http://eprints.qut.edu.au/15466/1/15466.pdf
In May, 2010, it was proposed that Victorian drivers over 85 should be required to affix an 'S-plate' for senior driver to their vehicles. The proposal has met with reservations because there are those who fear that elderly drivers will be victimised.
The full text of this report can be found at http://www.theage.com.au/victoria/s-plate-could-put-clamps-on-gramps-20100501-u0de.html
On August 26, 2011, ABC News carried a report of the Tasmanian government's decision to remove compulsory driving tests for motorists over the age of 85. the full text of this report can be found at http://www.abc.net.au/news/2011-08-26/20110826-tests-for-older-drivers-axed/2856646
On September 26, 2011, inmycommunity.com.au reported on changes in West Australian regulations regarding elderly drivers. West Australian seniors aged 75 and 78 will no longer require a medical assessment to renew their drivers licence, following recognition that the current requirement is not justified by road safety research. The full text of this report can be found at http://www.inmycommunity.com.au/news-and-views/local-news/Rules-relaxed-for-elderly-drivers/7603187//
On December 4, 2012, The Sunday Telegraph published an opinion piece by David Penberthy titled, 'Too many elderly drivers are on the road with a licence to kill'.
The full text of this comment can be found at http://www.dailytelegraph.com.au/news/opinion/too-many-elderly-drivers-are-on-the-road-with-a-licence-to-kill/story-e6frezz0-1226213012863
On December 16, 2011, The Adelaide Advertiser carried a report on a new mental function test that has been developed to help gauge the competence of elderly drivers. The full text of this report can be found at http://www.adelaidenow.com.au/news/south-australia/the-amazing-test-for-older-drivers/story-e6frea83-1226223354134
On February 19, 2012, Channel 9 News televised a report dealing with an 80-year-old driver who travelled the wrong way over the West Gate Bridge and the Domain Tunnel. The video report and a transcript can be accessed at http://news.ninemsn.com.au/national/8422173/man-drives-12km-wrong-way-in-melbourne
On February 20, 2012, 3AW Radio broadcast a segment on elderly drivers and the hazard they might represent on the road. This can be accessed at `http://www.3aw.com.au/blogs/breaking-news-blog/elderly-a-hazard-on-our-roads/20120220-1thvb.html
On February 26, 2012, The Herald Sun carried a report of elderly drivers' efforts to retain their licences. The full text of this report can be found at http://www.adelaidenow.com.au/news/national/seniors-fight-push-for-elderly-drivers-to-hand-licences-in/story-e6frea8c-1226275305397
Arguments against greater restrictions being placed on elderly drivers
1. Elderly drivers are not involved in a larger number of accidents
It has been claimed that elderly drivers are involved in few fatal road accidents. For example, statistics from Queensland's Department of Transport and Main Roads show that while there are a larger number of older drivers on Queensland's roads, they are involved in a declining number of fatal road accidents.
In 2010, of Queensland's 3.2 million drivers, 144,575 (4.5 per cent) are aged 75 years or above. The number of Queensland drivers aged 75 or older has increased from 137,873 in 2008 to 144,575 in 2010, an increase of 6702. Despite increasing numbers of elderly drivers, they were involved in fewer fatal accidents; 23 in 2008 down to 11 in 2010.
National Australian figures reflect the Queensland statistics. Older drivers are under-represented in fatality rates, for example, the fatality rate for drivers aged 80 years and over is 5.7 while for drivers aged 17 years to 24 years it is 10.7.
In Tasmania older drivers are involved in fewer fatality and serious casualty injury crash rates than any other age group.
Again referring to national figures, for older drivers the total fatality road trauma costs are around 10 times less than for drivers aged 17 - 20 years or 12 times less than for the 21 - 25 years age group.
The Motor Accidents Insurance Board (MAIB) advises that drivers aged 20 years or under have the highest number of claims per 1000 licences. These claims are across all categories (includes passengers and pedestrians) and all injuries. The ratio declines progressively to the 61-70 years age group and then increases for the 71 years and over age group. These claims are due to the fragility factor (that is, older drivers' frailty means they tend to be more seriously injured in any accident in which they are involved) so older people's injuries are more severe and it takes longer for them to recover.
Not only is the older drivers' crash risk lower than other age groups, but as they age it is less likely their mortality is linked to a car crash. For the 75 years or more age group, the number of car-related deaths is too small to register statistically and is only a minute proportion of the total cause of deaths occurring in old persons.
The West Australian Transport Minister, Troy Buswell, has stated in relation to his state's relaxed restrictions on older drivers, 'Given the ageing population, the state government is changing the regulations to lessen the unjustified imposition on senior drivers as well as the health system.'
2. Older drivers avoid risk-taking behaviour
Repeated studies have found that elderly drivers do not only avoid conventional risk-taking behaviours, such as speeding, they also recognised their diminished capacities and regulate their driving behaviours accordingly.
Older drivers are under-represented in crashes involving loss of control or collisions due to speeding, risky overtaking or driving under the influence of alcohol. This suggests that they are more aware of the risks that are associated with speeding and driving under the influence of alcohol, and are also more willing to avoid these kinds of risk-taking behaviour.
It has also been noted that many older drivers are aware that their reaction times etcetera may be slower and their vision less acute than they once were and they modify their driving behaviour accordingly. A United State's study concluded, 'per capita crash rates for older people are low because older drivers self-regulate; they avoid congested areas, left turns, night time driving, unfamiliar roads, and freeways.' The same study concluded, 'There is substantial evidence that today's older drivers are more careful, more experienced, and have better coping skills than comparable people just a few decades ago.'
Tasmanian studies have similarly determined that older drivers limit their risk-taking behaviour. Tasmanian authorities have noted, 'Older drivers' crash risk is mitigated by older drivers making behaviour change as they reduce their exposure to risk by driving less, making shorter trips, driving in less traffic volumes, in good driving conditions, in low speed zones and choose less hazardous roads etc. They also drive less distance and often. As older drivers generally don't work and have less commitments they have a greater opportunity to choose when they drive (for example, choose to drive during non-busy times).'
Tasmanian studies have further concluded, 'As a group older drivers do not generally engage in risk-taking behaviour.
"The diminishing desire for excitement and sensation when getting older possibly plays a role. In keeping with this, older people, on average, less often drink-drive than younger adults and generally obey traffic rules more frequently".'
3. Older drivers are the victims of discrimination and media stereotyping
It has been claimed that the Australian media frequently stereotypes older drivers as 'bad', 'hazardous' and 'dangerous'.
In 2008 three researchers from the Queensland University of Technology conducted a survey of media representations of elderly drivers involved in two high profile collisions that resulted in serious injuries to a child. The researchers concluded, 'This
[study] reveals the media's stereotyping of the older road users as being irresponsible, or childlike, which typically results in calls for greater paternalist measures (i.e. doctor's being called upon to report older drivers with medical problems). A separate, but closely situated concept... reveal[s] that "solutions" from the media involve either state-based policy changes [or] more punitive and legislative interventions...'
The study concluded that ethical guidelines are required which sensitise marketers and policymakers to flawed portrayals of the elderly as a strategy to eliminating negative stereotypes of older road users. Thus is seems that many of the demands that elderly drivers face greater restrictions are based on misleading stereotypes of these drivers promoted within the media.
The media's negative representation of older divers is also said to be reflected in popular attitudes and government policies. The recent relaxation of restrictions on older drivers in Tasmanian was taken in response to the state's belief that its former regulations were discriminatory. In justifying it new regulations the government stated, 'A recent review of the older driver licensing system in Tasmania was conducted, in response to a report by the Anti-Discrimination Commissioner claiming that compulsory aged-based driving assessments were discriminatory.
The review showed that older drivers are not a major road safety problem in Tasmania and not over-represented in crash statistics. Normal ageing does not increase crash risk as older drivers generally regulate their own diving and compensate for any gradual decline in driving abilities.'
4. Mobility and independence are very important to older drivers
It has been noted that mobility and independence are extremely important for the elderly. It has been acknowledged that elderly men and women have particular transport needs that driving a car enable them to meet.
Driving allows the elderly to continue to keep in contact with family and friends and to pursue hobbies and interests that are conducted outside the home. As such it is a valuable means of overcoming the isolation that can easily afflict those who have ceased to work and whose children have left home.
Driving also enables the elderly to more easily have their health needs meet. They can more easily attend doctor's appointments, make hospital visits, have medical tests done, collect results and have prescriptions filled.
The Australian government's seniors Internet page states, 'Continuing to drive has a number of benefits:
Social interaction is easier as you can drive to club events and social gatherings etc.
The independence of not having to rely on friends and family to go on short trips for shopping etc.
The entertainment value of getting out and about rather than being stuck in your residence all the time.'
A 2006 Monash University study concluded that the ability to travel is associated with freedom, activity and choice and driving offers an important mobility option for most elderly. Ceasing to be able to drive is linked to an increase in depressive symptoms and a decline in out-of-home activity levels and community involvement. Further, for at least some people, the same health conditions and functional impairments that may have contributed to a loss of driving rights will also limit access to other transport options.
5. There are more effective ways of detecting dangerous older drivers than blanket tests and restrictions
It has regularly been noted that driving tests applied to elderly drivers often succeed in removing some older drivers from the road; however, they are not well-targeted as the drivers disqualified are not necessarily a road hazard. Elderly drivers are frequently intimidated by poorly conducted tests conducted in testers' vehicles and perform far less well than they would under more normal conditions in their own cars. Thus the drivers removed from the road are often not those whose limited driving competence makes this the most appropriate option.
The United States and Australia have developed and are currently testing model programs that individual states could adopt to increase the cost-effectiveness and equity of their licensing approaches.
The model is a two-tier program with initial screening processes based on behaviour rather than age or appearance; they are designed to be easily, cheaply, and uniformly applied to drivers required to undergo evaluation. The first-tier tests can identify those older people who can continue to drive safely, those who might benefit from additional in-car driving training, and those who require additional screening or evaluation.
Then appropriate-and more detailed and expensive-tests are applied to those requiring additional evaluation; the outcome of the second-tier testing could be removal of the license, restrictions on the license, or mandatory retraining to keep the license.
Arguments in favour of greater restrictions being placed on elderly drivers
1. The relatively low incidence of accidents among elderly drivers is misleading
It has been claimed that although the absolute number of automobile crashes involving older drivers is low, these drivers have a high incidence of crashes per kilometre driven and a higher incidence of crashes involving serious injury or death.
Elderly drivers constitute a relatively small percentage of total road-users. They typically use their vehicles relatively infrequently and tend to drive in familiar areas and under better conditions, avoiding night driving and bad-weather driving. These factors help to account for their apparent safety. However, some studies have indicated that relative to the actual amount of driving elderly motorists do, they represent a major risk to themselves and all road users.
A 1986 United States study showed that 16- to 19-year-old drivers had 28.6 crashes per million miles and 5.6 fatalities per 100 million miles, 45- to 49-year-old drivers had 3.7 crashes and 0.9 fatalities, and drivers aged 85 years and older had 38.8 crashes and 30.7 fatalities. Using data such as this it appears that relative to distance travelled, elderly drivers are the group most likely to be involved in a crash and that the accidents in which they are a part are most likely to result in fatalities.
Another United States study has claimed, 'On the basis of estimated annual travel, the fatality rate for drivers 85 and over is nine times as high as the rate for drivers 25 through 69 years old.'
Statistics for South Australia issued in December 2011 indicate that repeat driving offenders and elderly motorists were most likely to have died or contributed to a death on the state's roads in 2011. Drivers over the age of 60 accounted for 23 of the 102 road fatalities in 2011 - one more than 2010 and the second year in a row for which the age group led the road toll.
After the age of 75, the risk of driver fatality increases sharply, because older drivers are more vulnerable to both crash-related injury and death. Three behavioural factors in particular may contribute to these statistics: poor judgement in making right-hand turns; drifting within the traffic lane; and decreased ability to change behaviour in response to an unexpected or rapidly changing situation.
2. Older drivers are at greater risk of cognitive impairment
Age increases the likelihood of cognitive impairment and cognitive impairment reduces driving competence. In 2009 the number of Australians with dementia was estimated to be 245,000 (over 1.0% of the population). This group is of concern because of the adverse effect the condition has upon driving competence. It has also been noted that in the early stages of the disease neither elderly drivers nor their families may be aware that there is a problem. In 2005 there were nearly 52,000 Australians newly diagnosed with dementia. The group undiagnosed could be just as large or even larger.
An article published in the Lancet in 1997 reported on a postmortem study of the brains of drivers aged 65 years and older who were killed in car accidents which found that over 50% had the neuropathological changes of Alzheimer's disease.
This study has been used to suggest that many drivers over 65 are likely to have some degree of dementia.
The high percentage of these drivers involved in fatal accidents has also been used to support the view that dementia reduces driving capacity.
A 1997 study published in the Medical Journal of Australia noted, 'Risks for car accidents are related to speed of information processing and efficient switching of selective attention, both of which are impaired in the early stages of Alzheimer's disease. When traffic conditions become complex and stressful (e.g., at intersections and roundabouts), demands on drivers with dementia may exceed their driving capabilities. Visuospatial orientation is important for selecting the correct side of the road and for making appropriate and safe turns. Impaired judgement would reduce a driver's ability to make appropriate decisions in traffic and to interpret traffic signs. Drivers with dementia would also have difficulty with aspects of driving that rely heavily on recent memory (such as remembering warnings about changed traffic conditions), and may not cope with sudden changes or new environments.'
It has also been found that some of the medications older drivers take to address conditions such as depression may impair their driving performance. This was suggested in a wide-ranging United States study published in 1992. There were 16,262 persons in the study cohort with 38,701 person-years of follow-up and involvement in 495 crashes resulting in injury. The study suggested a substantial connection between the use of anti-depressives in the elderly and automobile accidents.
3. Elderly drivers are more likely to have a range of physical impairments that reduce their competence
Several studies have found associations between visual acuity, visual field loss, or visual attention and motor vehicle crashes. Medical conditions that have been linked to driving ability or crashes include cardiac disease, diabetes, seizure disorders, Parkinson disease, and stroke.
It has also been demonstrated that lower extremity dysfunction, that is, conditions such as arthritis, which may affect the driver's ability to use the brake and the accelerator may also be implicated in an increased likelihood of car accidents.
Visual attention has been found to be a more reliable predictor of crash occurrence than other measures of visual function. That is, the driver's capacity for sustained visual attention has been suggested as a major determiner of their risk of being involved in a motor vehicle accident. Older drivers typically have a reduced capacity for visual attention.
Although none of these physiological conditions is found exclusively among the elderly, they are most commonly so. It is also the case that many of these conditions can be found in combination in some elderly drivers, dramatically reducing their driving competence.
4. There are no adequate measures in place to monitor the competence of elderly drivers
There are no generally recognised tests for measuring the extent to which driving capacity may have been reduced. It has also been noted that even when an elderly person is known to have a cognitive impairment that would reduce their driving competence there is no automatic requirement that they surrender their licence.
A report published in the Medical Journal of Australia in 1997 noted, 'Medical practitioners in Australia are not obliged by law to report drivers with dementia (there are much more specific guidelines for conditions such as epilepsy or stroke).
The current New South Wales Roads and Traffic Authority guidelines for medical practitioners do not specifically exclude all people with dementia from driving (rather, recommending that drivers with dementia should be referred for on-road assessment if their ability to drive is in doubt), and do not give specific direction about how to assess cognitive function and behaviour in relation to driving skills. The Federal Office of Road Safety does exclude any person with dementia from driving a commercial vehicle.'
Routine medical examinations often fail to identify elderly drivers with poor driving habits or those at higher crash risk. Increased crash risk may be associated with a lower score on standard mental competence tests; however, this is not always the case. Also, a spouse or other family member cannot be relied upon to predict the safety of continued driving.
It has been found that persons with borderline cognitive impairment were more likely to be involved in motor vehicle accidents than were those with higher or lower scores. This seems to indicate that in the early stages of a cognitive impairment, the sufferer and his or her family is less likely to recognise the condition and limit the affected person's driving.
It has been suggested that a multidisciplinary approach involving an occupational therapist and neuropsychologist can help identify unsafe drivers when there is still doubt after a medical assessment. The occupational therapist and neuropsychologist are skilled in assessing cognitive impairments such as attentional deficits, impaired concentration, visuospatial impairments, slowed reaction times and distractibility which are likely to result in impaired driving. It has been suggested that compulsory testing for all drivers over 70 would be the only way of ensuring compliance in screening.
A 1997 study published in the Medical Journal of Australia recommended, 'Doctors should use a recognised form of cognitive screening to assess all their patients over 70 years who drive. Doctors also need better training in medical driving assessments and diagnosis of early Alzheimer's disease.
A number of expert studies have suggested that more funding is needed for on-road assessment of cognitively impaired drivers and that there needs to be more research into the reliability of medical driver assessments, crash risks and cognitive screening measures, particularly for the very early stages of Alzheimer's disease. Future research may also involve interactive computer-based simulations to evaluate on-road driving skills.'
5. The restrictions placed on elderly impaired drivers are inadequate
It has been claimed that the restrictions placed on elderly drivers known to be impaired are not adequate.
Restricted licences are commonly issued for known impaired drivers in Australia. However, critics claim that the use of these licences to allow drivers with dementia to drive only short distances from home has not been proved effective or safe, and may give a false sense of security to drivers with dementia and their doctors based on the false expectation that people with dementia will not have problems if they remain in familiar surroundings.
Some authorities have claimed that the increased crash risk for drivers with dementia remains even though they may restrict their driving. In one study nearly 50% of drivers with dementia incurred at least one crash, compared with only 10% of control subjects, within a five-year period.
It has been claimed that this situation will not simply resolve itself because currently there are no guidelines as to when people with early dementia who have been permitted to continue driving should be reassessed and what sort of end-points should be used in deciding when to terminate their licences.
Further implications
The question of how to deal with ageing drivers will probably become more acute with time. As the baby boomer generation moves into its sixties and beyond the number of elderly drivers on the road will increase. It has also been suggested that the baby boomer generation will be more ambitious drivers in old age than other generations have proved. They are thus likely to drive for longer distances and in more challenging driving circumstances than many elderly drivers currently do. This more adventurous behaviour is likely to put both the ageing boomers and other road users at greater risk.
Blanket testing and blanket restrictions do not appear to be an appropriate means of addressing the problems that elderly drivers potentially pose as they are too insensitive. They do not acknowledge that many elderly drivers are not a road hazard. Blanket tests which might needlessly remove elderly drivers from the road would unfairly penalise these drivers, depriving them of the life opportunities and independence that easy access to transport provides.
The new testing schemes being developed within both Australian and the United States seem to offer a solution. These tests would only be applied to elderly drivers whose health circumstances or driving behaviour suggest that these drivers need closer investigation.
In Western Australia mandatory reporting of long-term or permanent medical conditions or driving impairments for all licence holders was introduced in 2008, and has been effective in identifying potentially high-risk drivers of all ages.
Elderly drivers identified as at risk would receive both further medical tests and practical driving tests depending on what their individual situations seemed to require. The tests would be tailored to detect the characteristics relevant to driving competence. The result of an adverse test result would not be automatic loss of licence. Rather, the elderly person's medications would be reviewed and they would be offered opportunities such as physiotherapy or a course of driver-instruction to help develop their skills. They might also be given a restricted licence in a manner more sensitive and appropriate than the way in which restricted licences are currently issued.
All of the above reforms would have the dual advantage of reducing the road risk posed by elderly drivers and of retaining elderly drivers' freedom and independence where possible. The downside is that such initiatives will be expensive. They would require a significant investment in new testing procedures and staff training among driving testers and instructors. There would need to be educational programs to heighten doctors' and physiotherapists' awareness of their responsibilities in this area and perhaps some new tests of physiological competence would have to be developed.
Coupled with the above, there would need to be a massive publicity campaign to shift popular attitudes toward elderly drivers so that younger drivers and the community at large become less prejudiced and punitive. Elderly drivers need to be able to trust that they will be treated fairly if their driving competence is called into question.
Newspaper items used in the compilation of this issue outline (see also Internet Information section for more)
The Australian: September 26, 2011, page 8, news item (ref to WA) by Debbie Guest, `State ups drivers' age for medicals to 80'. (no net link)
The Age: February 22, 2012, page 3, news item by Barry Park Park, `Safety watchdog rules out doctors dobbing in drivers'.
http://news.drive.com.au/drive/motor-news/safety-watchdog-rules-out-doctors-dobbing-in-drivers-20120221-1tlth.html
Herald-Sun: February 20, 2010, page 11, news item by Devic and Campbell, `Get them off the road / Seniors fight push for elderly drivers to hand licences in' (with statistics on Victorian ageing motorists).
http://www.heraldsun.com.au/news/more-news/seniors-fight-push-for-elderly-drivers-to-hand-licences-in/story-fn7x8me2-1226275191486
The Age: February 20, 2012, page 2, news item (photo of route followed by elderly caravan-and-car driver along Melbourne freeways / tollways / bridges) by Andy Park, `Collisions follow caravan of confusion'
http://www.theage.com.au/victoria/collisions-follow-caravan-of-confusion-20120219-1th9k.html