See, Smell, Taste....... Appetite!

This semester was so much more than what I expected from geriatrics.  But one of the biggest normal changes that I have

encountered this semester would be the decrease in appetite.  I had the opportunity to see breakfast and lunch served while

doing my fieldwork.  I saw many of the patients eat a little and then push their plates to the side. I did not know that so

many things affect their appetite such as taste, smell, and medication. I always wandered why my grandmother food

seemed to get more salty as she became older and now I know that as you age your taste decreases by 50 percent. Not only

that but as you age there is a decrease in taste buds which affects sweet, sour, salty, and bitter taste buds. I never thought

that age could cause you to loose sense of taste or smell, but now that I know I can see how an older person would lose

their appetite.  When you first get a plate of food the look and aroma of the food is the first thing that triggers your

appetite.  Then the taste and texture of food makes the meal more enjoyable.  But as you age you lose the ability to

discriminate food and you can’t really enjoy your food.  Many of my clients complained that the food was so bland even

after putting two packs of salt on their food.  There were many who added packs of sugar to their juice and still would state

that it was not sweet enough.  But these are the types of things that cause other issues such as hypertension, malnutrition,

diabetes, and a decrease in food intake.  I take a step back and wander what if that was me, what would I do? I am a very

picky eater so I’m sure my food intake would be at the very minimum.  But if I had someone to take the time to maybe

season my foods by adding flavors that could possibly enhance the taste or change the texture of my food so that it is

pleasing to me.  These are some of the little steps that we must take to ensure that our elderly are getting enough nutrition

and has the appropriate intake.  Food for thought when you have a terrible cold besides the aching and runny nose and

sore throat, how does food feel in your mouth without being able to really taste the flavoring of the food?  Here is a link

featured on msnbc news about appetite loss :

( http://www.msnbc.msn.com/id/8203257/ns/health-aging/t/appetite-loss-elderly-not-good-sign/ )

Loss of Abstraction

    "Optimal aging can...be viewed in terms of our successful adaptation and continued participation in life..." (Padilla, p. 33, 2012). So says our text book and I happen to like this loose definition of aging well. This past semester has been a wonderful opportunity to witness first hand exactly what we have been reading about in a book--the normal affects of aging. What surprised me the most about aging in normal ways and what I saw evidence of was the loss of abstract thinking. I naively assumed that the loss of something cognitive such as abstract thinking would come to equal dementia on some level. This is not necessarily the case. In fact, skills or tasks that require abstraction are one which naturally become difficult for seniors.
     One of the residents that I spent time talking with--I will refer to him as JG--was kind enough to allow me to perform a cognitive assessment on him. The cognitive screening tool I chose to use is called the FROMAJE which was created specifically with the geriatric population in mind. While this tool asks concrete questions about orientation to time and place, or math questions, or even memory questions, it contains a question which discusses proverbs and is meant to consider abstract reasoning. When questioning JG I found him to score well on all of the concrete questions, with maybe a little trouble on the math. But the proverbs discussion took us off into an explanation that didn't make sense. This semester has also pointed out to me that concepts such as selection and compensation are natural ways for the aging individual to adapt and at times, attempt to 'cover up' a deficit they may be experiencing.
     At first I considered it a possibility that JG suffered from a mild form of dementia, but after studying our chapter on the aging process out of Occupational Therapy with Elders, I can see that this may have been a perfectly normal blunder for him. It is important as a student but especially as a practitioner that I come to understand the difference in the changes which aging brings on as some of them are natural (primary) and some abnormal(secondary). Differentiating between the two will allow me to create appropriate treatment plans and get down to the "just right challenge" for each client.

Things That Make You Go "HMMM"

Remember the song from the early 90’s by C+C Music Factory “Things that make you go hmmm?”  I loved that song.  When I’m reading my textbook and I come across something that I’ve never heard of before I write the word “hmmm” in the margin.  It allows me to go back and re-read the paragraph later on.  Paragraphs that get marked with a “hmmm” contain things that blow my mind.  They’ve got brand new information that seems to come out of left field.  The information may be contradictory or illogical, but it always makes me happy to read it because it reminds me that there are a lot of interesting things out there still to be discovered.

I had an experience like this when I read this text in our textbook  

“Conversing with a patient and/or observing the individual perform a familiar ADL can be misleading because people frequently retain social skills in the presence of a cognitive impairment, and ADLs are overlearned activities and, therefore, not a good measure of ability to problem-solve, learn, and safely engage in ADLs and IADLs.” 

  I, naively, thought that if someone had a cognitive impairment, I’d know it when I saw it.  It’d be written all over their face and their actions.  Right?  WRONG! 

I discovered this firsthand when I was assigned a dementia patient on fieldwork.   When I first met her she seemed “as right as rain” as the old people used to say.  (I had mistakenly equated “Communication and Social Skills” with “Cognitive Skills.”)  We talked about her children, grandchildren, hobbies, etc.  She was, and still is, delightful.  I would never have believed that she had dementia if I hadn’t given her the “Set Test.”  When I did my eyes were opened.  I struggled to believe the information.  She scored very poorly on it, and, to be honest, it made me kind of sad.  I really thought that she had it “all together.”  

Then I remembered Ms. Gonzalez lecture when she said that elderly patients can conceal their dementia with their social skills and ability to do ADLs.  I had stumbled across a perfect example of that class.

I also saw examples of this when I took a field trip to a CCRC this summer.  Not only were the patients able to carry on conversations, but one patient was able to do an intricate craft that involved gluing small pieces of wood the size of matchsticks!  He was phenomenal!  Yet he was in the early dementia art class.  You can’t judge a book by its cover.

The reason that this lesson will stick with me is that in my career I’m sure I will see more than a few elderly patients that “seem to have it all together.”  I’m going to need to be cautious when dealing with them.  Just because they can carry on a conversation doesn’t mean they have the judgment to perform a stovetop cooking activity.  I have to plan my treatment sessions carefully.

That’s where my training will come in handy.  After I have achieved competency in several of the cognitive assessments, I can help identify those patients that need extra supervision.  I can work with them, and their families, to discover other activities that are less dangerous, but still allows them independence.  

As this semester comes to an end I am left with one resounding wish.  My hope for my patients is that they are as independent as they can be for as long as they can.  That’s the same thing that I’d want for myself.

May not flow so easy!

  

           There are many changes that can occur to older adults,  that may or may not be a part of the normal aging process.  Some of those changes can be more expected or more pronounce than others. One thing that surprised me be this semester was the decrease in fluid intelligence as we age.   Fluid intelligence is defined as  the ability to reason quickly and to think abstractly (www.about.com-psychology).  Fluid intelligence is very important especially in a rehabilitation environment, in which one will have to learn new strategies for doing things, or problem solving situations especially regarding safety. 

            This decline in fluid intelligence was very evident while working with Mr. B during my geriatric field work.  Mr. B is a very intelligent man, who enjoys staying abreast on the stock market during his leisure time.  Although his crystallized intelligence was unaffected, it appeared that his fluid intelligence was.  This was obvious while performing a cooking session for therapy.  The therapy kitchen where we were working was unfamiliar.     Although it was also my first time working in this kitchen I was able to problem solve how to work the oven as well as locate items based on where items are usually located in my own kitchen.  This ability to abstract and problem solve was rather difficult for Mr. B.  He required assistance to locate the cooking items in the kitchen needed to complete the meal.   He also often complained about how different this kitchen was from his own.  I acknowledged the fact that I knew this kitchen probably differed from his dramatically but he was unable to move beyond the fact that is was a different environment, reiterating it numerous times.

            The decrease in fluid intelligence was also obvious when asking  Mr. B  to make cookies shaped into the letters OT and PT.  Initially it was hard for him to conceptualize how to create the letters.  Following demonstrated,  he was able  to complete the activity. 

Fluid intelligence despite its name,  is not what you know and have learned, it is more of your theability to see a situation in a new way or from a different perspective.  This is very important, especially for the geriatric population because now they may not be able to do things they same way they once were.  The ability to have a flexible way of thinking can go a long way with how to adapt to life’s new changes in a positive manner.

            There are many studies the show that fluid intelligence can improve through specific training.  There are many game website than can be used increase fluid intelligence.  In one study there was an improvement in fluid intelligence in participants who participated in the training games for 25 minutes a day. The increase in fluid intelligence increase as the daily usage of the games increased.

The following video is an example of the type of game that can increase your fluid intelligence.

Here is a website where  you can actually play some of the games that will increase your fluid intelligence.  There is also more information on increasing fluid intelligence. http://cseweb.ucsd.edu/~ckanan/FluidIntelligence.html

Time moves in one direction, memory in another

One thing that has surprised me over the course of this summer semester was learning about, and witnessing how implicit memory, also known as emotional memory, is preserved during the aging process. According to Occupational Therapy with Elders, primary aging includes a slowing of information processing and psychomotor speed, decline in abstract thought, divided attention, etc. Seniors may also face more severe issues associated with secondary aging or dementia, but no matter what degree of cognitive decline they face, emotional memories are spared.

The emotional experiences that we have, whether they be good or bad, leave an imprint on the brain. This means that people may forget details associated with day to day life, but they can recall the emotions associated with significant life experiences. This can vary from remembering the happiness associated with their first date, the sadness of a loved one passing away, or the laughter associated with the visits from a Occupational Therapy student.

I was privileged to witness this preservation of emotional memories a few times over the course of this semester. Once was during a conversation with a resident at our fieldwork site, Mrs P., who had dementia. During my conversations with Mrs. P she had trouble putting events in her life in chronological order. She would often tell me that she worked for IBM beginning in the 1990's, but she also showed me her IBM key card which was dated 1978. During the course of my conversation with her one day, I stumbled across an emotional memory while asking her several abstract questions which she was unable to answer. I asked her if she had any regrets in life, and the smile drained from her face. She frowned and said, "Staying with my first husband as long as I did." She then told me how he was abusive, and how she finally worked up the nerve to leave him one day. She said that it was either leave him, or kill him! Clearly the memories of her first husband are more positive than negative.

Another occasion was during a visit Central Regional Hospital, and a conversation that some classmates and I struck up with a resident. This particular resident was recalling to us what brought him to Central Regional, what sort of ailments he had, as well as other details about his family and childhood, when one of us asked him about marriage history. Well, you've never seen a man light up and smile more than this resident did as he salaciously regaled us with his sordid dating history. Clearly we stumbled across emotional memories that delighted this resident....and made us blush!

I also witnessed emotional memories surface when I asked my client, Mrs H., about food....in particular Lexington bbq. While working with Mrs. H. one afternoon I asked her where she was from; her reply was Lexington, N.C. I asked her, "They make a lot of bbq there don't they?" Her reply surprised me when she looked into my eyes, smiled, and said "Oh yes, sugarbaby!" She then told me how she loved to get bbq sandwiches and hushpuppies from a restaurant in Lexington, and that she was going to take me home and make bbq for me! After seeing her light up, I may never look at a bbq sandwich the same way again.

No matter what stage of life or cognitive level we are in, we will all have emotional memories that will linger on.

 

It's COLD in here!!

 

One thing that I learned this semester that surprised me is our body’s temperature regulation. More specifically, how cold most elderly people get. It was the middle of the summer for us on our fieldwork and there were patients wearing sweaters and blankets. One day at my job there was a patient that had his window open…in June! According to the Mayo Clinic, “An older person may develop mild hypothermia after prolonged exposure to indoor temperatures that would be tolerable to a younger or healthier adult — for example, temperatures in a poorly heated home or in an air-conditioned home.” ("Hypothermia," 2011).  So basically, if they tell you they are cold, you better believe them!  As most of you know, I am about as hot natured as it gets so I cannot fathom being cold in the middle of the summer.  But hey, maybe that is something to look forward to!!

 As we age, our body’s subcutaneous tissue begins to atrophy which gives the elderly thinner skin, making it hard for them to regulate their temperature. THIS CAN BE VERY DANGEROUS! Hypothermia can slowly set in and, if so, actions need to be taken. Our normal body temperature is around 98.6 F, and hypothermia sets in as your body passes below 95 F. If someone is showing some of the signs below, take their temperature and, if necessary, call 911.  Here are some warning signs to look for:

• shivering (or not shivering when cold)
• abnormally slow breathing
• cold, pale skin
• loss of coordination
• fumbling hands
• slurred speech
• lethargy
• fatigue
• exhaustion
• confusion
• memory loss
• drowsiness

 For more information on hypothermia click here

In the first 1m25sec of this video you will see another interesting theory on why the elderly are always cold. :)

Information taken from:

Donahue, J. (2004, October 25). The cold facts about hypothermia in our elderly. Retrieved from http://www.caregivershome.com/news/practical.cfm?UID=4

Hypothermia. (2011, June 8). Retrieved from http://www.mayoclinic.com/health/hypothermia/DS00333/DSECTION=symptoms

 

Not older...Wiser!

I remember so many good memories taking trips across the country with my Grandpa and DJ Grams but now as they are getting older, I forsee their trips becoming less frequent and not so far.  My grandparents have come to the realization that they just aren't quite 'the same' as they once were.  Unlike my grandparents, there are older adults who are not as acceptable to the changes that old age as brought them, and continue to drive despite these changes. 

According to the Centers for Disease Control and Prevention (CDC) "Motor vehicle crash deaths per mile traveled among both men and women begin to increase markedly after age 75 and age-related declines in vision and cognitive functioning, as well as physical changes, may affect some older adults' driving abilities."

As my grandparents and other adults in their age group age, I do feel that their license renewal should be more frequent than the average drivers.  Honestly, once a year should be the mandatory renewal for drivers over the age of 65 yo.  The exam should be very extensive and should include a vision screening.  The vision screening should not only be the "E" chart or the sign chart, but should include functional aspects like a rolling ball or a car in the peripheral vision.  The exam should also include a driving test, and not just making 4 right turns around the street, rather an extensive 30 minute drive on a moderately busy route.  This will allow the testers, to get the most accurate evaluation of the driver's abilities.

There are many resources available to educate seniors and their loved ones on the best strategies to allow them to maintain their independance safely.  AAA has a senior center where there is and educational portion to cut your crash risk in half, find your perfect carfit, and also take an online or classroom driver improvement course. 

The AAA senior center website is a great resource and can be accessed here.  Another great resource for statistics or older adult drivers is the CDC website

On the road again.....

I have fond memories of my grandfather, aka Paw-Paw, taking the family for scenic drives through the mountains of Tennessee. During these drives he would point out interesting sights along the way, ie his arm would be in your face pointing out the passenger side window at something along the road, all while he navigated roads barely big enough for one car along roads that resembled a slalom more than anything. After he passed away, one of my great aunts took on the task of driving all her sisters back and forth to the grocery store once a week, and to church on Sundays and Wednesdays. She did this because she was the only woman of her generation in her family who had bothered to get her driver's license; the others had relied on their husbands to do all the driving. This woman drove completely different from my grandfather. Her eyes were always on the road paying attention to everything around her. She drove slowly and deliberately, and to specific destinations with no deviation along the way. Being able to drive was important to her, and vital to her family.

Currently the state of North Carolina requires people ages of 18-53 to renew their license every eight years. If they are 54 or older, then they must renew their license every 5 years. Is this time period too long for seniors to renew their licenses. Should they have to renew license every 3 years, or even every year? Statistically speaking, I don't think you can accurately lump people into two different categories for renewing your license. The time period should vary with age, and testing should become more frequent with age, but should also start off more frequent as well. Looking back on my own experiences driving, I had a car accident at a rate of about once per year until I was in my very early 20's. I had taken classes on how to drive, but due to carelessness and inexperience I had accidents. It's very likely that when I reach my senior years that I will have accidents again, but for different reasons.

This is just an idea, but perhaps from ages 53-65 seniors should have renew their license every 3-4 years, but at age 65 seniors could take a one-time, mandatory senior driving class, and then renew their license every year. This senior driving class could educate older drivers on the challenges they face, and ways they can compensate for the natural declines that come with age. This is but one idea, and probably not the best.

Unfortunately a lot of seniors simply stop driving because they can no longer afford to. With the rising cost of taxes, registration, gas, insurance, and regular maintenance some seniors simply cannot afford to drive once they are on a fixed income. According to Esurance.com, car insurance rates begin to increase for seniors at age 70, but some insurance companies actually refuse to insure drivers over the age 70 because they are at such a high risk for causing an accident.

There is no simple answer when it comes seniors and driving, but one thing is for certain: it's a subject where almost everyone has an opinion, and no two opinions are exactly the same. What we have to remember is behind every statistic is a person trying to maintain their independence through diving.

Safety First

SAFETY FIRST

In my opinion, yes individuals should have to renew their licenses more frequently as they age. I feel that it should be at least every 2 years.  We do not all age the same so what one person my struggle with another may not.  My grandmother was driving until she was 85 years old after going through a knee replacement on her known dominant knee, her began declining and she still tried to drive until she was in an accident and she still had an additional 3 years remaining until her license needed to be renewed.  I believe that 2 year renewals should began at the age of 65, just as social security begins. At the DMV vision is tested and they suggest glasses but they are unable to really know if they can’t see or they are suffering from cognitive deficits and just can’t recall what the sign is or what it represents.  I think the vision test for renewal should include a multiple choice written exam with questions about what should you do if this was to happen.  On the road exams should include location and proper use of all buttons in the car that could be life or death threatening. You never want to make a person feel that they are incapable of being independent in something they have been doing so long.  Elderly people have a lot of wisdom and they are very cautious of decisions they make, but sometimes their delayed reactions can sometimes cause accidents that could be avoided.  Smartmotorist.com states “Statistics show that older drivers are more likely than younger ones to be involved in multi-vehicle crashes, particularly at intersections.”  Aging is not a process that we can’t prevent from happening; we can only conform to what our bodies allow us to do.  This link is a prime example of how accidents can happen so quickly.  This driver was going on a six block trip in which she had done numerous of times, but this particular morning her absence of attention took the life of someone.  We have to be prepared for life’s changes and except them.

 

Not so fast.

The current NC law for license renewal states that people between the ages of 18-53 must get their license renewed every 8 years.  If the person is older than 54, they are required to get it renewed every 5 years.  (See http://www.dmv.org/nc-north-carolina/renew-license.php) Based on this law, North Carolina has determined that 54 is the age in which changes start to happen that will affect driving. 

According to our textbook, Occupational Therapy with Elders Third Edition, on p. 202 there are numerous changes that an older adult can experience that will negatively affect their ability to drive.  Visually these changes include “decreased visual acuity, color discrimination, depth perception, figure ground, peripheral vision, and increased sensitivity to glare.”  Physically these changes include “changes in sensation, range of motion, decrease in reaction time, and decrease in decision-making abilities.”  These changes are varied from person to person, and the text doesn’t identify one particular skill as being the most important.

However, in a University of Nebraska-Lincoln article, the writers lay the blame on one skill: depth perception.  (See http://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1099&context=libraryscience&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Ddepth%2520perception%2520as%2520a%2520function%2520of%2520age%26source%3Dweb%26cd%3D1%26ved%3D0CFAQFjAA%26url%3Dhttp%253A%252F%252Fdigitalcommons.unl.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1099%2526context%253Dlibraryscience%26ei%3Dd8T5T9PaLJCe8QSfs-HmBg%26usg%3DAFQjCNFTiz8JEHxnuLtpHb5PsI_EHb_FDw#search=%22depth%20perception%20as%20function%20age%22) ) 

Also, remember what we learned about Primary and Secondary aging.  Primary aging results in the gray hair and wrinkles that everyone gets as they age.  Secondary aging results from our lifestyle choices and affects things such as impairment, dysfunction, and disease – all of which could negatively affect driving.  Thus, a 70 year old who has chosen a healthy lifestyle could, theoretically, expect less dysfunction than a 60 year old that had made unwise choices.  

Would it be fair to make all 60 year olds submit to visual and cognitive assessments prior to driver’s license renewal based on the bad choices made by a small percentage of people?  I, personally, don’t think so.

One bit of popular news reporting discusses the lethality of older drivers.    (For example see http://www.usatoday.com/news/nation/2007-05-02-older-drivers-usat1a_N.htm which came from Carnegie Mellon University and AAA.)

“From ages 75 to 84, the rate of about three deaths per 100 million miles driven is equal to the death rate of teenage drivers. For drivers 85 and older, the fatality rate skyrockets to nearly four times higher than that for teens.   Safety and health specialists are especially concerned about drivers 85 and older, who, federal crash statistics show, are involved in three fatal accidents a day.”

If one cursorily reads this report, it implies older adults are “killing machines.”  My knee-jerk reaction when reading this article is to take away the driver’s license of every older adult. But a National Highway Safety Administration article offers another explanation for the increase in deaths, i.e., the frailty of health of older adults.  (See  http://www.nhtsa.gov/search?q=Rory+Austin+and+Barbara+Faigin&x=17&y=7.) To prevent you from having to read the entire article I’ve included the main idea here:  “One factor contributing to older adult fatalities in passenger vehicle crashes may be an increased fragility. Using the Fatal Analysis Reporting System (FARS), the General Estimates System (GES), and the Nationwide Personal Transportation Survey (NPTS) Li et al. (2003) examined the roles of fragility and crash involvement in fatality risk for older drivers relative to their younger counterparts. Fragility begins to increase at 60 to 64 years old and continues to increase steadily with advancing age. In turn, the increase in older driver deaths grows sharply, and for 80 and older the fatality rate is over four times that of drivers between 30 and 59 (Eberhard et al., 2003). Unless significant countermeasures are employed, traffic fatalities for older adults are projected to increase substantially; projections indicate that fatal crashes for drivers over 65 may double or even triple during the next 20 years (Eberhard et al., 2003). Adults over 85 are of particular interest because these individuals experience dramatic rises in frailty levels and increased risk for injuries, and they comprise the fastest growing demographic group in the United States (Older Americans, 2004).”

As a result of this article, I’d say that older adults are not killing younger drivers, but instead they are killing themselves as a result of the impairment in their driving skills.  Regardless of whom is to blame, if the fatality rate of 85 year olds is four times that of teenagers, we can’t ignore that.  What is the answer?  Let’s look at how other states deal with age-related driving changes?

In Illinois a driver’s license is good for 4 years for people aged 21 through 80, for 2 years for people 81 through 86, and only 1 year for people 87 years and older. (See http://illinoisdriverslicense.org/renew.html)  “If the driver is seventy-five years of age or older, they must renew their Illinois driver’s license in person” and they must take a driving exam.  (See http://illinoisdriverslicense.org/renew.html?utm_source=Google&utm_medium=CPC&utm_term=renew%2Bdrivers%2Blicense%2Bin%2B+illinois&utm_content=Renew&utm_campaign=Illinois%2B-%2BKeyword-targeted) 

According to the USA Today article sited above “New Hampshire requires older adults to pass road tests,” too. 

Texas requires that people under 85 years old renew their license every 6 years and every 5 years for those older than 85.  (See http://www.dmv.org/tx-texas/renew-license.php) Texas allows a person to renew their license online if they are 79 and under.  No road test or driving exam is needed.  However  those older than 79 have to take a vision exam. 

Florida deals with the issue in a slightly different way.  (See http://articles.sun-sentinel.com/2011-10-21/business/fl-driving-license-revocations-20111021_1_older-drivers-drivers-licenses-fran-carlin-rogers).  People can anonymously report anyone who is suspected of having a physical or mental condition that would affect their driving.  (Reports must be in writing and include the reporter’s name.  If the erratic behavior is currently happening, the viewer should contact the police immediately.)  The police are the primary ones who report problem driving in the elderly.  The most common cognitive reasons an older adult would get reported is due to dementia, stroke, and seizures

It should be noted that most older adults do not lose their license due to physical or cognitive deficiencies.  Most lost their license because they submit the medical paperwork that was required by the state.

Perhaps due to the high number of elderly, Florida has a Strategic Safety Plan for the aging.  See http://www.safeandmobileseniors.org/FloridaCoalition.htm#Strategic_Plan   To allow aging in place “TRIP, a national transportation research group and AASHTO, the American Association of State Highway Transportation Officials have released a report "Keeping Baby Boomers Mobile: Preserving the Mobility and Safety of Older Americans."  (See http://www.tripnet.org/docs/Older_Drivers_TRIP_Report_Feb_2012.pdf) 

Other resources:

In addition to individual state regulations, other agencies offer support for the older driver.

AAA offers the following programs for older adults.

AAA Roadwise Review is a computer-based self-screening tool designed to assess a driver’s functional abilities important to safe driving.

• CarFit and AAA’s Smart Features for Mature Drivers help to enhance seniors’ comfort and safety while driving.
• Safe Driving for Mature Operators classroom and online courses provide driver training to help address the changes caused by aging and how a driver may compensate.
• In March, AAA will launch an improved senior driving website, www.aaa.com/seniordriving, offering research-based resources and tools designed to help keep seniors behind the wheel for as long as safely possible.

From the AARP website: 

“The AARP Driver Safety course, an eight-hour class for drivers 50 and older that deals with the effects of aging on driving, is available in classroom and online settings.

You may be eligible to receive an insurance discount upon completing the course, so consult your agent for details. You might also be eligible to receive a discount on roadside assistance plans.

By taking a driver safety course you'll learn the current rules of the road, defensive driving techniques, and how to operate your vehicle more safely in today's increasingly challenging driving environment. You'll learn how you can manage and accommodate common age-related changes in vision, hearing and reaction time. In addition, you'll learn:

• How to minimize the effects of dangerous blind spots
• How to maintain the proper following distance behind another car
• The safest ways to change lanes and make turns at busy intersections
• Proper use of safety belts, air bags, anti-lock brakes, and new technologies used in cars
• Ways to monitor your own and others' driving skills and capabilities
• The effects of medications on driving
• The importance of eliminating distractions, such as eating, smoking, and cell-phone use”