One of the most controversial topics in maintaining safe mobility in an aging society is the evaluation of an older person’s fitness to drive. The controversy stems from a number of questions: Should evaluation be based on age? Are evaluation instruments valid and reliable? Are the time and financial costs of evaluation worthwhile expenses? Some of the controversy, however, results from a lack of clarity in defining the difference between driver screening and driver assessment. For this book, we use consensus-based definitions developed at the North American Driver License Policies Workshop (Molnar & Eby, 2008a):

Figure 6.1 presents our conceptualization of the fitness-to-drive evaluation process, including the professionals and venues where screening and assessment take place. Driver evaluation can take place in three venues represented by the three boxes in the figure: home/community, clinical settings, and driver’s license agencies. In each of these settings, there are various people who conduct the screening or assessment. The potentially unsafe older driver is generally first identified in his or her community, either through someone observing unsafe driving, an incident such as a crash, or the driver noticing a potential driving problem. In all cases, either formal or informal screening is taking place. At this point the driver may be referred to the licensing agency or may voluntarily seek medical evaluation, participate in an education and rehabilitation program, or self-regulate his or her driving.