Driving is the great American pastime, particularly for baby boomers who grew up believing that the ability to drive marked independence and freedom as an adult.

With the number of older adult drivers rapidly increasing — up 34 percent in 2012 versus 1999 — resources and actions to address safe driving are increasingly important to our public health. In 2015 alone, there were 6,165 people 65 and older killed, and an estimated 240,000 injured in motor vehicle crashes. Geriatrics health-care professionals and caregivers, as well as family and friends, need to speak with older adults about driving — encouraging conversations about aging, safety, and the reality that we all can stay active even after independent driving is no longer a safe option.

As a geriatrician, I have worked with many older adults — including my own mother — who face challenges associated with aging and driving. The best piece of advice I can give is one that many people don't recognize: Age is not the only, or even most important, factor in determining whether it's time to stop driving. Instead, it is most important to look at changes in behavior and mental or physical abilities, and to follow the steps below to ensure that we all feel safe and confident every time we get behind the wheel.

  1. See a health-care provider and get tested. Many times, driving skills change as we age because of adjustments in our mental and physical well-being. These are often symptoms of specific issues with specific solutions. The first step is to see a doctor or other health-care professional to get tested for impairments, both physical and mental. Pain, poor vision, and difficulty with certain skills can at times be prevented or slowed through medical treatment or occupational therapy. Different states have different resources for testing and rehabilitation, all of which can assist older adults in continuing to drive safely for as long as possible.
  2. Change habits and adapt. Driving can seem daunting as we age, but it is important to remember that older adults already have adapted to many challenges throughout their lives. Adopting new driving habits or transportation means is just another example of that. For older adults who are still able to safely drive, some of these habits may include avoiding highways or other busy routes, limiting such distractions as car radios, and adjusting seats to make driving more comfortable. It can be useful to research routes in advance to find the best and safest way to reach a destination.
  3. Speak honestly about driving and limitations. At some point, it may be important to look critically at our own driving skills — or to trust that a caregiver, friend, or family member will do the same. Taking 30 minutes to sit with an older adult to discuss transitioning from driving independently can prevent numerous crashes and even save lives. These conversations are not always easy, but it is important to ask older people whether they feel safe operating a vehicle or why their driving habits might be changing. When trying to facilitate a conversation about safe driving and driver transitions, a geriatrics health-care professional can be a great ally. Other helpful resources include tip sheets and guides developed by the American Geriatrics Society and the National Highway Traffic Safety Administration - all available on www.HealthinAging.org.
  4. Come up with a transportation plan. When driving is no longer a safe option, remember that this is not the end of independence or mobility. It simply means we need new transportation plans to meet our needs. Many cities have programs to help older adults pursue everyday activities. People 65 and older can show state identification, a Medicare card, or several other forms of identification for free rides on SEPTA buses, trolleys,  subways, and soon, regional rail. Customized Community Transportation (CCT) in the Philadelphia area also provides paratransit service to older adults and individuals with disabilities. Contact 215-580-7145 or accessibility@septa.org for more information.

Just as you would make a transportation plan if you were injured or needed a ride to an important appointment, transitioning from driving simply means planning a bit more in advance to come up with valuable and effective solutions. We can meet this challenge just as we have met so many others on our way to aging successfully.

Alice Pomidor, MD, MPH, is editorial board chair for the American Geriatrics Society's Clinician's Guide to Assessing and Counseling Older Drivers.