When is it time to take car keys from elderly drivers?

Ray Kolpacki has spent a lifetime taking care of his home, his family and a girl named Sally he met at a Detroit bowling alley nearly six decades ago.

Suggest to the 80-year-old that it might be time to hang up the car keys for good, and well, it’s not going to go over well.

“It’s a death sentence,” said the former GM worker whose Westland neighborhood is street after street after street of homes.

Without his 1998 Buick, the Kolpackis will be cut off from Kroger, their doctors, church, and her Friday morning hair appointments.

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“You know what I’d do if I couldn’t drive?” he barks from inside his home, with a nod to a living room recliner. “I’d go sit down right there in that chair and die.”

With America’s 65-and-over population set to double by 2050, senior advocates, car companies and government agencies are working on new strategies to keep folks driving longer and safely so they remain independent and avoid the depression and loneliness that can develop after the keys are taken away.

The increased risks and potential solutions will be examined at the four-day 2014 North American Conference on Elderly Mobility starting Sunday at the downtown Detroit Marriott at the Renaissance Center.

The Kolpackis are among seniors in metro Detroit, the eldest of whom — according to research — may be at increased risk when they get behind the wheel. When calculated by miles traveled, the risk of dying in an accident increases noticeably at 70 to 74 years old, according to the Insurance Institute for Highway Safety and Highway Loss Data Institute.

In 2012, 4,079 people ages 70 and older died in motor vehicle crashes — possibly an indication of the frailty of an aged driver or passenger as much as a change in driving skill. At crash speeds of just over 31 m.p.h., a 50-year-old female has about a 10% risk of a serious injury in a frontal crash, but an 80-year-old female has about a 40% risk, according to the National Highway Traffic Safety Administration.

Crash statistics show senior drivers are also more involved in certain types of accidents, mostly involving left-hand turns that cross traffic.

Older Americans are not disproportionately represented among crashes overall, according to the National Safety Council and NHTSA.

They’re less likely to be involved in drunken driving accidents or in crashes involving bad weather, for example. But some experts argue the numbers don’t paint a full picture because senior drivers, especially those who don’t rack up work miles, drive so much less than others. And they’re less likely to drive in inclement weather or after dark.

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The problem may be a layering of aging problems, not the least of which is the slower mental processing of an older adult, said Cathy Lysack, occupational therapist and researcher at Wayne State University’s Institute of Gerontology.

Consider the mental processes involved with a left turn, a particularly dangerous maneuver for older adults, according to the research.

A driver must receive and interpret visual stimuli from a stop sign or traffic signal, scan the visual field, determine what’s relevant, dismiss what’s not …

… assess direction and speed of multiple objects moving in different directions, operate a turn signal and steering wheel, apply precisely the proper pressure to brake and gas …

… Continue checking mirrors.

“And what if something major or unexpected happens?” Lysack said. “That’s when there’s not much of a buffer left. That’s where that younger driver might be able to react a tiny bit faster to avoid the accident, but the older adult has the accident in the exact same circumstances.”

65 and older to double by 2050

The concern will only grow.

The nation’s 65-and-older population is projected to reach 83.7 million in 2050, almost double from the 2012 level of 43.1 million, according to the U.S. Census Bureau.

In southeast Michigan, where mass transportation is fragmented at best and practically non-existent in other places, seniors understandably hang onto the keys for as long as possible, Lysack at Wayne State said.

And like other seniors, the Kolpackis compensate.

Macular degeneration means he doesn’t drive in bad weather or after dark.

And other drivers seem to be so impatient these days, he said. So they’ve begun to avoid expressways and rush hour, too.

“Life is getting to a standstill,” said Celine (Sally) Kolpacki.

‘I’ll have no life’

People often ask to speak to Dr. Alan Dengiz — privately — in the hallway.

As a professor and geriatrician at the University of Michigan, Dengiz often knows what’s coming. Can’t he just take away Mom’s keys? they want to know. Doesn’t he think Dad needs to park the car for good?

But losing a driver’s license means isolation and a loss of dignity — things that other research shows leads to depression and health problems.

So Dengiz isn’t going to rush such a decision.

Among the tests he gives is a “trail making test,” in which a patient must connect letters and numbers in alternating ascending order: 1-A-2-B-3-C and so on. The speed at which the patient connects the points offers clues to how well he or she can think and react on the roadway.

More often than not, he said, the senior agrees to limit driving to familiar places with low speed limits or to daylight hours — a compromise that satisfies all for the time being, he said.

But although Dengiz and other doctors don’t have the authority to take away drivers licenses, they do — like family members or law enforcement — have the ability to alert the Michigan Secretary of State’s Office that a driver needs to be retested.

Sometimes, it’s simply no longer safe to be behind the wheel, he said.

“I’ve had people just stand up and walk out of the office and say, ‘You’re crazy and I’m going to continue to drive.’ I’ve had others say, ‘I don’t understand why you’re doing this to me; I’ll have no life,’ ” Dengiz said.

Dave Brown has seen it, too.

He runs the driving school at Beaumont Hospital Royal Oak, where older drivers often can regain driving skills following a stroke, for example. The program is geared for those wanting to “become a safer driver or resume independent driving.”

When that doesn’t happen, the news can be devastating, Brown said.

“Sometimes they say, ‘I might as well kill myself.’ ”

And that leaves doctors, the community and loved ones facing tough decisions.

“It’s complicated. No one wants anyone to get hurt in an accident that was preventable,” Lysack said. “On the other hand, it’s very disabling … Loneliness and depression is really, really bad for your health.”