At least once a month, staff at the Rice Rehabilitation Center must deliver the bad news to an older driver: You've just failed your simulated driving exam. It's never easy to tell someone they should no longer be behind the wheel, said Sarah Tanner, an occupational therapist at the rehab center.
"The independence factor is a huge thing," she said.
"It is hard on families too."
With greater numbers of older drivers on the road, it's an issue families increasingly confront, officials say.
It's a question of public safety, not only for older drivers at risk of a crash but for other motorists too, said Dan Hartog, Kandiyohi County Sheriff.
"There's getting to be more and more older drivers just because our population is aging," he said.
"Are they capable of being out on the roads driving anymore?"
Age alone doesn't mean someone should have their car keys taken away.
Many older drivers sense their skills are diminishing and will limit themselves to situations in which they feel safer, Hartog said.
"I think a lot of elderly people avoid driving in the dark."
Compared to young motorists, far fewer older drivers drink and drive or engage in risky road behavior.
But there's a down side. Statistically, aging drivers have the highest rate of crashes per miles driven. They're also the age group most likely to be injured or killed in a crash.
Experts say many of the skills needed for safe driving tend to diminish as people age. They may be less able to accurately judge distance and speed. Their reflexes might be slower or their vision not as sharp.
The Rice Rehab Center does six to 10 simulated driving exams a month, testing the skills of older drivers whose capabilities have been called into question.
It has proved to be a useful, objective way of assessing whether someone can still safely drive, said Lynn Stier, rehabilitation services director.
The simulator's program can mimic a variety of driving conditions -- snow, rain, dusk, heavy traffic, highway speeds. The rehab center's staff also went out and took photos of traffic signs and roads within a 10-mile radius of Willmar and incorporated them into the software, making for a more realistic simulation.
Sensors record the driver's every move during the assessment. If someone doubts they committed a traffic violation or caused a crash, "we can show them the overhead view and tell them, 'If you look, here's what really happened,'" Stier said.
The majority of those who take the simulator test don't pass -- often because those who get referred for testing are the same drivers whose skills are the shakiest, she said. "We get them when they're at the point when they shouldn't be driving."
In some cases, these older drivers have already been in a crash and have been told by law enforcement officers they need an evaluation, Hartog said. "If we see somebody that's obviously having problems driving and they have a car, we'll send in an evaluation form."
With extra help, many aging drivers can continue to drive safely.
Refresher courses such as 55 Alive are helpful in reinforcing driving skills and the rules of the road, especially for people whose last behind-the-wheel test might have been 40 or 50 years ago, Hartog said. "I think those help. Face it, until you get to that point, you don't really get updated on the driving rules."
Some older drivers might simply need some rehabilitative services, Tanner and Stier said.
And sometimes it's not the driver who has a problem -- it's the fit of their car. For the past few years, the Rice Rehab Center has sponsored Carfit, an assessment that helps determine how well an older driver can see over the steering wheel, reach the gas and brake pedals, and sit comfortably while driving.
A few adjustments and perhaps some adaptive equipment often can give older drivers a better, safer fit in their vehicle and allow them to continue driving, Tanner said.
This year's Carfit assessment will be held later this summer, she said. "It's a good thing for people to go through. A lot of people notice the benefits."
Many older drivers, though, will be advised -- or ordered -- to stop driving.
"It's kind of a tough topic," Hartog said. "You're taking away their freedom."
"People are upset because of the independence factor," Tanner agreed. "They say, 'How am I going to get groceries? How am I going to get to appointments?'"
It's especially challenging in rural communities where transportation is limited, she said.
Communities have begun to recognize this and are beginning to offer more options. Many congregations, for instance, provide volunteers who can give people rides to church. Senior companion programs offer help with errands, shopping and appointments. Kandiyohi Area Transit also has a senior service that provides door-to-door transportation for those over age 60, using volunteer drivers with their personal vehicles.
"We try to give people resources," Stier said. "There are options out there."