Consider the following statements:
“I’ve been driving for 57 years and I’ve never had an accident.”
“If my driving skills were deteriorating, I’d know it.”
“I don’t drive at night, in bad weather, or on highways.”
As an occupational therapist and driver rehabilitation specialist, I am in contact with many drivers who have a family member or a physician who is concerned about their continued driving or return to driving after illness or injury.
Our society keeps a close eye on older drivers because they are more likely to have health concerns that may impact safe driving, and because they are less likely than their younger counterparts to survive a major collision. Statistics show that older drivers are more likely than drivers of other age groups to self-regulate when it comes to driving. Common self-restrictions include not driving at night and not driving on highways. As a group, older drivers do not text or talk on a cellphone while driving.
“Positive self-bias” is the psychological term for the belief that one’s own abilities are better than the average or better than the majority for a particular task. We would expect that a person with a brain injury or dementia might lack insight into their deficits, but we generally expect that a healthy person is capable of making appropriate restrictions on his or her driving. This blog entry suggests that even those of us in good health are not adequate reporters of our own driver safety.
Research into many areas of human behavior demonstrates that we are not as skilled or adept as we think we are in areas of performance including parenting, teaching, and communication. It is widely recognized that another person’s judgement of us, while carrying some degree of bias, is better than our self-assessment most of the time. When it comes to assessing driving skills and performance, a professional driving evaluation can offer an expert assessment with significantly less bias.
A research group out of Lakehead University and St. Joseph’s Care Group in Thunder Bay, Ontario have been publishing research on the topic of driver self-assessment for many years. Their recent paper in the Canadian Journal of Occupational Therapy1 reflects on positive self-bias among older drivers, its relationship to driver confidence and self-restriction, and its correlation with driver safety. Two studies were performed on healthy adults, ages 65+ who scored in the passing range on a common clinical test of cognitive performance. These studies compared results of different self-rating scales and questionnaires against on-road performance on a standardized road test.
Based on my preface, can you guess at the results?
If data is boring to you, you can skip the next two paragraphs. No measurement of driver confidence correlated with performing well on the gold standard, on-road assessment!
Ninety-one percent of drivers in study 1 who believed they had the skills to get themselves out of a dangerous driving situation passed the on-road examination. However, of those who failed, 92.1% held the same belief. There was no significant difference in pass/fail scores between those who restrict some driving behaviors and those who do not restrict at all. Likewise, there was no significant difference in outcome for those who reported themselves “not as likely” to crash versus those who reported themselves “just as likely” to crash.
In study 2, overall driving comfort levels for those who passed the on-road test were 65.52% compared to 65.61% for those who failed. Neither the daytime or nighttime scales revealed significant correlations with actual on-road scores.
The bottom line: we are not accurate reporters of our own driving safety. To make a better judgement on driving fitness, a second-party or a third-party should be employed. A second-party would be a friend or a family member who is willing to ride along with the driver to take note of driver habits and safety in a variety of traffic situations. A third-party would be an occupational therapist or driver rehabilitation specialist with knowledge of aging and traffic safety. Driving evaluators use research backed tests which are predictive of on-road outcomes and, therefore, driver safety.
Four ways we can help ourselves and those we care about to gain insight into older driver safety:
1. Take the AARP Driver Safety course on Wednesday, June 15th 2016. This class is offered twice annually at Emerson Hospital, and taught by an AARP volunteer. It is a 5-hour classroom based course focused on how cars and roads are changing, and includes a review of safe driving techniques and education about the most common driver errors for older drivers. The cost is $15 AARP members and $20 non-members. Call Kristen at 978-287-8244.
2. The Fitness-to-Drive Screening Measure can be found at http://fitnesstodrive.phhp.ufl.edu/. A friend of family member who has driven with the driver in the previous three months is asked to complete a survey about his observations of the subjects driving. This measure has been proven to be a more accurate predictor of driver safety than the estimate of the driver alone.
3. CarFit is a free program developed by the AAA, AARP, and the American Occupational Therapy Association (AOTA) to help to explore issues of comfort, safety, and fit of an individual driver within their own vehicle. Emerson Hospital offers this program twice annually. More information on this subject is available at www.car-fit.org.
4. Occupational therapy driver assessment is available at several hospitals in Massachusetts including Emerson Hospital. Visit our website at https://emersonhospital.org/en/KeystoIndependence1.aspx to learn more about this program.
Kristen Dixon Keilty is an occupational therapist and driving instructor at Emerson Hospital. She will be giving a lecture on Older Driver Safety at the Westford Council on Aging on Tuesday, June 14th at 6pm. The AARP Driver Safety Program will be held on Wednesday, June 15th from 10am-3pm at 300 Baker Avenue in Concord. A free CarFit event will be held in Fall 2016, to be announced. To register for the upcoming AARP Driver Safety class, or for more information on driver evaluation at Emerson Hospital, call Kristen at (978) 287-8244.