On April 21 in Ontario, new changes to the over- 80 licence testing take effect. The new evaluation has a vision assessment, in- class group education, review of the driver’s record and two short exercises, determining if further assessment is required. At 90 minutes, it’s half the time of the old one, and the cognitive tests, with no computer component, are available in advance. No surprises. This new procedure is a far better measure than the previous one.
The two short exercises are the highlight of the new test. Dr. Louisa Gembora, an independent clinical psychologist specializing in rehabilitation is also a driving instructor. “The clock drawing exercise seems simplistic, but it’s…reliable and viable – we’ve used it for many years, providing the evidence to implement it.”
It tests auditory language skills – following instructions. It tests memory, as the individual must exercise visual spatial function. Motor ability is needed for drawing and linguistic skills to draw the numbers. It highlights executive functioning, the need to plan and organize the drawing. Gembora notes it supersedes any language barriers.
“It’s rank discrimination,”
Kitchener’s Tom Trent, 84, wrote to me after the Ministry of Transportation of Ontario (MTO) announced changes to reassess drivers when they hit 80. Is the government coming after Tom and his friends? Is there a mass movement to strip older driver of their freedom and independence?
There is if you think people whose vision is so impaired they shouldn’t be driving. There is if you believe dementia or failing cognitive skills affect how one drives. There is if you base that movement on cold hard facts according to Statistics Canada: drivers over 70, when you adjust for miles driven, are second in crashes only to those the wild teenage boys we hear so much about. And it’s the seniors who are more likely to die. Choosing to evaluate drivers as they age is evidence based.
My mother passed a crash scene 40 years ago. An elderly driver had hopped a curb and pinned a boy walking by to a fence. The lad lost his leg. The old man was in shock, declaring he’d never seen him, never seen the curb. It was the route I took home from school; my mother kept remembering the boy’s backpack.
Ontario currently requires doctors to report patients they believe impaired by medical conditions or prescriptions that may caused diminished ability behind the wheel. Alberta requires medical exams beginning at aged 65, and anyone can report a driver they believe dangerous. B.C. starts medical exams at 80; Saskatchewan has a gradual delicencing for compromised drivers, based on times driven, distance and time of day.
The AAA in the U.S. says ”seniors are outliving their ability to drive safely by an average of 7 to 10 years.” Family interventions are fraught – and fought – with anger. Nobody driving on our roads today would argue we don’t need a better system in place.
The new guidelines come from years of work with CANDRIVE, an interdisciplinary group of researchers seeking ways to keep the elderly driving safely. Brenda Vrkljan, Assistant Professor in the school of Rehab Sciences at McMaster University and a member of the CANDRIVE team, says the ministry is embracing the work the organization does. “We put our best self forward in a test, but cognitive tests like the ones now included will reveal gaps that can be missed. We are constantly looking for evidence based, fair testing that protects individual as well as public safety.” The test determines how your brain is actually working, not how you appear.
There is predictable anger among seniors who mistake a driver’s licence with a membership for life card, or who understandably believe clean driving records speak on their behalf. But studies like CANDRIVE hope to soon have in doctor’s hands a comprehensive, definitive way to take only those who are truly compromised off the road – before a fatal lapse.
I called Tom back, explained the changes, and said the test was a better, fairer judge of cognitive ability, rather than a case of blanket discrimination based on age. He was interested in the explanation.
Discrimination based on age? Yes. But it’s predicated on evidence.