Jacob Mendelson has belonged to the Old Dominion Boat Club in downtown Alexandria, Va., for most of his 82 years, and nearly every day, he drives over from his apartment in an adjacent community. He knows he reacts more slowly in traffic and sees less because of glaucoma, so he tries to be careful. He has no intention of hanging up his car keys. "I'm not going to stay here and look at four walls," he said.
Doris Jackson is 81, and these days the garage of her Washington home stands empty. She gave away her treasured Honda in the fall after suffering a stroke and other medical problems. For any trip now, she must arrange for friends to pick her up, or group her errands to minimize cab rides. "I'm finding it very difficult," she conceded.
Mendelson and Jackson embody the predicament facing many elderly men and women, their families and the country.
As an aging America is starting to realize, addressing the issue of millions of drivers in their 70s and beyond involves a tough trade-off between safety and mobility, between the risk to life and the risk to quality of life.
"Transportation is the glue that keeps life together," said Joseph Coughlin of the Center for Transportation Studies at the Massachusetts Institute of Technology. "If you pull it without [providing] an alternative . . . it's like sentencing many elderly people to isolation."
More attention is being paid today to helping seniors or giving them options once their driving days are over. The next two years could be pivotal on both fronts.
This spring, researchers in Salisbury, Md., hope to begin a pilot run for a driver assessment that someday could serve as a standardized test nationwide. Elderly subjects would be asked to perform a brief series of tests, including quickly walking a short path, recalling three words after several minutes' time, reaching as high overhead as possible and tapping their right foot between two marks.
And with the United Nations having declared 1999 the International Year of Older Persons, one of the foremost U.S. experts on the subject intends to keep public interest focused. Among other things, John W. Eberhard wants to convene a series of town meetings across the country to discuss mobility and the elderly.
"Everything's coming to a head now," said Eberhard, senior research psychologist at the Department of Transportation.
Dozens of states have initiatives underway. Maryland is organizing a consortium of social service agencies, transportation organizations and health professionals intent on keeping people on the move.
The impetus for these efforts is demographics. By 2020, the United States will have more than 40 million registered drivers at least 70 years old. There are 24 million such drivers already.
The number of crashes and fatalities involving seniors can be daunting. When calculated per miles traveled, the driver-fatality rate shows that they are more vulnerable than any other age group but teenagers.
Some researchers, however, question how much weight should be given to those worst-case statistics. They note that one reason more elderly people are killed in motor vehicle accidents is that they are more frail physically. Based on other numbers, seniors actually pose less danger. According to the National Highway Traffic Safety Administration, the 70-and-older crowd has 34 crashes per 1,000 drivers, compared with 63 crashes for drivers ages 35 to 44, and 50 crashes for those ages 45 to 54.
"As a group, older drivers are pretty safe," said Susan Ferguson, a vice president at the Insurance Institute for Highway Safety.
Many regulate themselves quite effectively as they age, studies show. As hearing and vision diminish, or attention and confidence lag, they curtail night travel and limit themselves to familiar streets. Women tend to stop driving earlier than men, which can have drastic consequences if husbands on whom they depend for transportation die.
Instead of discouraging seniors, Eberhard would keep as many as possible in the driver's seat. "I'd like to demonstrate what the impact of that has on the quality of life and the cost to society," he said.
In northern Virginia, Jacob Mendelson has repeatedly taken the "55 Alive" course offered by the American Assn. of Retired Persons. For two days recently, he was back in class, listening to Gene Hastings, a volunteer instructor, offer safety strategies, review traffic laws and warn that medications can impair driving.
Hastings, well into his 70s, says little seems quite as devastating as the loss of independence. "It's almost as much trauma as losing a mate." Even so, he added, there's probably a point when everyone should cease driving.
Yet not all seniors approach the issue with such equanimity.
Richard Marottoli, a physician at the Yale University School of Medicine, will not soon forget one patient's response after he told her she should surrender her license. "You might as well put a noose around my neck," she said bitterly.