Q: My 82-year old parents continue to drive their cars locally and on long-distance trips. They both take prescription drugs for high blood pressure, and my father suffered a heart attack eight years ago. Should they consider suspending their driving privileges now?

A: For many older drivers, the ability to get places independently is a precious privilege that they're unwilling to give up easily. However, at some point, safety issues must take precedence. The high accident rates for older drivers are directly related to physical and mental changes associated with aging, such as impaired vision, hearing, mobility, and neurological function. Side effects of medications can also play a significant role in their driving ability.

Recent driving history is an excellent indicator of the current level of risk in driving. Previous accidents, near misses, traffic violations, and incidents of getting lost are all red flagsand the individual should receive a full assessment by a physician before continuing to drive. The physician can determine probable reasons for driving difficulties by assessing the level of mental, motor, and medical impairments the driver demonstrates, both in the physician's office and at home. The physician may be able to improve the individual's driving abilities through changes in prescription medications or even a new exercise regimen. For example, proper driving requires muscle strength and endurance as well as a wide range of motion.

Drivers with physical disabilities may want to consult the Association for Driver Rehabilitation Specialists. They will be connected with a driver rehabilitation specialist in their area who can provide a comprehensive evaluation and make recommendations. AARP also offers eight-hour driver-safety programs in classroom settings around the nation.

As a general rule, there are certain precautions that elderly drivers can take in order to stay safe on the road. These include the avoidance of night driving, rush-hour driving, highway driving, or driving in dangerous conditions such as snow or rain storms. Remember, though, if the person's driving skills can not be improved to a reasonable degree of safety, alternatives to driving must be sought out. Public and private transportation are great options as well as carpooling, senior citizen shuttles, volunteer services, friends, and family.

Another alternative is to limit the need for driving through home delivery of groceries and medications. Older drivers should remember that losing a small degree of independence does not compare to the serious injury they could possibly impart on themselves or other passengers if they continue to drive.

Joanne Hill, M.S.W., is the author of Elder Organizer: A Journal of Information for Family Elders. This self-help book is a comprehensive guide, with educational articles and record keepers for important information, designed to help adults with retirement planning or with aging parents. For more information, visit www.lifeworkspublishing.com. Ms. Hill is a member of the American Society on Aging, the National Association of Baby Boomer Women, and the International Council for Active Aging.