Mention elderly drivers, and the talk often turns to incidents like Sunday's on the Massachusetts Turnpike, when an 87-year-old man drove 11 miles on the wrong side of the high-speed, divided highway, all the way from Auburn into Grafton.

While such stories get obvious and well-deserved attention, most elderly drivers are safe drivers. They generally drive more slowly, follow the rules of the road, wear seat belts, don't drive drunk, avoid rush hour and stay home during bad weather.

However, physical limitations such as worsening eyesight, cognitive decline that can include memory loss and the use of medications with side effects eventually come into play, and there comes a point when elderly drivers need to turn in the keys.

But at what point?

Short of an accident or an incident like the wrong-way driver on the pike, occupational therapist Bill Shea says, there are several red flags for people concerned about an elderly person behind the wheel:

• If you're not comfortable getting in the car with the driver.

• Near accidents, or minor ones — running over the trash can, for example.

• A general decline in the driver's memory and mental acuity.

• Deteriorating vision.

Shea has been an occupational therapist at Fairlawn Rehabilitation Hospital for 25 years, and he gives presentations such as the one Tuesday night at the Tatnuck Park senior living community, called “Aging Drivers: When to Retire From the Road.”

In an interview earlier in the day, Shea said that after falls, car crashes are the leading cause of accidental death among 75- to 84-year-olds. And crash deaths per mile traveled spike after the age of 75, according to the federal Centers for Disease Control and Prevention, although that is largely due to older drivers' susceptibility to injury rather than their tendency to cause accidents.

Massachusetts included a provision on elderly drivers in the Safe Driving Law, which was passed in 2010 and also made it illegal to text and drive.

The law requires that those 75 and older must renew their licenses at a Registry of Motor Vehicles office, versus online, and must pass a vision test or present a vision screening certificate from an eye doctor. The measure also enables health care providers and law enforcement officials to report potentially unsafe drivers to the registry without civil liability.

Fairlawn evaluates drivers who have been referred by a doctor or who are at the hospital for other reasons and should be checked for their ability to drive safely, Shea said. Staff assesses patients' vision, cognitive and motor skills, ability to read and interpret road signs and tests their driving skills, including braking time on a simulator.

An interactive computer program called DriveABLE plays a key role in the therapists' assessment. The program measures reaction time, attention span and decision making. “If they fail on the DriveABLE, there's a high likelihood that they're going to perform poorly on the road,” Shea said.

Many older drivers retire on their own, according to Shea. For others whose ability to drive safely might be suspect, family members could accompany them to a doctor's appointment.

“That's a good point to start the discussion, to bring up the subject that 'I'm a little worried about Mom or Gram driving," Shea said.

Often, getting someone off the road before they get hurt or hurt someone else is a difficult task, for both families and drivers. For most people older than 65, driving is the main mode of transportation, enabling them to shop, visit friends and otherwise stay independent.

“A lot of people are afraid,” Shea said. “They don't want to lose their license.”


The Centers for Disease Control and Prevention offers the following tips for older drivers:

• Ask your doctor or pharmacist to review medicines for possible side effects
• Have your eyes tested at least once a year
• Plan your route
• Leave lots of room between your car and the one in front of you
• Avoid distractions, including eating, talking on the phone or listening to loud music
• Consider alternatives to driving, like taking public transportation or getting a ride from a friend or family member