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Lift weights, eat carrots, play ping pong to keep driving

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Senior drivers
Professor Catherine Sullivan, left, who teaches occupational therapy at St. Catherine University, and 86-year-old Geraldine Thompson, of St. Paul, look for a place to attach a small handle to Thompson's car during a CarFit clinic Thursday, April 19, 2012. Thompson said she sometimes struggles to lift herself out of her car, so their idea was that a handle might help. Unfortunately, they couldn't find a sturdy place to attach it.
MPR Photo/Jennifer Simonson

"As we age, we shrink," said 73-year-old Glenda Noble, backing her Dodge Intrepid from the garage of her Waconia townhouse. That's why she sits on a small blue pillow and has adjusted  her car in other ways. "You'll notice that I have the passenger seat set back so I can see," she said crisply, checking for oncoming cars through trifocal lenses.

Noble was on her way to one of the exercise classes she attends four times a week, which keep her generally fit but also make her limber and sharp for driving. "It's important to stay alert and keep the brain alert," she said. "When you are doing physical activity, you are stimulating blood flow to the brain."

The retired high school teacher, who also has a law degree, has been driving since she was 16 and intends to keep driving as long as she can. She belongs to the local friends of the library group as well as the League of Women Voters. She serves on the Waconia Commission on Aging and runs a social club called Young at Heart. In Waconia, just under an hour from the Twin Cities, driving is essential, Noble said. The local bus can be expensive and inconvenient because it only runs Monday through Friday until 7 pm.

Glenda Noble
Glenda Noble discusses the alterations to her diving habits and activities as she ages. The support of her driving skills helps maintain her independence.
MPR Photo/Jennifer Vogel

Keeping Noble and others like her in their cars is one way to address the economic and demographic factors that make it harder for many Minnesotans to get where they want to go. If she couldn't drive, she said, "I think I would lose a sense of self and independence that nothing else would be able to replace."

By the time a driver reaches his or her 70s, the risk of accidents typically starts to increase. Children scrutinize their parents as they merge onto highways, nervously gauging reaction times and the effects of arthritis and diabetes.   Seniors, in turn, tend to bristle at the suggestion that they should give up their keys.

WHEN YOU DON'T DRIVE, YOU DON'T GO OUT

The fear has practical roots. Seniors who stop driving make significantly fewer trips out of the house than those who drive. One national study from 2004, called "Aging Americans: Stranded Without Options,"found that "more than 50 percent of non-drivers age 65 and older... stay home on any given day partially because they lack transportation options." 

Non-drivers, especially those in rural areas, visit stores and restaurants less and make fewer trips to "social, family and religious activities."

"It's important to stay alert and keep the brain alert."

Driving is especially important in outstate Minnesota, beyond the reach of metro transit systems, where people often must travel long distances on routine errands. People outside the Twin Cities ride buses less than their urban counterparts, in part because service is usually limited. Several counties in the state offer no public transit at all. 

When driving is your best option, you want to keep doing it for as long as possible. And myriad programs help seniors not only evaluate their driving skills but also extend their years behind the wheel. CarFit events, for example, utilize trained technicians who adjust seats, mirrors and other features to make driving easier. And AAA's Roadwise Review software allows seniors to test their flexibility and visual acuity at home away from prying eyes.

Catherine Sullivan, an occupational therapist and associate professor at St. Catherine University in St. Paul, started a program in 2010 called "Safe Access to Destinations," in which seniors learn ways to evaluate and improve their driving abilities. "To be healthy physically and mentally, it's important to be able to go out and participate in your community," said Sullivan. "Transportation is a huge barrier for so many people."

Senior drivers
Jillian Mazura, right, an occupational therapy graduate student at the University of Minnesota, checks to be sure that St. Paul resident Kathleen Holmberg sits a safe distance from her steering wheel when she drives at a CarFit clinic Thursday, April 19, 2012. Students from the University and St. Catherine University held the event to help seniors adjust their cars for maximum safety and comfort.
MPR Photo/Jennifer Simonson

On a recent Thursday, half a dozen senior women attended one of her sessions at an independent living facility in St. Paul focused on transportation alternatives. It's part of a series that includes topics like "personal strategies for driving safely," which can mean playing ping pong to improve coordination or rolling eyes left and right to sharpen vision. The classes are largely conducted by Sullivan's students.

Standing at the front of the room, Sullivan donned an orange reflective safety vest. "You're probably wondering why I'm wearing this," she said. She explained that she was hosting a CarFit event the following week and wanted participants to understand that she wasn't the police. "Last time, two people turned around because they thought I was the police."

CarFit was created in 2005 by the American Society on Aging, AAA and other organizations. Seniors drive into a parking lot, where the technicians check their car settings. "With a lot of women, if their spouses are the main driver of the car, they get in and don't dare adjust anything," said Noble, who became a technician after attending an event and having her own car adjusted.

"They're sitting there with the seat too far back, stretching so just their toes reach the pedals," she said. "It's dangerous. The airbag would hit them in the wrong place if it were to go off. A lot of older people aren't used to the modern conveniences and don't know the seats can be adjusted up and forward and back and the backrest can go up and down."

The atmosphere is "very non-threatening," Noble added. "The police are not involved at all. We urge people to come and take advantage of it without feeling they will have their license taken away."

Beyond these programs, seniors can make lifestyle changes to keep up their driving skills, such as eating vision-strengthening vegetables like carrots and apricots and completing crossword puzzles. Or they can attend exercise classes, like Noble does.

Wearing white sneakers and a San Francisco sweatshirt, Noble is the picture of determination as she rounds the walking track with a friend, who also is 73 and used to be a postal driver. In class, she crunches a rubber ball between her knees, lifts weights, uses rubber straps to strengthen her arms and stands on one foot to improve her ankle strength and balance.

Of 10 people in the class, all but one are women. "Women are more open to changing things," said Noble. "Men think it's wussy to exercise."

SENIOR DRIVERS ON THE RISE

The number of senior drivers promises to skyrocket. First, the "silver tsunami" of baby boomers reaching retirement age is especially noticeable in rural areas. The growing emphasis on "aging in place," a social and cost-saving philosophy that involves staying out of nursing homes for as long as possible, is a factor too.

The increase has started already. Between 2005 and 2010, the number of licensed drivers 65 and older rose by 13 percent, to more than 625,000, according to a report last year from the Minnesota Department of Public Safety. The number of drivers 85 and older increased at an even greater rate during the same period, by 22 percent, to over 74,000.

Here's another way to look at it: In 2005, one in eight licensed Minnesota drivers was over 65. Five years later, the figure was one in just over six.

This may strike fear into the hearts of younger drivers. But the stereotype of the unsafe senior motorist isn't entirely true. While seniors are more likely to be injured in an accident because of their physical frailty, they are involved in fewer accidents than other age groups. The same state report said, "People aged 15- 24 make up 15.2 percent of the licensed drivers, yet they accounted for 25.3 percent of the crash-involved drivers... By contrast drivers over 65 made up 15.7 percent of the driving population, but accounted for just 8.0 percent of the crash-involved drivers."

Senior drivers
At a CarFit event in the parking lot of Gloria Dei Lutheran Church in St. Paul, seniors were invited to consult with occupational therapy students from St. Catherine University and the University of Minnesota about how to adjust their cars for improved comfort and safety Thursday, April 19, 2012.
MPR Photo/Jennifer Simonson

That's because what seniors may lack in sharpness of vision or quickness of reflexes, they make up for in caution. As drivers age, they may be less able to turn their heads to see behind them. 

Their vision may become centralized so they pay less attention to what's happening on the periphery. But seniors can and often do adjust for these factors. Many stop driving at night or during rain or snow storms. They may no longer drive in the city, sticking to rural roads with less traffic. Perhaps they drive more slowly and avoid risky left turns. They are also not likely to text while driving.

"I find that my peripheral vision isn't as good as it used to be at night," said Noble. "The glare bothers me from car lights, so I'm cautious about where I go. I don't like to drive out of town very much. I don't go out a lot at night, of course. In the winter I don't get out on the roads and highway during the bad weather. I know my limitations."

THE SENIOR DRIVING GENDER GAP

Interestingly, women may pay more attention to their limitations than men do. Some even think women sometimes give up driving too soon. "There is a clear difference," said Sullivan. "Men tend to not give up early enough. They wait too long. It's different for men. Driving is part of their identity. I don't know if that's a generational thing. Boomers are more used to alternating the gender roles in driving. Men tend to have an accident before they give up. Women are the opposite. They look at accidents that others have and become anxious and worried."

"I try to encourage women to drive so they don't lose practice," Sullivan said.

Women are also more cautious than men on the road, according to recent data from the Centers for Disease Control and Prevention. Of those 65 and older surveyed, significantly more women than men said they avoided driving under certain conditions. "Only 9 percent of older men, but 34 percent of older women, reported avoiding driving on highways or high-speed roads."

91-year-old Mae Koershen lives in an assisted living facility in Norwood Young America and is considering giving up her car this year. As it is, she gets her Dodge Spirit out only during the summer, a dramatic shift for a woman who started driving when she was 17 and living on a farm.

"I used to go driving around in the country around here, sightseeing around Eagle Lake," Koershen said. "I'd go to Waconia." She's narrowed her range significantly and also no longer drives at night or takes passengers, who can be distracting. "I don't drive to Princeton anymore because of the traffic in Montevideo and Buffalo," she said. "I've cut down a lot. In fact, I think I'll get rid of (my car) this fall. I don't want to, but maybe at my age I should. I hope I don't have any accidents before fall. Three men have backed into me when I was coming into a parking lot."

Koershen could take the bus to the grocery store and her church will pick her up for events. Asked what she'd miss if she stopped driving, she paused. "All of my friends are gone," she said, indicating that she doesn't have a lot of people to visit anymore. "I don't want to rely on others to do something I've always done myself," she said.

"I would feel like I'm locked up for good."

(For more information, see the Minnesota Gerontological Society video called "Love of Car.")