When Steven Gnepp and his wife, Paula, got a call from his 87-year-old mother, Claire, asking him what she was supposed to do with the license-renewal form she received in the mail, they were concerned. If she couldn’t understand that, they thought, they couldn’t trust her driving. So they signed her up for a driving assessment test at a local hospital. Claire failed the cognitive-abilities test. “It never even crossed her mind that she might not pass. It was a big shock to her,” says Steven Gnepp, a retired NASA computer scientist.

Problems arise when seniors begin losing their cognitive or physical abilities. “The challenge is coming up with a system for identifying those drivers who are no longer safe,” says Eby of the University of Michigan. “It’s far too expensive and potentially biased to set an age limit and say everyone must get tested.”

Currently, 28 states plus the District of Columbia have special provisions for renewing the licenses of older drivers. Provisions can include more frequent renewals, restricting online or mailed renewals, and vision or road tests. Adult driver education can be helpful in brushing up on skills.

Extending the driving years. Many seniors begin having problems long before they lose their driving ability. Some have basic challenges in simply getting in and out of their vehicles and being able to see out properly. CarFit, a program sponsored by AAA, AARP, and the American Occupational Therapy Association, holds events around the country to help older drivers assess such things as their seat position, mirrors, head restraints, and controls. “Many people buy a new car, just jump in it, and drive, and don’t adjust all the safety features to their maximum effectiveness,” says Julie Lee, vice president and national director of AARP Driver Safety.

Automakers have been somewhat hit or miss in designing cars that are friendlier for seniors. Some are designing controls with larger buttons and more readable labeling. For drivers who find it difficult to turn their heads, features such as rear-backup cameras, blind-spot-detection systems, small convex mirrors added to a car’s regular side mirrors, and cross-­traffic alerts that detect passing cars in the rear when backing up help increase visibility and awareness of surrounding cars.

Lane-departure warning systems can alert a driver who begins drifting from his lane, and some can even make minor steering corrections to deter that. Ford has developed an inflatable rear safety belt for passengers vulnerable to breaking bones in crashes. And small SUVs usually make it easy to get in and out by providing big doors and chair-height access.

Unfortunately, some designs make driving more difficult. Thicker windshield and roof pillars and smaller windows in many vehicles limit outward visibility. Complicated control systems can be difficult to use and distracting. And some modern infotainment systems encourage drivers to take their eyes off of the road.

To make traffic signs more visible and easily understood, the Federal Highway Administration has developed guidelines for improvements. Changes include making signs more reflective, using upper- and lowercase letters for readability, and increasing the distance between signs and exits or interchanges to give drivers more time to react.

A lack of options. If their skills decline to the point where they can’t drive safely, many seniors face a difficult situation because of limited alternatives. “Driving cessation is an ugly topic, and there is not a public transportation system in this country that can really support seniors as they age out of the car,” says Bryan Reimer, a research scientist at the Massachusetts Institute of Technology’s AgeLab.

Sandra Rosenbloom, Ph.D., a director at the Urban Institute, an economic and social policy research organization, notes that about three-quarters of people 65 or older live in suburban or rural areas, where there are few alternatives to the car. “We know that nine out of 10 people want to stay in the homes where they raised their families,” says Lee of the AARP, “but the communities aren’t necessarily set up to help older people do that.”

Some people are working on solutions. After her 3-year-old son was hit and injured by an 84-year-old driver, Katherine Freund of Portland, Maine, said she didn’t blame the driver. Rather, she blamed the lack of a transportation system that could meet his needs. In 1995, she founded ITN America (Independent Transportation Network), which provides door-to-door driving services for seniors. The program has since expanded to 20 communities around the country.

Evelyn and Cliff Orman of Westbrook, Maine, who decided to stop driving in their mid-80s, are ITN America customers. “For us, giving up the car was sad. It was just another step in the aging process,” Evelyn Orman says. Still, “We felt it was time.”

Families will need to help out as much as possible. “Much like we plan for finances and health insurance, we need to do transportation planning as we age,” ­Reimer says. He suggests figuring out specific ways that the senior can get around.

Introduce the concept gradually. “People need time to adjust because growing older is not for wimps,” Freund says. Get information on public transportation and services for seniors. Then help plot ways to get to common destinations. Write down instructions if necessary.

Ann Dellinger, Ph.D., M.P.H., leader of the Transportation Safety Team at the CDC’s National Center for Injury Prevention and Control, adds, “It will end up that we will all play a part in maximizing mobility in the community.