The Role of the DMV

Some state DMVs have strict vision requirements while others have no minimum for peripheral vision. Some require in-person license renewal so cognitive function can be minimally assessed by DMV counter personnel, but other states allow mail-in renewal so an older driver may go decades without being seen or tested by a DMV representative.

However, the graying of America is necessitating system-wide changes in all states so these disparities will soon diminish. State DMVs now know that the functional factors underlying the elevated crash risk of older drivers can be identified and incorporated into early detection screening tests. Proactive screening of drivers at regular intervals, and of drivers referred by traffic officers and physicians, not only saves lives, and money, but also helps to extend the safe-driving years.

Nationally, Maryland’s Motor Vehicle Administration has taken the lead in developing a scientific approach to identifying, evaluating, and remediation at-risk drivers. The MVA Driver Safety Research program focuses on early detection of emerging threats to driving safety. At-risk drivers in Maryland undergo a battery of functional capacity screening tests that measure vision, physical ability, and cognitive skills. The results are used at license renewal to assess the driver’s need for remediation and re-training, and only when necessary, to revoke the driving privilege, because the overriding goal of the MVA’s comprehensive screening and early intervention program is to prolong independent, safe mobility for all drivers, and insure public safety.

Many states, aiming to keep drivers on the road as long as they are safe, have already adopted elements of Maryland’s model program. Thirty-five state DMVs now have medical advisory boards that coordinate detection and intervention activities with impaired drivers. More state DMVs are doing periodic reviews of drivers’ functional status, actively educating the driving public, and training healthcare providers to better understand the link between functional status and driving risk.

The benefits of active family involvement, increased availability of driver self-assessment tools, peer counseling by trained volunteers, and better alternative transportation options will encourage at-risk drivers to make responsible driving decisions that may not be in their own, immediate self interest—giving up the keys. However, voluntarily resigning from driving is the least traumatic path for the elder driver because the individual remains in control. Referral to DMV authority may only be necessary when a driver refuses to, or is incapable of acknowledging their inability to drive safely.