The short answer is: It's better to be safe than sorry.
That may sound trite but that's the advice I give adult children who are worried about whether their elderly mother or father should still be driving. The major deciding factor should be this: if you think your parent can get hurt or endanger the lives of pedestrians, other drivers and their passengers, then the time has come to ask for the keys.
It won't be easy. Driving is the single most important issue that represents freedom, independence and self-esteem for your elderly parent. Take that away and parents often feel helpless and at a loss, knowing they will have to rely on others for driving.
To make sure you're making the right decision, here are two options to consider:
• Find a driver rehabilitation specialist (DRS) in your area who will give your parent an eye exam and on-the-road driving test. The DRS will tell your elderly parent whether he/she should be driving. Although these programs are primarily offered by rehab facilities for adults with disabilities, many also make this service available to the elderly. Even though it is not a state or legal requirement, it is my opinion that any driver over the age of 70 should be tested every two years to determine if he/she is a safe driver. You can contact your doctor for a referral or the Association for Driver Rehabilitation Specialists (ADED) for a specialist in your area. Their website: www.driver-ed.org or www.aded.net or telephone number: 1-800-290-2344.
• Take a test drive yourself with mom or dad. Do you think that he/she is a safe driver? Answer the questionaire provided by the American Medical Association called "Am I a Safe Driver?" to determine if your parent's safety is at risk. See Page 3 of the pdf document at http://www.ama-assn.org/ama1/pub/upload/mm/433/appendixb.pdf
If you take the test drive with your elderly parent, here are some of the warning signs that indicate your parent may need to stop driving:
• Drives too slow or too fast;
• Stops in traffic for no apparent reason;
• Confuses the gas with the brake pedal;
• Oblivious to other cars, pedestrians, bike riders;
• Ignores, misinterprets or disobeys stop signs and traffic lights;
• Doesn't stay in lane;
• Turns left from the right lane;
• Reflexes are not sharp and response time is slow;
• Judges distance poorly between cars while driving and/or parking;
• Gets honked at frequently or passed often;
• Fails to yield to pedestrians or drivers who have right of way;
• Has an unusual number of dents or fender benders;
• Has paint on his/her car from driving into the side of the house
• Has difficulty looking over the neck or shoulders while driving or parking;
• Is not strong enough to grip wheel or turn it suddenly in an emergency such as when a child darts into the road;
• Appears drowsy, confused or frightened;
• Gets lost in familiar places and forgets where the car has been parked
• Runs over curbs and medians.
Combine two or more of the above warning signs with recent tickets for moving violations, comments from passengers about close calls or near misses, and recent increases in insurance premiums and you can be sure your parent is at risk.
You should also know that older people need three times as much light to drive at night and that their peripheral vision deteriorates with age. Cataracts, macular degeneration and glaucoma are also three conditions that can interfere with vision.
In addition, there are also a variety of other physical and medical conditions that can impair driving. For example, observe your elderly parent getting in and out of chairs. If he/she has difficulty with this task, your parent may have stiff joints which could hamper driving.
Other medical conditions that could affect driving include cardiovascular diseases and certain psychiatric or neurological conditions. For example, severe arthritis, Parkinson's disease and several mini strokes are warning signs that your parent should not be driving. Although some may disagree, elderly parents who have dementia should not be driving. This disease causes serious memory, personality and behavioral problems that puts your parent's life at risk when driving. Unfortunately, people with dementia often cannot recognize that they should no longer be driving. That's when you must step in and take over the situation. Also, keep in mind that many medications can make your parent drowsy or affect the reflexes such as certain anti-depressants, sleep aids, antihistamines for allergies and colds, painkillers, and diabetes prescriptions.
If your parent fails the test drive, how do you tell him/her that driving is no longer an option?
• First, discuss the situation with your elderly parent at a time when he/she seems rested, relaxed and in the mood for conversation. Be non-threatening. Emphasize the general problems that affect the older driver. Then explain why you are concerned. Tell mom or dad what you have noticed about their driving. Give specific examples relative to his/her situation. (For example, maybe your parent disobeyed stop signs, made a left turn from the right lane and had several "near misses.") Also maybe your parent has had more than one accident in the last six months, an unusual number of dents in the car or has experienced a change in their mobility. Discuss these points in a gentle, yet firm manner.
• Second, recognize that this topic will probably make your parent angry and defensive. As a result, it may take at two, three, or more conversations before your parent responds to your suggestion.
• Third, if your parent doesn't respond to you, make an appointment for your parent to see his/her doctor. Contact the doctor in advance, express your concerns and ask him/her to discuss the topic with your parent. Then accompany your parent to the doctor to make sure he/she provides the correct information. Many elderly parents often deny the reality of their situation and don't tell the correct story so they can continue with the status quo. Know that doctors are required to file a report with the state if they feel their patient should not be driving.
• Fourth, stage an intervention. Confront your parent with a group of family, friends, neighbors, healthcare professionals and others he/she views as authorities. This activity often used in substance abuse cases, can be very effective in helping your parent see the light. Recognize, however, that this event can be an emotional situation for everyone. Consequently, be firm, yet compassionate, when handling the situation.
• Fifth, contact your local AAA or Department of Motor Vehicles (DMV) and report your concerns. Most states will contact older adults and have them take a driving test, revoking their license, if necessary.
• Sixth, if none of the above works, take the keys, disable the car or move it off the premises beyond your parent's reach. You can disable the car by leaving the headlights on all night or disconnecting the battery. If you think mom or dad will call a mechanic or the AAAs, you have no choice but to eliminate all access to the car by moving it off the premises.
Although your elderly parent may be resentful or angry or with your actions, eventually he/she will realize this was the best solution and it was done out of love and concern for his/her safety.
What do you do when your parent retires from driving?
Create a transportation plan that will give them a variety of options when he/she needs to go somewhere. A written description of this plan should be easy to follow and comfortable to use, can be placed in a binder or notebook and left in an appropriate location in your parent's home such as near the kitchen phone.
Prior to starting the plan, you may want to contact your local Area Agency on Aging to see if they can refer you to local transportation services for senior citizens. Once you've researched this, you can then begin to develop your parent's transportation plan. Here are a few suggestions of what you may want to include:
• A table of contents. List every transportation option here and its appropriate page number in the notebook. This will help your parent find exactly what he/she needs quickly and efficiently.
• A list of friends and families who can offer rides. Call your parent's neighbors, friends and other family members. Tell them what you are doing and ask for their cooperation in providing their telephone numbers and days and times they are available to help. Then include this information on one or two pages in the notebook, perhaps in alphabetical order.
• A list of public transportation options. Call your local cab, bus and train companies for their schedules. Affix the schedules …one at a time…on individual pages or sleeves in the notebook. Make sure the phone numbers of these services are large enough and easy to find. If not, you may want to write them down next to the schedules in large, bold print. To reduce cab fares, find out if your community offers discounted fares for seniors. Also, call some of your parent's older friends and find out if they would be interested in sharing cab fees. Then include their names and phone numbers on the same or adjacent page.
• Include a Senior Shuttle Service for seniors, if available. Find out about any discount or reduced rate programs for older adults. In Pittsburgh, make sure to include the name of "Access" and its phone number. Also, determine if there are other transit shuttles that are sponsored by non-profit or senior organizations to transport those in your local or retirement communities to area shopping areas. Many cities have a service like this, including Pittsburgh. In Pittsburgh, contact Elder Express at 412-702-0050. It is available to only those in the Squirrel Hill area.
• Identify volunteer drivers. Sometimes local churches or synagogues have a driver volunteer program. Find out the names and phone numbers of these folks and place them in your notebook.
For more information about driving safety for your parent, contact:
American Association of Retired Persons (AARP)
601 East Street. NW
Washington, DC 2004
800-424-3410
http://www.aarp.org
American Automobile Association
1000AAA Drive
Heathrow, FL 32746-5063
407-444-7000
http://www.aaa.com
AAA Foundation for Traffic Safety
1440 New York Avenue, NW, Ste 201
Washington, DC 20005
202-638-5944
http://www.aaafts.org
Paula Tchirkow, MSW, LSW, ACSW is president of Pittsburgh-based Allegheny Geriatric Consultants which specializes in geriatric care management and counsels adult children who are struggling with the stress and overwhelming issues of caring for an elderly parent. Visit Paula's website at www.caregivingadvice.com and sign up for her bimonthly newsletter which offers practical tips for caring for your elderly parent. |
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