One of the most upsetting situations that many families have to face in the care of elderly parents is the decision of when the elders should give up their car keys. In my family, my parents resented this more than the decision to have them give up their home and move in with my sister! Driving is central to adult independence, and elders often feel that losing their driver’s license is the ultimate indignity. They will fight to the death (almost literally) to hold on to driving. So let’s look at this crucial decision and to try to come to a plan that everyone can live with. The first question is
Should they still be driving?
The question of whether or not your elderly parent should be on the road is subjective and complex. For me, it comes down to three considerations: How important is driving to their sense of dignity and independence? How dangerous is their driving to themselves? How dangerous is their driving to others? Let me try to give you some guidelines for evaluating your particular loved ones.
How’s their driving record?
Has there been an increase in accidents or tickets lately? Have there been complaints about their driving from passengers? neighbors? bystanders? If no one has complained, and there haven’t been any accidents or tickets, then there is a good chance the driver in question may be safe to continue for a while, at least on short familiar routes such as to the store, the church, or a friend’s house who lives nearby.
Do they have memory issues?
My experience is that seniors can often continue driving safely for years after age-related forgetfulness begins. You have to look for the particular manifestations of dementia to fairly evaluate an individual’s safely as a driver. Are they getting lost close to home on familiar streets? Do they have episodes of confusion where they can’t figure out where to go and might, for example, try to enter a highway the wrong way or go down a street on the wrong side? Do they forget, even once, such things as how to turn on the car, lower the window, or use any of the controls? All those would be signs that they should give up the keys immediately. If a person has been diagnosed with Alzheimer’s, he or she should give up the keys immediately. That disease is progressive and incompatible with driving.
Are they physically strong enough?
If your parent has weakness in his hands, he may lose grip on the steering wheel when turning. If he has weakness in his right leg or foot, he may not be able to hit the brakes fast enough and hard enough to avoid an accident. If he has stiffness in his neck and shoulders, he will need to be extra sharp and vigilant with mirrors to compensate for his inability to perform head checks before changing lanes. There is evidence to support the idea that if a person has arthritis, his or her stopping distance is measurably lengthened.
What chronic conditions do they suffer from?
Does your parent take insulin for diabetes? If so, has he ever passed out from complications arising from it? How is your loved one’s hearing? Is he aware if people honk at him? How is his vision? Macular degeneration creates a blank spot in a person’s focal vision. That means he may not see what is dead ahead, and he can’t read signs as well. How is your parent’s spatial perception? Does he stop at the right place at a stop sign? How is his reaction speed? Does it take him a long time to notice and respond when a traffic signal changes? What medications does your parent take? Do any of them cause drowsiness? If so, that needs to be considered when planning trips in the car. Many health conditions affect driving. If there is any question as to the physical health of your aging parents in relation to driving performance then it is important to consult a physician. Also, some driving schools (including Colonial Driving School) offer senior assessments that provide actionable information and peace of mind.
How do you tell your parent that they shouldn’t be driving?
Empathy is key. How would you feel if you were being told that you couldn’t drive for the rest of your life? Keep in mind that people too old to drive are usually too old to use smartphones, Uber, Lyft, or even the bus system (if it exists in their area, which it probably doesn’t!) They probably feel that taxis are expensive luxuries used only by the rich, so they may be unwilling to use them no matter how much money they have in the bank. Most elders are understandably defensive when you bring up concerns about their driving. It can help if you develop and begin to implement a plan for getting them where they want to go before they finally give up the keys. Transitioning into the use of alternative methods is sometimes better than jumping in cold turkey. Think hard and creatively about how you can lessen the sudden decrease in independence. Also, be prepared to provide concrete unbiased information about what is affecting their driving performance. The Senior Assessment at Colonial Driving School includes a DMV road test, which does a great job of bringing families together around objective measurable data.
What to do if your parent is definitely unsafe but won’t stop driving?
If an agreement cannot be reached, and you and your siblings are reasonably certain that your parent needs to stop driving immediately, it is possible for you to report him to DMV as an unsafe driver. The report is confidential and the DMV will usually respond by requiring your parent to re-take the DMV knowledge and road tests or surrender his license. If he can pass, then maybe he isn’t as unsafe as you think, but the likelihood is that he will not pass. The current version of the DMV knowledge test is difficult.