Policy and Practices Updates Assessment of older drivers in New Zealand: The current system, research and recommendations Petra Hoggarth Van der Veer Institute for Parkinson's and Brain Research, Christchurch; and Department of Psychology, University of Canterbury, Christchurch, New Zealand Carrie Innes Van der Veer Institute for Parkinson's and Brain Research, Christchurch; and Department of Medical Physics and Bioengineering, Canterbury District Health Board, Christchurch, New Zealand John Dalrymple-Alford Van der Veer Institute for Parkinson's and Brain Research, Christchurch; Department of Psychology, University of Canterbury, Christchurch; and Department of Medicine, University of Otago, Christchurch, New Zealand Matthew Croucher Psychiatry Service for the Elderly, Canterbury District Health Board, Christchurch; and Department of Psychological Medicine, University of Otago, Christchurch, New Zealand Julie Severinsen and Jane Gray Department of Occupational Therapy, Canterbury District Health Board, Christchurch, New Zealand Jenny Oxley and Barbara Brook OTRS Group Ltd, Hamilton, New Zealand Paul Abernethy Pegasus Health Ltd, Christchurch, New Zealand Richard Jones Van der Veer Institute for Parkinson's and Brain Research, Christchurch; Department of Psychology, University of Canterbury, Christchurch; Department of Medical Physics and Bioengineering, Canterbury District Health Board, Christchurch; Department of Medicine, University of Otago, Christchurch; and Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand The purpose of this article is to clarify the current New Zealand driving licensing requirements for older adults and to provide practical recommendations for those health professionals who make decisions regarding driving ability in older adults. Health professionals involved in the assessment of older drivers were asked to clarify areas where more efficient use could be made of assessment resources. A review of driving literature was performed to find specific factors associated with increased risk of negative driving outcomes in older adults. Particular attention was paid to the suitability of different types of on-road assessment for certain patient groups, the effect of specific diseases and medications on driving safety, and the effect of cognitive impairment. A list of seven recommendations were compiled which include a focus on appropriate on-road driving assessment referral, driver refresher courses, cognitive screening for those presenting for licence renewal and sensitive broaching of the topic of driving cessation. Key words: aged, automobile driving, health planning, licensure, risk assessment. Introduction This article is a collaborative effort between researchers, driving specialist occupational therapists (OTs), an old-age psychiatrist and a general practitioner (GP) representative to clarify the current older driver relicensing requirements in New Zealand, to provide accurate summaries of interna- tional research investigating risk factors for unsafe driving in older people, and to provide concrete recommendations for how GPs and other health professionals charged with assess- ing driving ability can make the best use of time and resources to detect those older drivers who are at increased risk for unsafe driving. Driving assessment in New Zealand Up until December 2006, New Zealand drivers aged 80 and over were required to sit biennial on-road driving assess- ments in order to retain their drivers licence. This policy was ended in 2006 because of accusations that it was ageist. Drivers are now required to obtain a ‘medical fitness to drive’ certificate from their GPs at ages 75, 80 and biennially there- after. A guide exists for medical practitioners, optometrists and OTs for assessing medical fitness to drive [1]. The guide is not specific to older drivers but has sections on medical illnesses more common in older people. A fact sheet related to older driver relicensing is available on the New Zealand Transport Agency’s (NZTA; formerly Land Transport New Zealand) website (http://www.nzta.govt.nz/resources/ factsheets/57/older-drivers-licence-renewal.html). The NZTA provided a flow chart for GPs in 2006 detailing the steps involved in older driver licence renewal (Figure 1). The chart depicts four decision pathways. The most direct options (1 and 4) are for a GP to decide independently whether a patient is medically fit to drive and to recommend this unconditionally. These options should be used when the GP is satisfied that their patient is fit to drive (Option 1), or Correspondence to: Miss Petra Hoggarth, Van der Veer Institute for Parkinson’s and Brain Research. Email: petra.hoggarth@vanderveer.org.nz DOI: 10.1111/j.1741-6612.2010.00478.x 148 Australasian Journal on Ageing, Vol 30 No 3 September 2011, 148–155 © 2011 The Authors Australasian Journal on Ageing © 2011 ACOTA