Diminished motor skills: 'Silver tsunami' of elderly drivers prompts tough decisions

With more older drivers hitting America's roads every day, loved ones and lawmakers alike face the dilemma of whether -- or when -- to take away grandpa's car keys.

Roughly 10,000 Americans reach age 65 every day, and nearly 1 in 6 people will be in their golden years by 2020. Most will still be licensed to drive, according to the American Automobile Association. And while many will continue to drive safely for years, the diminished eyesight and reflexes that come with aging will take a dangerous toll on others’ ability to operate cars, experts say. Striking a balance between road safety and respect for the independence of society's elders falls to a broad coalition of family members and caregivers, state regulators, insurance companies and even carmakers.

"The idea is to prepare before the person has a problem, finding alternatives before it's needed," said Elizabeth Dugan, an associate professor of gerontology at the University of Massachusetts Boston and author of "The Driving Dilemma: The Complete Resource Guide for Older Drivers and Their Families."

Dugan said loved ones are often in the best position to judge an aging driver's cognition, mobility and vision and get them off the road if necessary.

"Right now, everyone waits until there's an accident or a health event,” Dugan said. “But you have to be able to see, think and move to operate the car, and if you have limits on any of those, you have to consider the impact on your driving."

Many elderly drivers curtail driving voluntarily as their level of comfort at the wheel declines. They may gradually refrain from driving at night or on highways, according to Dugan. For others, a string of fender-benders or more traumatic events may signal they waited too long.

With no "magic age" to announce when driving becomes unsafe, Dugan advocates that elderly drivers be required to renew their licenses in person. Most states do, but 14, including New York, Pennsylvania and Florida, allow seniors to continue renewing their licenses by mail or e-mail.

Twenty-eight states and the District of Columbia have additional requirements for older drivers, starting as early as age 65. Those requirements include more frequent renewals and vision and road testing. In Massachusetts, for example, drivers older than 75 are required to renew licenses in person. Motorists in Florida, however, must renew every 6 years starting at age 80 and must pass a vision test. But in other states like New Jersey, West Virginia and South Dakota, no special provisions exist for elderly drivers, according to the Insurance Institute for Highway Safety.

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Increased testing for seniors is a good idea in theory, but pinpointing the right age is difficult, said Jake Nelson, director of traffic safety advocacy and research at the American Automobile Association.

"What's the right interval? Every two years, three years, eight years? We don't know," he said. "There's really no information on what the right answer is."

Further complicating the issue are statistics that show older drivers are actually "some of the least dangerous" on the road, according to Nelson. They're less likely to speed or drive drunk and they are more likely to wear seatbelts. Drivers ages 65 to 69 have the same fatal crash involvement rate as drivers in their 30s, and it is not until age 85 that older drivers overtake teenagers as the age group most likely to be involved in a fatal crash.

Citing anti-trust issues, insurance industry officials won’t say how or if aging impacts premiums.

But David Snyder, vice president and associate general counsel of the American Insurance Association, noted that fatal crash rates do not increase until sometime after age 70.

"So a large segment of this aging population is actually good risk and better risk than younger populations, so that's a good thing overall," Snyder said. "The collective challenge for all of us is to identify problems and help families make decisions for older drivers."

Observation of a loved one’s driving can be more instructive than counting birthdays when it comes to gauging safety, Nelson said. Frequent dents and dings, being on the receiving end of an increasing number of honks and confusion on familiar routes are all signs it's time for an older driver to slide out from behind the wheel.

"Those are the types of things that can be warning signs, but one of those isn't a reason alone to move from the driver's seat to the passenger's seat," Nelson added.

Giving up the keys needn’t mean losing independence as long as there is a support system in place. Family members and caregivers can soften the blow and feel positive about helping a senior citizen and, possibly, preventing an accident. Kristen Dougherty, an employee of Senior Helpers in Kansas City said driving local seniors to doctor's appointments, malls or social events has become a rewarding part of her work as a caregiver.

"We are a lifeline for them and their families, literally," Dougherty, 40, told FoxNews.com. "It's a big issue with seniors when they lose that ability to drive. They realize it in their mind, but it's a hard pill to swallow and no one wants to think they can't do something anymore."

For more information on elderly drivers, click here to visit AAA's Senior Driving website.