When is it time to stop driving?

When is it time to stop driving or take the keys away?

At some time you will feel concern or even fear that your parents should no longer drive an automobile. AgingCare.com points out that in a recent year, over 14 million Americans were involved in accidents with elderly drivers. But is age the only issue in deciding if it is time to stop driving? Or, is it the risk of accidents?

Of course, it isn’t really just either of those!

If that were true, then, statistically, young adults should not drive! When driving, you are in control of a 4000-lb machine that can easily hurt you or someone else. And, we see people, young and old, who concern us while driving.

Physical and mental condition and abilities are probably the key area to consider. Even the airlines ask if you are “capable” of doing the things it takes to sit in the exit row. Why not ask this of other tasks, including driving?

What are some of the areas of concern?

  • Vision: Can the driver see well enough to drive? Can they see signs? Can they judge distances? Can they see at night? Can they physically see over the dashboard? Personally, as my cataracts get worse, I have less light entering my eyes. This will eventually reduce my focus ability and night vision. It isn’t a demonstrable problem yet, but I “keep an eye on it”.
  • Hearing: The driver must be able to hear sirens or RR-Crossing warnings.
  • Strength: Can the driver manage the vehicle? Turning the car at a slow speed can require a lot of arm strength. Have you ever tried to drive with your arm in pain? Or hit the brakes if your leg is weak from an injury? It is hard! And, risky.
  • Medications: Is the driver on any medications that could affect speed of thought? Or one that would make them sleepy? Both situations can spell disaster. Medications and their interactions can have serious effects.

Is there anything specific to dementia?

For the topic at hand, Alzheimer’s and dementia, there might be unique issues that cause changes to the abilities that can affect driving.

  • Forgetfulness can be an important consideration. Not just about destinations, or how to return home. That happens, of course. But, look for confusion about stop signs, forgetting to use blinkers, or making that left turn into the retirement home without regard for oncoming traffic (one of my clients had two car-totaling accidents this way before his license was revoked).
  • Judgments: When an emergency happens, can the driver make decisions fast enough to avoid an accident? Sometimes, that ability to judge what is coming up avoids the emergency in the first place. Alzheimer’s and other dementias can rob a person of the ability to process information fast enough to drive.  To compensate, some drivers with slow reactions may turn too late, stomp on the brakes after they pass their destination, or just drive slowly.

How can you evaluate the driving?

Ride with them. Watch how they drive. Observe without comments, but record what you see for later reference. Some of the warning signs showing that the ability to drive safely is beginning to decline include:

  • Difficulty changing lanes.
  • Suddenly drifting into other lanes.
  • Problems judging distance when braking.
  • Forgetting to use turn signals.

Check the vehicle. Look for dents on the car, especially at the corners. Ask about the missing mirror. Check the sides of the garage door for damage.

Again, a personal note … seeing how my mother-in-law drove even years before symptoms of Alzheimer’s appeared should have alerted us to impending problems. She had dents and dings on all four corners of the car and had some trouble being attentive to traffic. I didn’t want to ride with her anymore! We didn’t stop her from driving for a few more years, and fortunately, nothing serious happened.

How to actually take the keys, if you must…

Have a plan. If you take the keys, says the Huff Post website, you should be able to provide an alternative. You can drive, you can sign the driver up with a local transportation option, such as Durham Access, or even teach the driver how to use Uber.  But, don’t leave them with no options.

Have a conversation. This is a shared decision, and your loved ones should be a part of the process. Elizabeth Dugan, author of the book, “The Driving Dilemma: The Complete Resource Guide for Older Drivers and Their Families,” suggests that you ask them what to do and share your concerns (“I don’t want to lose you in an accident”). Use open-ended questions and focus on what you are worried about, not what they should do.

Involve a trusted third party. Leverage a doctor or therapist (or the DMV) for help.

Be creative. For some drivers, simply “losing the keys” is enough. We disconnected the battery, and the car just would not start.

What if your loved one still refuses to stop driving?

Here are two ideas from dailycaring.com to force the issue:

Contact the DMV. There is a form on the website (ncdot.gov) that allows you to report the driver and ask for a driving evalutaion. Failure to pass would limit their driving.

Use forgetfulness to your advantage. When mother-in-law’s car would not start, it wasn’t long before she stopped wanting to drive and accepted rides and help from others. If she asked, we simply suggested that the car could not be fixed. Similarly, you can lose the keys or even disable the car entirely (like we did with the battery cable).

Also, Protect your own car and keys. Some people will take another car in the household to drive. So, protect that car too by controlling your own keys.

If there is really a problem, don’t feel guilty. You are doing what is necessary.

What if you do take the keys?

If you feel that it is time for them to hand over the keys, recognize that you may run into resistance. Taking the car keys removes the parent’s independence, the ability to drive to the market or to meet friends for coffee, to church and the senior center, the library or to visit friends. The experience can be traumatic.

But, be aware that taking away the keys can mean an earlier move to assisted living.  Is that affordable or even a good idea?  Be prepared to step in with meaningful assistance during this transition.

Summary

The bottom line is that this is a hard conversation and will require patience and planning.

If you need help, check out the articles referenced on this blog or contact a geriatric professional care manager.

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