Business and community groups could use school buses to take seniors on shopping trips at off-peak hours, suggests an editorial in the Canadian Medical Association Journal. (CBC)

A senior's licence to drive shouldn't trump public safety, say doctors advocating better transportation programs for an aging population.

In an editorial published Monday in the Canadian Medical Association Journal, Dr. Noni MacDonald, section editor, and Dr. Paul Hébert, the journal's editor-in-chief, note that one in four Canadians will be 65 or older by 2025.

"Just as planning for job retirement is the social norm, we should be planning for driving retirement by creating programs to help seniors drive safely as long as possible and when they can't, to help them get around," the editors write.

Reverse graduated licensing should be adopted in all provinces, they said. For example, the conditions on some seniors' licences might include:

• Restricted access to four-lane highways, rush-hour traffic times or distance travelled.
• Restrictions on driving at night, when vision may not be as good.

The pair suggested municipalities, health authorities, community groups and all levels of government could develop creative solutions for driving seniors, such as:

• Providing tax or financial incentives when people carpool to grocery stores and social events.
• Mandating urban planners consider seniors' needs when planning public transit routes, and placing housing and shopping areas.
• Subsidizing shuttle van services for suburban and rural communities.
• Establishing grocery bus services through local businesses and community groups, using school buses during off-peak hours or on certain days to take seniors for shopping and a coffee break.

Without such programs, seniors will prematurely find themselves in nursing homes at significant personal cost and public expense, the authors said.

Fit to drive?

Doctors sorely need a simple, widely applicable screening assessment tool to help determine whether a senior is able to drive safely, the pair said.

Physicians and other health professionals will always be required to report people they suspect are unsafe drivers, but the authors said only governments should be responsible for revoking a driver's licence using standardized driving assessments.

Once a doctor has deemed a person unfit to drive, the licensing authority would decide whether that person should continue to be eligible to drive.

There is no set age that defines when a person should stop driving. But experts suggest drivers consider how any medical conditions or impairments have affected their driving skills.

In February 2009, the Canadian Association of Occupational Therapists launched the National Blueprint for Injury Prevention in Older Drivers, a federally funded research program that includes a website on safety for older drivers and a series of brochures. The website describes the effects of normal aging and offer tips to reduce the risks.

The blueprint's authors concluded older drivers who want to stay behind the wheel longer are looking for measures such as refresher courses to help them continue safely.

The researchers noted that some older drivers can be retrained to improve their response times, visual search abilities such as scanning for hazards, and flexibility to turn and see behind them.

The website offers a list of questions to drivers and their families to determine whether they should continue driving.

Questions to the driver include:

• Have you noticed a change in your driving skills?
• Do others honk or show signs of irritation?
• Have you lost confidence in your driving ability, leading you to drive less often?
• Have others criticized your driving or refused to drive with you?

Family members wondering whether an elderly person should continue driving might want to consider whether they feel comfortable when that person is driving, as well as whether the person has exhibited abnormal behaviour behind the wheel or had recent accidents or traffic tickets.

In January, Ontario Transportation Minister Jim Bradley said the province has the "toughest regime" in Canada for elderly drivers.

When Ontario drivers turn 80, they must pass a written test and attend a class with other drivers. A driver with demerit points must pass also pass a road test.

Drivers over the age of 70 who cause an accident are required to take a re-test. Any medical problems must also be reported to the ministry by law, and the driver's licence is suspended until those problems are overcome, Bradley added.

With files from The Canadian Press