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Driving after 75: Safety first, or ageism?

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Driving after 75: Safety first, or ageism?
Is singling out drivers 75 and older “grossly unfair”?
(First of a two-part series.) Prime Times
Alberta Transportation is quietly closing loopholes like “doctor shopping” that will make it harder for some older seniors to renew their driver’s licence.

Alberta drivers are required to pass a mandatory medical exam to renew their licence at age 75, age 80, and every two years after age 80.

According to the government’s website, “the age requirement is based on research that shows some medical conditions and cognitive challenges are more common at certain ages.” (That said) “you will be evaluated on your ability to drive safely on an individual basis, regardless of your age.”

Alberta is one of only three provinces requiring drivers to pass a medical exam to renew their driver’s licence at 75. British Columbia and Ontario don’t require seniors to begin submitting a medical report from their physicians when renewing their licence until age 80 and every two years after that. The rest of the country, including Saskatchewan, have no restrictions based on age.

Brooklyn Elhard, press secretary for the Ministry of Transportation, explains in an email that “the government’s purpose with its policy is to promote and enhance safety on Alberta roads, among drivers and all other road users.

“The decision to revoke a person’s licence is not based on age, but on medical fitness to drive. However, over the 14 years (2003-2016) of collision statistics available, collision rates tend to decrease as drivers age. Drivers aged 70-74 have the lowest collision rates. However, the collision rates gradually increase for drivers 75 years of age and older.”

Some seniors advocates say age-related screening requiring seniors to pass a medical exam when they have no existing medical conditions but might develop them, and have had no accidents or tickets, is ageism – discrimination on the grounds of a person’s age. Drivers may or may not develop medical conditions and cognitive challenges at any age, they argue, so the same rules for renewing a licence should apply whether a person is 25 or 85.

Ruth Adria, executive director of the Elder Advocates of Alberta Society, says Alberta’s process for licensing older drivers is the issue that generates the most complaints her group gets from seniors.

Singling out drivers 75 and older is “grossly unfair,” she adds, noting there’s a general misconception that seniors are more dangerous behind the wheel because of their health, when they actually get into fewer accidents than young drivers.

Rob de Pruis with the Insurance Bureau of Canada in Edmonton, backs that up.

“Statistically speaking from an actuarial perspective, a younger male driver that’s not married is more likely to be involved in an accident than a mature, experienced driver,” he says. “From a pure claims perspective (mature drivers) seem to be a less risky type of driver. My own thoughts are because of their experience they would stick to the speed limits, they’re not doing some things like distracted driving, they’re typically not in a hurry, and depending on their age they may not be working anymore, so not travelling back and forth to work, so they’re literally on the road less.”

Donna Durand, executive director of the Alberta Council on Aging, thinks if older drivers require a medical to renew their licence “it should be (required) across the board.

“Saying when you’re 75 (you have to take a mandatory medical exam) is saying you’re 75, you’re old, you’re sick, we’re looking for the symptoms now. You don’t have them? You will, so we’re really marking people at that point to say you were an autonomous independent adult and now you’re a sick senior,” Durand explains. “We’re actually seeing people under a different lens right then and there. Is that ageism? Yes.”

Government-appointed Alberta Seniors Advocate Sheree Kwong See hears from a lot of outraged seniors facing their first mandatory driver’s medical.

“The response in many cases is shock and bewilderment and a sense of violation – ‘I’ve never had an accident, I’m a good driver why do I have to do this?’ And then the question is ‘Isn’t this discriminatory? And is it a bad thing?’

“We try to explain that it would be discriminatory if this was solely about age,” Kwong See says, “but it isn’t about age, it’s about medical conditions that make it unsafe for people to be on the road. This applies at all times across the lifetime and it just so happens as we grow older there are more age-related medical conditions that can occur that make it unsafe for us to drive and so you have to tap that in some way.”

“We’re very threatened when we’re older around being tested cognitively because we are all fearful of potential dementia,” Kwong See points out. “In many things that happen to us in our life there is ageism, we do know that, but around this particular issue … age is an indicator, age is the proxy.”

However, like many people interviewed for this story, Kwong See acknowledges the implementation of the process of licensing older drivers “is a problem.”

“The process might work … if (seniors) have a great doctor who knows the process and uses it well and knows them very well and is able to use the tools on an individual basis to know what’s really going on with the patient, but that is, like many things in life, not always the case. There will always be some doctors that are better than others.”

Adria hears from seniors who can’t get a doctor to give them a driver’s medical or who have failed the medical, some of whom have successfully challenged the decision and had their licence restored after spending many anxious months and money on further testing.

She’s recently become more upset with the process since learning that seniors can no longer
“doctor shop” or look around for a doctor that will give them a pass on the required driver’s medical.
Adria says one driver went to his doctor for a driver’s medical where he was told he would also have to take a SIMARD MD test (screening for cognitive impairment) and a DriveABLE test (computerized cognitive assessment), even though neither is mandatory. The man went to a walk-in clinic instead where the doctor gave him a medical only, which he passed, and would have allowed him to renew his licence. But the doctor opened a separate electronic driver’s medical file in which the man’s family doctor had listed him as “doctor shopping.” The doctor told the man physicians are now required to report seniors who are doctor shopping and because of that he could not give him a pass on his medical, Adria says.

Seniors should be allowed to get a second opinion if a doctor has told them they’re not fit to drive, she says. “In my world … if I’m given some sort of diagnosis I’m not happy with or I’m concerned, I can go to another doctor, but here this is now punished and its hidden. It’s horrific. (Government) has done horrible things before, but this is the worst. It’s indefensible.”

Donna Paradowski, a family nurse practitioner with SAGE (Seniors Association of Greater Edmonton), says being referred for further driver fitness assessment to places like the Glenrose Rehabilitation Hospital is getting a second opinion. And while a SIMARD MD test is not mandatory, it is a more objective cognitive test, unlike the subjective assessment by a doctor of a longtime patient, Paradowski says.

According to Elhard, the government doesn’t have any statistics on the number of complaints it gets about the way older drivers are licensed. It also doesn’t have any stats on how many driver’s licences are revoked by age, how many such decisions are appealed, or how many licences are returned.

However, as of March 31st, Alberta had 35,857 female drivers and 39,020 male drivers aged 75-79; and 30,236 female drivers and 36,826 male drivers aged 80 and over, Elhard wrote. The latter age group includes some drivers 100 and older.

Adria says she and a couple of senior drivers who had lost their licences met with Ric McIver after his election in 2012 when he was the Conservative government’s Minister of Transportation and found him to be “very sympathetic” to their concerns.

While a Progressive Conservative leadership candidate in 2014, McIver said when he was transportation minister he received a steady stream of complaints from seniors who felt they were being set up to fail the DriveABLE test, which is administered by a private company.

“I’m just going to say it’s not going to be a test that we use anymore,” he said then.

Adria and five other seniors, including a retired Leduc transport truck driver who had to hire a lawyer to get his licence back after it was suspended by a doctor, made a second trek to the legislature to meet with Wayne Drysdale in 2014, when he took over transportation from McIver, to complain about the SIMARD MD and DriveABLE tests.

Adria argued: “there’s no correlation between the testing and the ability to drive,” but Drysdale said he wouldn’t change the rules.

The Conservatives lost the provincial election in 2015, but McIver is again the Minister of Transportation after joining the United Conservative Party which won the provincial election earlier this year.

Is he still sympathetic to the concerns Alberta seniors have over the way older drivers are licensed and does he plan any changes?

In July, Elhard wrote: “Minister McIver is still considering the relevant information for this specific issue.”
Several unsuccessful attempts were made to speak with McIver for this article.

Adria has sent letters and made calls asking to meet with Transportation Minister Ric McIver and Seniors Minister Josepine Pon about doctor shopping but has had no response.