The Netherlands is aging and with it the use of cars on Dutch roads. The over-75s increasingly own a car and also drive it more often, according to the most recent figures from Statistics Netherlands. The Netherlands has 1.3 million over-75s and together they drove 3.5 billion kilometers in 2015. That’s about 75 percent more than a decade earlier.
‘People don’t get it’
The elderly, traffic organizations and the ministry are now struggling with the question of how this can be done safely. After all, old age comes with flaws, including those that affect driving ability. And not always someone is aware of it.
“At a certain age, diagnoses increase, which can lead to problems,” says geriatrician Arend Arends. “They already cause problems without people realizing it. For example, people don’t notice that they have cataracts so quickly. Then their vision has deteriorated faster than they realize.”
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‘You can say anything, that doctor doesn’t know you anyway’
Joke Wiesemann (66) knows the danger of a motorist who is too old. In 2017, she lost her 42-year-old son Marvin when he was hit by an 89-year-old driver while walking his dog. Both the driver and Marvin did not survive the accident. Wiesemann: “Afterwards I heard from the police that the driver was actually no longer allowed to drive by his family.”
Wiesemann believes that the inspection for the elderly should be different: “I don’t want to get all the elderly off the road, but the inspection must be different. Now it is once every five years, which is far too little. It should be every year and the general practitioner must be given a role. Now the examination does not mean anything. The medical certificate does not check it properly, you can say anything because the doctor does not know you anyway. An examiner should also drive to test the responsiveness .”
“In my environment I also see elderly people who are as deaf as a quail, but still get in the car every day. When I see that, my blood boils and I can’t do anything with it. I think that’s terrible.”
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Now people over 75 have to undergo a medical examination every five years, but there is regular discussion about whether this is the most suitable way, because should not driving skills also be looked at? And shouldn’t the elderly be inspected more often?
The LBKR, the professional association of driving school owners, is not happy with the current system. Anyone who is now concerned about the driving skills of an older driver can report this, after which someone is obliged to be inspected.
“That is a high threshold. It is difficult enough to ‘betray’ a family member, as it were, let alone if they end up in the maddening of the CBR,” says board member and driving school owner Brigitte Halberstadt. “I also give refresher courses myself. Once I advised a driver against driving. Due to dementia, he could no longer find the car.”
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How does the system work now?
A person over 75 must now undergo a medical examination every five years by a medical examiner. They fill in a medical statement themselves with questions about their medical condition. This form is then discussed with an examining physician, who also performs a few tests, after which the examining physician makes a recommendation to the CBR.
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Solutions are being sought. For example, the Ministry of Infrastructure and Water Management is currently investigating alternatives to improve the system of medical fitness to drive.
One of the alternatives that is being explored is to have the examination carried out by one’s own GP instead of by the medical examiner. There is one problem: GPs are not waiting for that.
Examination by GP
The KNMG doctors’ federation writes in its guideline that ‘A treating doctor may not pass judgment on the fitness to drive of his own patient’. It could put pressure on the trust relationship between doctor and patient. There is therefore no support among doctors for having the examination carried out by the general practitioner.
Many driver’s license holders think very differently about this. SWOV, the scientific institute for road safety research, asked license holders on behalf of the ministry how they view the alternatives.
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This shows that a majority of them (63 percent) would rather be examined by their own doctor than by an independent doctor. And the CBR has no objection to such an examination by its own GP.
And there are more initiatives that, according to SWOV, have a chance of success. Think of the abolition of an age-related certificate or the introduction of a periodic screening, whereby a driver’s license holder must complete a health statement every time the driver’s license is renewed. Another option: convert the moral obligation for driving license holders to report changes in the medical condition into a legal obligation to report.
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