Mary G., 72, was the primary caretaker and chauffeur for her 78-year-old husband who suffered from declining vision and heart problems. Although Mary was in excellent physical and mental health, she started having small fender-benders on a fairly regular basis.

Mary's family soon noticed the dents and scratches on her car and suggested she have her reflexes tested. When the tests showed some decline in responses, they discussed how she might get along without a car. Mary and her husband decided to sell their suburban house and take an apartment in the city, which offered more public transportation options. It turned out to be a wise decision. Mary's family worked downtown, and they even came to visit Mary and her husband more frequently.

"Giving up driving for a senior citizen is a major event, almost like when a person first gets a license," says Scott Spier, MD, chief of the Division of Psychiatry at Mercy Medical Center in Baltimore, Maryland. It represents a loss of mobility, which leads to a sense that independence, competence, and well-being are compromised.

Knowing When to Hang Up the Keys

Are you concerned about your own driving ability or your loved one's ability? Barbara L. Spreitzer-Berent, gerontologist and president of Quest Learning Resources in Detroit, Michigan, offers these questions as way to start evaluating driving skills:

• Has there been a pattern of close calls, violations, or minor collisions?
• Do you have trouble spotting pedestrians, signs, or other objects?
• Are you surprised by passing cars or do you brake harder than normal for hazards, stop signs, or stopped traffic?
• Have you gone through red lights or stop signs? Have you backed into or over things or run into curbs?
• Are you having trouble coordinating hand and foot movements?
• Is the glare of oncoming headlights causing more discomfort?
• Do you have trouble turning your head, neck, and shoulders as you back up?
• Are you more nervous behind the wheel?
• Do you experience increased anger or frustration while in the car?
• Are you quickly fatigued from driving?
• Do you lose your way, even in your own neighborhood?
• Do you get lost or make poor or slow decisions in traffic?
• Have you ever hit the accelerator instead of the brake?
• Are other drivers honking, tailgating, or passing you aggressively?
• Do you take medicine that may impair your driving? (If you are not sure if the medicine affects your driving ability, talk to your doctor or pharmacist.)

Too many "yes" answers could mean that you or your loved one may not be able to handle the vehicle in an emergency situation. Experts also say it is not a good idea to rely solely on the state testing agency that tests drivers and issues driver's licenses. If a driver has reflex problems, he may be able to squeak by and still pass the test.

Checking Driving Ability

To get a better idea of driving skills, rehabilitation centers and insurance companies offer tests that objectively rate driving ability. Moreover, some senior centers, hospitals, retirement communities, and civic organizations offer driver improvement programs for seniors who never really learned good motoring habits—but are perfectly capable of doing so.

The primary care doctor can also let you or your loved one know when it is time to think about giving up the car. The doctor will consider muscle strength, eye sight, reflexes, and general overall health, along with questions about close calls in traffic.