RECOMMENDATIONS

Based on the findings and conclusions presented, the authors recommend that the following activities to remove the barriers to intervention and motivate family members and friends to intervene in driving decisions of at–risk older drivers be considered.

• Develop a comprehensive, cohesive, and consistent social marketing campaign that achieves similar changes in national behavior as have the MADD and Seat Belt campaigns:

• To identify unsafe driving as a public health risk and make intervention socially acceptable and responsible (e.g., “Friends don't let friends drive unsafely”);
• Targeted to the general public and authority figures: healthcare; law enforcement; DMV; policymakers; lawmakers and the courts.
• With cohesive and consistent multimedia communications, themes, and messages that identify specific indicators of unsafe driving, consequences of unsafe driving, specific examples of intervention, and portray families and friends who:
  • Believe their older driver is in imminent danger to themselves and others on the road
  • Believe they have a “responsibility” for and to their older person
  • Will be the primary or secondary caregiver
  • Are able to make decisions for their elder's good, over their elder's objections
  • Are able to overcome any feelings of disrespect or guilt
  • Have the support or at least the tacit approval of other family members
  • Are willing to provide or secure transportation when their older driver stops driving
  • Perceive that alternative transportation exists
  • Attend support groups dealing with functional disabilities and/or caregiving
  • Have the support of the physician, law enforcement personnel, and the DMV for reporting and retesting.

• Establish and implement federal and state policies and regulations mandating reporting and procedures for retesting

• Enforce enacted laws; require retesting and license revocation for people with too many traffic tickets or who cannot pass retest; have “no loopholes”.
• Develop functionally–appropriate assessments, tests, and measures with cut–off scores to identify at–risk drivers of any age.
• Account for differences in driving performance styles between young and old without an age bias

• Establish at least one driving assessment clinic in regional metropolitan and suburban areas

• Publicize classes to improve driving skills

• Enlist the help of insurance companies as gatekeepers

• Establish an interactive relationship between DMV's and insurance companies
• Renew insurance only if relicensed; write requirements for insurance into state code
• Discount insurance premium for taking driving classes

• Improve current alternative transportation to meet the needs of those who have stopped driving

• Plan and implement new services that not only meet riders' travel needs but also “pools money now going for insurance and car upkeep into fund to get a ride somewhere”

• Develop and implement mobility training programs to help the elderly learn to use alternative transportation services

• Develop national policies and provide sufficient funding to support local, customer–focused, alternative transportation services

• Give authority figures (healthcare community; law enforcement personnel; DMV) the information and tools to make them responsive to families who need assistance through: pamphlets and other reference materials that list signs of driving impairment; reference materials to help older drivers plan for a change in mobility; and a pamphlet listing costs and benefits of driving versus alternatives to driving

• Develop proactive and cooperative measures for the police and DMV's to help get at–risk drivers to stop driving/help families and friends intervene
• Develop ways to involve professionals in working with older adults and family members to plan early for changes in mobility

• Establish transportation planning and counseling along with retirement planning programs

• Encourage social service agencies to establish support groups for older drivers, families, and friends

• Conduct additional research related to family and friends intervening to increase knowledge about interventions and test social marketing campaign strategies and materials

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