Last week, we discussed the many transportation options that exist to help aging adults maintain their independence after handing over the car keys. Now that you're familiar with the alternative transportation choices and know where to turn to find out what resources exist in your local area, you are prepared to have this difficult discussion with your aging loved one. But how do you start the conversation, and how is this difficult subject broached successfully?
First, know the warning signs
The first step is determining whether it's really time to have the talk with mom or dad about their safety on the roads. HelpGuide.org outlines several warning signs that could indicate it's time for an aging adult to stop driving. Some key warning signs include:
- Taking medications with warnings against operating vehicles or machinery - While some medications have warnings regarding drowsiness, dizziness and other side effects, some also have explicit warnings advising patients not to drive or operate heavy machinery until they know how a medication will affect them.
- Combined medication effects - Some medications can cause stronger or different side effects when combined. If your loved one's physician has prescribed a new medication, it's a good idea for mom or dad to avoid driving until they know exactly how this specific combination of medications will affect them. Your loved one's pharmacist can also be a helpful resource for learning about the side effects associated with certain medication combinations.
- Vision impairment - Vision deteriorates with aging for many older adults. Problems with vision, such as a loss of peripheral vision, can create challenges for older adults behind the wheel, making it difficult to interpret the full visual field. Likewise, sensitivity to light, trouble seeing in the dark or blurred vision are safety concerns for drivers.
- Hearing impairment - While it is possible to drive with a hearing impairment, auditory cues are more important than you may think for safe driving. When older adults experience sudden or significant hearing loss, it may be time to evaluate their safety on the road.
- Slow reflexes and decreased range of motion - Drivers must be able to react quickly and adapt readily to sudden changes or unexpected situations on the road. Older adults with slowed reflex response and decreased range of motion may not be able to react quickly enough to avoid accidents.
- Problems with memory - If your aging loved one is suffering from memory loss, it might be time to consider having the talk about giving up the car keys. Memory impairment can actually be quite dangerous for older adults who drive. For instance, a memory lapse could cause your loved one to forget where she was going and sometimes just keep driving until she realizes she's in unfamiliar territory.
- Too many close calls - If your loved one has had multiple close calls or minor accidents, scrapes and dents, it's time to take a look at whether it's time to stop driving.
Understand it may take several conversations
The first time you bring up the subject of handing over the car keys, your aging loved one may not immediately acquiesce. Often, learning that he/she is unsafe on the road is difficult to hear and a harsh reminder that he/she is, in fact, getting older. Be gentle when you bring up the topic and plan ahead so that your first discussion is happening well before it's urgent that your loved one stop driving immediately. This allows you time to have a preliminary discussion, get your loved one's thoughts about her safety behind the wheel, and find out what specific concerns she may have about no longer driving.
Do your research and offer alternative transportation options
Once you learn what your loved one's concerns are and whether she feels that it may be time to stop driving, you can do some research. If being isolated and unable to get to important appointments or to the grocery store is a concern, present a specific plan for meeting these needs and information on the alternative transportation options available in your local area.
Be respectful of their independence and opinions
Ultimately, the decision is not yours alone. Unless your loved one is incapacitated, the choice to stop driving is truly his, although you can provide input and support. Be respectful of your loved one's desire to maintain his independence and offer advice and opinions while stating your commitment to ensuring that his independence is maintained should he decide to give up his car keys.
Know your options when the need is urgent
Unfortunately, some families encounter situations in which an aging loved one is truly unsafe on the road yet he/she can't accept that it's too dangerous to continue driving. If the need is urgent, and it's imperative that you get your loved one off the roads as soon as possible, there are legal options. Most families turn to these options as a last resort, as they'd rather not have to force their loved ones to hand over the keys against their will. If you reach this juncture, here are a few legal options for getting your aging loved one to give up the car keys recommended by AgingCare.com:
- The physician - Older adults may be more likely to listen to the advice of their physician, so enlisting the doctor's help to talk with mom or dad about giving up the keys can be helpful. In fact, the American Medical Association recommends that physicians counsel their patients directly, and they can even ask for and accept the car keys. A physician can also write a medical status report that caregivers can take to the Department of Motor Vehicles (DMV).
- The optometrist or ophthalmologist - These providers can have a similar discussion with an older adult as a physician would, explaining how the patient's vision impairments make it unsafe to continue driving.
- Your state's Department of Motor Vehicles - As a family caregiver, you can meet with your local department representatives to present background and health information. This is followed by your request for your aging loved one to receive new vision exams, paper tests and possibly an examination drive with an inspector. Decisions or actions are determined by the inspectors, and the driver receives notice prior to the renewal date on her driver's license. Even if your mom or dad passes all required tests and exams, you'll at least have peace of mind that she is deemed safe to drive independently. Note that each state has its own licensing standards and protocols, so the specific process may be different depending where you live.
- The family attorney - An estate attorney can discuss the implications for the estate with the family should an accident occur, such as a loss of assets should a lawsuit arise from an accident. Your attorney may agree to sit down to discuss the reasons why mom or dad should stop driving with you and other family members.
- The police - While most caregivers hesitate to take this step, notifying the police for minor accidents and violations facilitates the creation of a report, and the police can make their own request to the Department of Motor Vehicles for new testing if they feel it's warranted.