Promoting Older Driver Safety: Guide for State Practices (2023)

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30 C H A P T E R 5 This chapter provides examples of effective messages, educational materials, and outreach programs adopted by different states to mitigate older driver safety risks and gaps. 5.1 Safety Behavior Messages Compared to other traffic safety issues such as impaired and distracted driving or occupant protection, only a few safety behavior messages unique to older drivers are promoted by the SHSOs or other national organizations. Some sample messages used by different SHSOs and other agencies follow. The Florida Safe Mobility for Life Coalition built their outreach around the message You Hold the Keys to Your Transportation Future to build the brand and increase awareness of their program (Figure 3). The Coalition is careful to use positive messaging in addressing the target audience by not calling them “older drivers” or other similar names. The materials developed around this safety behavior message encourage aging Floridians to seek mobility independence and provide information on how aging road users can maintain safe driving skills and mobility. The Maryland Department of Transportation’s (MDOT) Motor Vehicle Administration (MVA) promotes a culture of safety. MVA hosted Maryland Older Driver Safety Symposiums in 2012, 2013, and 2015, as well as regional training workshops on older driver safety. The symposia focused on the latest research on older driver safety and best practices from across the United States. The target audience included professionals in healthcare, community services, engineering, and law enforcement. The symposia built on information presented in previous gatherings and promoted safe mobility for life (Figure 4). The Ohio Department of Transportation (ODOT) and its partner agencies recognize how important it is for drivers of all ages to be safe on Ohio’s roadways and are committed to helping everyone “stay fit to drive” as they age. Through its Stay Fit to Drive campaign (Figure 5), ODOT shares information about resources and services available to older Ohioans, families and friends, caregivers, and others who interact with older road users. The American Society on Aging (ASA) and NHTSA developed a driver safety toolkit, Drive Well: Promoting Older Driver Safety and Mobility in Your Community (Figure 6), for people working directly with older adults. This toolkit helps older drivers to • Understand the issues related to older drivers and later-life independence and mobility. • Plan and implement public information events for older drivers, their families and loved ones, and other community members and organizations. • Evaluate the effectiveness of older driver public information events, community understand- ing of safe mobility issues, and progress in mobilizing community members to act. Samples of Effective Messages, Materials

Figure 3. Florida safety programs: (a) Safe Mobility for Life; and (b) You Hold Your Keys to Your Transportation Future. Figure 4. MDOT Older Driver Safety Symposium. Figure 5. ODOT Stay Fit to Drive campaign.

32 Promoting Older Driver Safety: Guide for State Practices 5.2 Educational Materials This section provides examples of educational materials promoting older driver safety collected from SHSOs and the project literature review. The sample educational materials are from state older driver safety programs managed by the SHSOs or by other agencies such as the DOT or the driver licensing agency. Florida Florida’s Safe Mobility for Life Program is a robust aging road user safety program (Figure 7). The Florida Department of Transportation (FDOT) partners with the Pepper Institute on Aging and Public Policy at Florida State University to facilitate a comprehensive, statewide coalition to address the needs of Florida’s aging road users. Coalition members work together to improve older driver safety and mobility by achieving reductions in their fatalities, serious injuries, and crashes, while maintaining their safe mobility and connection with the community. Figure 6. ASA Drive Well program (https://www.trafficsafetymarketing. gov/get-materials/older-drivers/ drivewell-toolkit). Figure 7. Safe Mobility for Life Program website (http:// safemobilityfl.com/FloridaCoalition.htm#Coalition).

Samples of Effective Messages, Materials 33 Florida’s Guide to Safe Mobility for Life The Florida Safe Mobility for Life program developed Florida’s Guide to Safe Mobility for Life as an educational piece for aging road users (ages 50+), families and caregivers, and health care providers on the three keys to achieve safe mobility for life: Understand the impact aging has on driving; be proactive—as a driver, pedestrian, bicyclist, transit rider, motorcyclist, and golf cart driver—about safe driving skills, assess self-driving ability and learn driving tips; and plan for a safe transition from driving while maintaining safe mobility and independence by identifying transportation options. The guide includes a wide range of resources on older driver safety and is available on the website for order and for download in English and Spanish (Figure 8). Law Enforcement Resources The Coalition developed Law Enforcement Resources including a Law Enforcement Tool- kit to help law enforcement officers identify and respond to older drivers at-risk. The toolkit includes a Driver Medical Referral Visor Card to provide officers quick access to information and resources on referring unsafe drivers for medical review. The toolkit’s law enforcement edu- cation and training video, “Helping Florida’s Aging Drivers Stay Safe and Mobile,” (Figure 9) helps officers identify drivers who may have a medical impairment, know how to respond, and learn about helpful community resources. A dedicated web page on Laws and Regulation con- tains information on Florida’s driver’s license renewal for older adults, ID card, vision require- ment for license renewal, and information on several traffic laws (i.e., Move Over Law, red signals, sharrows indicating shared lanes, and three-foot bike passing) to help older drivers safely navigate the road. Health Care Provider Resources The Safe Mobility for Life Health Care Provider Resources web page offers a range of resources to support the medical community and help physicians recognize and report aging at-risk Figure 8. Florida’s Guide to Safe Mobility for Life brochure.

34 Promoting Older Driver Safety: Guide for State Practices drivers. Resources include occupational therapist and driver rehabilitation information, the Clinical Assessment of Driving Related Skills (CADReS) Score Sheet, and the Clinician’s Guide to Assessing and Counseling Older Drivers (published by the American Geriatrics Society and NHTSA) for detecting at-risk aging drivers early through screening and assessment of driving ability or tness-to-drive. is resource page has key ndings of a research project, “Health Care Providers and Older Adult Service Organizations to Assist in the Prevention and Early Recogni- tion of Florida’s At-Risk Drivers” that helps determine baseline levels of community practice, knowledge, interest, and resource needs regarding at-risk drivers. Find-a-Ride Find-a-Ride, a project between the Safe Mobility for Life Coalition and the University of Florida, provides a statewide listing of transportation service providers in the state’s 67 counties (Figure 10). is resource helps older adults nd transportation options that can take them to visit with family and friends, shop at the mall, or go to a doctor. Family, caregivers, and health care providers can use the Find-a-Ride Florida Outreach Toolkit to help older adults nd dif- ferent local transportation options and maintain their mobility even aer retiring from driving. Tip Cards on How to Use Transportation Options in Florida e Coalition developed Tip Cards on How to Use Transportation Options in Florida on walking, bicycling, public transit, transportation network companies, and golf carts. e series Figure 9. Safe Mobility for Life. Nov 25, 2019 (https://www.youtube.com/watch?v=LAXakRnBANg). Figure 10. Safe Mobility for Life. Mar 26, 2018 (https://www.youtube.com/watch?v=EL6te0GeIHM).

Samples of Effective Messages, Materials 35 empowers road users with the ideas and resources needed to safely get where they need to go with or without a personal vehicle. The Coalition website has a Roadway Safety Tip Card Series and Digital Safety Graphics to educate aging road users about Florida’s roadways and to help them be prepared when encountering new situations on the road. The tip cards are based on results of human factors research. Maryland Maryland’s Resource Guide for Aging Drivers Maryland’s Resource Guide for Aging Drivers (Figure 11) contains information to help older drivers drive safely, identify the risks and warning signs of change, and conduct a self-assessment on driving performance. It provides information on involving families, caregivers, and medical care providers in conversations toward a smooth transition to retiring from driving and the development of a transportation plan. The guide also includes medical conditions to report to the MDOT MVA and the medical review process for every driver referred to the MVA. Healthcare Provider Tools and Tips The MDOT MVA Healthcare Provider Tools and Tips web page links to resources to guide health care providers in identifying and observing changes that impact medical fitness-to-drive, and referring patients to the MVA. Information includes details on the MVA’s medical review process and the functional test capacity screening that measures basic visual, cognitive, and physical abilities needed to safely operate a motor vehicle. Occupational therapist and driver rehabilitation specialist information and older driver safety resources developed by NHTSA and AAA are also included. Safety for Older and Medically At-Risk Drivers The MDOT MVA Safety for Older and Medically At-Risk Drivers web page features links and resources on older driver safety and information on aging, health and wellness including Figure 11. Resource Guide for Aging Drivers.

36 Promoting Older Driver Safety: Guide for State Practices resources for driver assessment information and training tools, mature driver education courses, driver rehabilitation, and transportation options. Zero Deaths Maryland—Older Driver Safety The Maryland SHSP Zero Deaths Maryland—Older Driver Safety website includes information on older driver safety from NHTSA. Additional linked resources include the AAA self-rating tool, CarFit, and the MDOT MVA Older Driver Resource Guide. California DMV Senior Guide for Safe Driving The California DMV developed the DMV Senior Guide for Safe Driving (Figure 12) for senior drivers to learn about driver safety and how they can stay on the road longer. The guide includes information on recognizing changes as people age, assessing driving skills, the driver’s license renewal and reexamination process, and signs indicating when to stop driving. Further resources and links include information on adaptive devices, mature driver improvement courses, and alternate transportation options. Driver Safety Hearing Officer A DSHO is an employee of the California DMV who receives specialized training on how to observe applicants for conditions that could impair their ability to drive safely. The train- ing material for DSHOs includes a module describing special concerns when evaluating senior drivers. The hearing officers review the medical reports, conduct hearings, interviews, and Figure 12. California DMV Senior Guide for Safe Driving.

Samples of Effective Messages, Materials 37 reexaminations. Based on the evidence, officers determine if there is a need to take an action against a driving privilege. Driver Orientation Screen for Cognitive Impairment The DOSCI (Figure 13) is a screening tool for law enforcement officers to help identify drivers with potential cognitive impairments. The Training, Research, and Education for Driving Safety (TREDS) at the University of California San Diego, the California Highway Patrol (CHP), and the California DMV developed the tool as part of a training program. It includes a training video with a pocket-sized card to guide officers in assessing cognitive impairment and suggested actions based on the assessment score. California DMV Senior Driver Website The California DMV Senior Driver Website focuses on senior driver safety and includes information for older drivers on license renewal, how aging impacts driving, and transportation options. It provides a link to the DMV Senior Guide for Safe Driving and additional safety infor- mation from NHTSA, AAA, AARP, and other organizations. The website also features informa- tion on the Senior Ombudsman Program, whose ombudsmen serve as a “go between” for DMV and the public. Their outreach seminars promote driver safety to large and small audiences in California with an emphasis on senior issues. The Mature Driver Improvement Program web page (Figure 14), under California DMV, provides detailed information on driver improvement courses designed for drivers 55+, and outlines the benefits of participating. Age Well Drive Smart The Age Well Drive Smart program by the CHP aims to reduce motor vehicle collision and pedestrian deaths and injuries experienced by older Californians and to increase older drivers’ alternate transportation options when driving is no longer an option. Missouri Missouri Coalition for Roadway Safety—Older Driver Website The Missouri Coalition for Roadway Safety considers older drivers a safety focus area. The Coalition’s website has an Older Driver Safety web page (Figure 15) featuring older road user statistics, tips for aging road users, and resources for older drivers with medical conditions. The web page links to resources on driver evaluation and rehabilitation, how to report an unsafe driver, the aging well program, and ChORUS. Figure 13. TREDS, a tool to guide officers in assessing impairment. 2016 (https://vimeo.com/ 176674115).

38 Promoting Older Driver Safety: Guide for State Practices Figure 14. Mature Driver Improvement Program (https://www.dmv.ca.gov/portal/vehicle-industry- services/occupational-licensing/occupational- licenses/mature-driver-improvement-program/). Figure 15. Older Driver Safety web page (https://www.savemolives.com/mcrs/older-drivers). A 30-second video on Aging Road Users, developed by the Missouri DOT, encourages older drivers to drive safe and directs them to savemolives.com for resources and guidance (Figure 16). Fit to Drive—Aging Adult Safe Driving Guide e Missouri DOT Fit to Drive—Aging Adult Safe Driving Guide highlights Missouri trac crash statistics, increases awareness of risk factors for motor vehicle crashes and provides prac- tical driving suggestions to help improve safety on the road (Figure 17). e guide talks about what puts older drivers at risk and provides an overview of physical changes and medication that could impair an older driver and warrant an evaluation by a physician. Keep Your Keys e Keep Your Keys program is a driver safety course geared toward people 55+, caregivers and facilitators, health educators, nurses, and highway patrol departments. e University of Missouri Health Care’s Injury Prevention and Outreach Program provides resources for adults who may need support to continue driving or help with retirement from driving. ey hold free community seminars and facilitator trainings (train-the-trainer method) throughout the state. ese trainings include tips on maneuvering new roadways and staying safe on the road, what aects driving ability as people age, how to help older family members retire from driving, and taking a self-assessment to check if it is still safe to drive. Information is also available in the Keep Your Keys Presentation.

Samples of Effective Messages, Materials 39 Ohio Stay Fit to Drive ODOT, along with its safety partners, developed the Stay Fit to Drive Booklet to share infor- mation about resources and services available to older Ohioans, families and friends, caregivers, and others who interact with older road users. The booklet includes older driver crash facts; discusses how aging, medication, and medical conditions affect driving abilities; and offers tips on transitioning from driving. Safe Routes to Age in Place Toolkit The Ohio State University, Age-Friendly Columbus, and Franklin County developed the Safe Routes to Age in Place Toolkit, funded by ODOT, to understand the transportation pat- terns of older adults in a given community, inform community-wide changes that improve Figure 16. SaveMOlives. Nov 24, 2020 (https:// www.youtube.com/watch?v=wKUtbwzSFQo). Figure 17. Missouri DOT Fit to Drive brochure.

40 Promoting Older Driver Safety: Guide for State Practices transportation use and accessibility, and enhance the well-being of older adults (Figure 18). The toolkit provides guidance on how to collect information from hard-to-reach populations that can lead to data-driven interventions with transportation options and infrastructure improve- ments in a community. Older Driver Safety—ODOT Web Page ODOT and its partner agencies recognize how important it is for drivers of all ages to be safe on Ohio’s roadways and are committed to helping everyone “stay fit to drive” as they age. Through its Stay Fit to Drive program, ODOT shares information about resources and services available to older Ohioans, families and friends, caregivers, and others who interact with older road users. ODOT’s Older Driver Safety web page provides resources and tools in one place to promote the Stay Fit to Drive campaign for older drivers. The website includes older driver crash numbers and provides links to older driver safety related materials including a Stay Fit to Drive Handout, Safe Routes to Age in Place Toolkit, a Driver Safety Self-Assessment Checklist, videos and print- able resources on roundabouts, bicycle safety and pedestrian safety, and a DOSCI video and tip card for law enforcement. New York The New York State DMV’s Safe Driving Tips for Older New Yorkers web page features older driver safety tips and information on self-assessment, evaluation of driving skills, driver safety courses, and the use of adaptive equipment to enhance safety while driving. It also includes a driver and caregiver handbook and Roadwise Rx, an online tool that helps individuals find out the impact of medication on driving abilities. Figure 18. ODOT Safe Routes to Age in Place.

Samples of Effective Messages, Materials 41 What to Do: A Guide for Drivers and Caregivers What to Do: A Guide for Drivers and Caregivers is a handbook developed by the New York State Office for the Aging (NYSOFA) to guide families, friends, and caregivers on the safety concerns of an aging driver, how to monitor them when they do not live nearby, how to raise the subject of unsafe driving, and how to help them cope with the change (Figure 19). The handbook includes transportation tips and alternatives for getting around, and information on adaptive vehicle equipment to enhance safety, simulators, and classroom and in-car programs to maintain mobility for life. Conclusion These examples show that states have developed important and transferable materials to address older road user safety issues, ranging from suggesting how older drivers can take con- trol of their mobility futures to providing ways for friends, family members, and caregivers to discuss driving performance with older drivers. These examples provide ways SHSOs can create practical and compelling material that will resonate with older road users as well as with their family, friends, and caregivers and the community agencies confronting mobility and safety challenges with the aging of society. Figure 19. NYSOFA guide for drivers and caregivers.