Improving the Safety of Older Road Users (2005)

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53 Law enforcement officials can play a key role in identifying at-risk older drivers. They are also respected spokespersons for delivering educational materials and messages to older adults about how they can improve their safety as drivers, passengers, or pedestrians. Because of their familiarity with driving conditions within a community and their investiga- tions of crashes, law enforcement officials can also help to identify potential problem locations where changes in road- way design or traffic operations (signage, signaling, pave- ment markings, etc.) can improve safety. Most of the work of law enforcement officials is carried out at the local level and without special emphasis on older road users; therefore, it is not as well documented as some of the other program areas addressed in this synthesis report. However, law enforcement, as well as the judiciary, is an important link in a comprehensive program to improve safety and mobility for older road users. This chapter will highlight the range of programs and activities that law enforcement officials across the country have engaged in to promote older road user safety and mobility. FEDERAL GOVERNMENT AND NATIONAL INITIATIVES NHTSA maintains strong ties with the law enforcement com- munity. The committed participation of law enforcement is critical to the success of countless highway safety programs, policies, and initiatives, from promoting seat belt use and discouraging drunk driving to enforcing speed limits and reporting on crashes. Along with engineering and education, enforcement is a cornerstone of NHTSA’s safety initiatives. In the late 1990s, NHTSA initiated a research project to involve law enforcement officers in its efforts to identify at- risk older drivers. Drawing from the growing body of litera- ture on risk factors for older driver involvement in traffic crashes, the brochure Older Drivers: Cues for Law Enforce- ment was developed (1998). The brochure identifies specific cues an officer should look for when investigating a crash or making a traffic stop—cues that might suggest that a driver requires further evaluation. For example, does the driver know what time of day and day of the week it is, is his appearance disheveled, or does he have difficulty finding and removing his/her driver’s license (see Figure 9). The brochure also identifies ways an officer might intervene to assist an older adult in need of help, such as by making a referral to a local assistance agency or seeking additional information and support from family members. The Older Drivers: Cues for Law Enforcement brochure was field tested by Florida State Troopers in Pinellas County, Florida, and has since been used by law enforcement agencies across the country. In 2003, NHTSA published A Compendium of Law Enforcement Older Driver Programs (Ticer 2003). The Com- pendium was compiled by a sergeant with the Arizona Depart- ment of Public Safety who was participating in NHTSA’s Officer Leadership Program. It drew from responses to an NHTSA request for information, along with Internet searches and follow-up telephone interviews. The report, available on the NHTSA website, provides brief descriptions of programs in place in communities and cities in 28 states, along with con- tact information for further information about the program. A very frequently cited activity in the Compendium was teaching or facilitating one of the available driver safety courses for older adults, such as the AARP, AAA, or NSC courses. Law enforcement agencies were also frequently active in TRIAD programs, partnerships with senior groups to reduce the victimization of seniors. Another frequently noted activity was educating law enforcement officers about Alzheimer’s disease and other aspects of aging to increase their awareness and sensitivity to issues affecting older adults’ safety and mobility. There were also many creative and unique programs described in the Compendium that other communities might emulate. Following are noteworthy examples: • Senior citizen volunteers with the San Diego, California, Police Department teach a 2-h class, Look Out Before You Step Out, in an effort to reduce pedestrian fatali- ties and injuries. Community safety officers also offer “Awareness Training” presentations for older drivers and pedestrians that are tailored to local streets and conditions. • The TRIAD partnership in Shelton, Connecticut, has implemented a “Yellow Dot” program. Seniors fill out a yellow card with important medical information and place it in the glove compartment of their car. A yellow sticker on the rear window of the car alerts first respon- ders in an emergency to the presence of the card. CHAPTER SEVEN LAW ENFORCEMENT AND OTHER JUDICIAL PROGRAMS

• The Creative Light Program, created by a sergeant with the Pasco County, Florida, Sheriff’s Office, provided flashing beacons to pedestrians crossing a particularly dangerous section of highway at night, to make them more visible to motorists. • A deputy sheriff in Seminole County, Florida, devel- oped a class especially for law enforcement officers. The Graying of America: How It Will Affect the Deliv- ery of Law Enforcement Services has been taught to law enforcement agencies nationwide. • By presenting safety talks at a local bingo hall, the Crime Prevention Unit with the Alsip (Illinois) Police Department is able to reach 100 to 200 seniors at a time. • The Chicago, Illinois, and Newton, Massachusetts, police departments both assisted the Alzheimer’s Association in producing Safe Return and Law Enforcement, Saving Lives Together, a video to help train police officers in how to interact with Alzheimer’s patients. • An officer with the Waltham, Massachusetts, Police Department developed S.A.F.E., the Senior Academy for Education. This popular, 15-h course for seniors addresses both driver and pedestrian safety. • The Missouri State Highway Patrol assisted the Mary- ville University Occupational Therapy Program with the development of a training video, Partners for Safe Driving: A Guide for Law Enforcement and Licensing Agency Professionals. These examples highlight only a few of the many pro- grams described in A Compendium of Law Enforcement Older Driver Programs, but clearly demonstrate the vital role that 54 law enforcement agencies can have in helping to address the safety and mobility needs of older adults. The Alzheimer’s Association has been an especially strong partner in addressing the driving and mobility concerns of persons with Alzheimer’s and other forms of dementia. The Safe Return and Law Enforcement, Saving Lives Together video noted earlier was produced by the association specifi- cally to engage the support of the law enforcement commu- nity in preventing Alzheimer’s patients from endangering themselves and others on the roadway (see Safe Return . . . 1995). The association’s training program for law enforce- ment officers addresses issues such as medical reporting and the use of Global Positioning System technology to locate lost patients. These and other materials for law enforcement officers can be ordered from the association’s website. In addition to law enforcement officers, a second potential point of contact for impaired older drivers is the court system and, in particular, judges. The National Judicial College pro- vides education and training opportunities to judges through short courses offered at its facilities in Reno, Nevada. Two of its courses are of particular relevance to the older driver: Traf- fic Issues in the 21st Century and Sentencing Motor Vehicle Law Offenders. The traffic issues course has included special sessions to provide participants with an overview of aging driver trends and factors contributing to older driver crashes. One session incorporated “aging sensitivity” training in which participants wore special glasses to experience what it is like to have glaucoma, macular degeneration, or vision loss as a result of stroke. Another session provided information on approaches for assessing driving skills and assisting older adults in “keep- Front of Card Back of Card I FIGURE 9 Cue card from NHTSA’s Cues for Law Enforcement brochure.

55 ing the keys.” The second course, Sentencing Motor Vehicle Law Offenders also incorporated a session that focused on the special problems of cognitively impaired older drivers and appropriate sentencing options when these drivers appear before the courts. Both courses were provided with funding support from NHTSA (S. Samson, personal communication, Feb. 2005). STATE AND LOCAL INITIATIVES Additional state and local law enforcement programs and activities were uncovered in the course of preparing the cur- rent synthesis report. As noted earlier, many states and com- munities have established TRIADS, or partnerships between law enforcement and various public and private agencies and organizations, to address issues and concerns of senior citi- zens. Through TRIADS, law enforcement gains a better under- standing of the fears and concerns of seniors and coordinated responses to these needs are developed. At the community level, TRIAD programs are often implemented by a S.A.L.T. (Seniors and Law Enforcement Together) Council. Although a primary focus of TRIADS has been crime prevention, their scope extends to all areas of importance to seniors, including traffic safety. Florida has an especially active TRIAD organization that has partnered with the DHSMV in many of its older road user safety initiatives. Florida’s DHSMV has also developed a train-the-trainer program to educate the law enforcement community about the important role it can play in identify- ing and referring at-risk drivers of any age. Beyond simply referring to DHSMV, officers are encouraged to link the individual to an appropriate social service agency or the Area Agency on Aging to access needed assistance. Medical refer- rals are one component of DHSMV’s larger Mature Driver Transportation Lifetime Choices program, described else- where in this synthesis report. Florida has also taken the lead in educating judges and their staffs about the special needs and concerns of older adults. The Elder Justice Center is a special program available to adults over the age of 60 entering the court system. It provides guid- ance and referrals, ensures access to the courts and its various programs, and informs the court about the special needs of older clients. In Tampa, Florida, volunteers at the Elder Justice Center have also received training to serve as court monitors. In this capacity, they make random visits to wards of the court (persons who have been declared legally incapacitated) to ensure that they are being well treated and cared for. In the fall of 2003, the Florida DHSMV conducted a pilot project in Jacksonville designed to increase public awareness of how to recognize and report an unsafe driver. The identi- fied target audience for the campaign included law enforce- ment, the judicial system, medical professionals, social ser- vice providers, DHSMV employees, and the general public. A key strategy in the campaign was the training of law enforcement officials, using a 15-min roll-call video on how to recognize and report an unsafe driver. Teleconfer- ence and media training sessions were also employed to educate judicial staff, judges, and traffic hearing offices. The project led to increased support from the law enforce- ment community in recognizing and responding to the prob- lem of unsafe drivers. In Illinois, the Circuit Court of Cook County received funding from the Illinois DOT to develop a comprehensive traffic safety initiative as part of the Safe Communities ini- tiative. Although the Safe Community grant funding offi- cially ended in September 2003, the court has been able to continue its program entirely with court resources. The proj- ect, which involves specially tailored programs hosted by local senior centers, was described in the previous chapter. The program remains a model for court involvement in traf- fic safety initiatives. Before the Alzheimer’s Association developed its Safe Return video to educate law enforcement officers about the special needs of persons with dementia, health professionals in Ocean County, New Jersey, had recognized the important role that law enforcement officials can play in identifying potential dementia cases and bringing them to the attention of the health community before a traffic crash or other tragedy has occurred. The Safe Outreach for Seniors or S.O.S. pro- gram is a good example of law enforcement commitment to proactive efforts to protect vulnerable elderly populations (Howell and Macaluso 2001). In California, the Highway Patrol (CHP) has assumed the leadership role in implementing the state’s comprehensive plan for improving traffic safety among older adults, devel- oped in 2002 by a statewide task force (Yanochko 2002). The law enforcement working group of the task force also recently revised the California DMV’s Request for Reexamination form (DS 427), making it easier for officers to provide accu- rate information to the DMV driver safety offices responsi- ble for conducting driver reexaminations. CHP is also devel- oping a policy for their officers for when and how to refer drivers to the DMV for reexamination. As a final example of law enforcement involvement in programs to improve the safety of older road users, Highway Patrol Troopers in Texas are the official spokespersons for that state’s On the Road in Texas program. Described in chap- ter six, the program involves radio and television public service messages, reaching more than 2 million listeners each week. Although the messages address a wide variety of traffic safety topics, many of the issues are of special concern to older drivers, passengers, and pedestrians. STATE SURVEY RESULTS Only two survey questions focused specifically on the involve- ment of law enforcement in older road user safety initiatives.

The DMV survey contained the question, “Is your agency involved in any programs or activities with state or local law enforcement agencies addressing older road user safety and mobility?” and the Governor’s Highway Safety Office (HSO) survey asked a similar question, “Has your office engaged in any activities with law enforcement or judicial per- sonnel related to older road user safety and mobility?” (see Question 4 in Appendix E and Question 8 in Appendix G). Nine of the 34 responding state driver license offices indi- cated that they had collaborated with law enforcement agen- cies in addressing older road user safety needs. Responses from these nine states are summarized in Table 15. Although there are many described activities related to the reporting of unsafe drivers, of special note are the CHP’s leadership role in implementing the recommendations of that state’s compre- hensive traffic safety plan (noted earlier); the contribution of law enforcement to Iowa’s state and regional older driver forums; and the many, varied activities of the Florida law enforcement community, also described earlier in this chapter. Seven of the 24 respondents to the HSO’s survey also described collaborations with law enforcement agencies. These results were more varied and included participation on 56 task forces and planning committees, involvement in driver safety education courses (as frequently noted in the Com- pendium of Law Enforcement Older Driver Programs), and other public education initiatives (see Table 16). It should be emphasized that this information was reported by state driver licensing and highway safety agencies and not by law enforcement agencies directly. Thus, results are lim- ited to collaborations identified with these two state agencies. More information would likely have been obtained if law enforcement agencies had been surveyed directly. However, the Compendium report referenced earlier provides a com- prehensive survey of law enforcement activities in this impor- tant area. SUMMARY The programs and activities highlighted in this chapter show law enforcement and the courts to be important partners in maintaining the safe mobility of seniors. This is especially the case for older persons suffering cognitive or physical impair- ment. Law enforcement personnel are closely linked to their communities and can be effective and knowledgeable spokes- State Law Enforcement Participation California CHP is an active participant in the state’s Task Force on Older Adults and Traffic Safety and has assumed leadership responsibilities in implementing the Task Force’s recommendations. Florida Many initiatives identified, including the statewide TRIAD, Florida Highway Patrol Public Affairs Officers Mature Driver Outreach, Florida Crime Prevention Officers, and medical referral education/how to report an unsafe driver initiatives. Iowa Law enforcement is participating in state and regional older driver conferences. Driver license supervisors are involved with SALT. Maryland Reporting of unsafe drivers for reevaluation. Michigan Michigan State Police Office of Highway Safety Planning partners with the Office of Traffic Safety on elderly mobility planning issues; participation in training programs for reporting drivers for reevaluation. Nebraska No specific programs described. Oklahoma Reporting of unsafe drivers for reevaluation. Utah Reporting of unsafe drivers for reevaluation. Virginia Virginia Association of Chiefs of Police collaborated with the Department for the Aging to develop a brochure on Dementia and the Older Driver. State Law Enforcement Participation Iowa Representation on Older Driver Task Force and active participant in the Iowa Senior Mobility Forum. Kentucky Officers trained to teach the AAA Mature Driver Program. Michigan Law enforcement represented on both the statewide Task Force and the Elderly Mobility Workgroup. Ohio Participation in older driver education activities that are supported through GHSO grants. South Dakota Partners with the Office of Highway Safety to provide training and education at annual state AARP conferences as well as to community advocacy groups. Texas Spokespersons for the On the Road in Texas program. Puerto Rico Older driver and pedestrian safety issues addressed in training programs provided by the Puerto Rico Traffic Safety Commission for law enforcement, prosecutors, and judicial officers. TABLE 15 EXAMPLE OF LAW ENFORCEMENT PARTICIPATION IN DMV OLDER ROAD USER SAFETY AND MOBILITY INITIATIVES TABLE 16 EXAMPLE OF LAW ENFORCEMENT PARTICIPATION IN GOVERNOR’S HIGHWAY SAFETY OFFICE OLDER ROAD USER SAFETY AND MOBILITY INITIATIVES

57 persons and community partners. They both contribute a new dimension to older road user safety programs and help to tie together other dimensions. Useful Web Resources “Cues for Law Enforcement” (1998) [Online]. Available: http://www.nhtsa.dot.gov/people/injury/olddrive/cuesin dex.html. “A Compendium of Law Enforcement Older Driver Pro- grams” (Ticer 2003) [Online]. Available: http://www. nhtsa.dot.gov/people/injury/olddrive/LawEnforcement OlderDriver03/index.htm. Alzheimer’s Association [Online]. Available: http://www. alz.org/Resources/Resources/rtrlwand.asp. The National Judicial College [Online]. Available: http:// www.judges.org. “Safe Outreach for Seniors” manual [Online]. Available: http:// www.elderabusecenter.org/pdf/newsletter/news42.pdf.