If you’re reading this, chances are you’re worried about an elderly parent driving. The worry is enough to keep you up at night and question your own sanity. The decision to hand over the car keys is one of the most difficult decisions and transitions an aging family will make.
It’s the one day to day task critical to an older adult’s ability to maintain their independence and spontaneity. Without the ability to drive they become more dependent on you and isolated from society.
However, your impaired elderly parent behind the wheel of a car puts innocent people in harms way. Just the other day, an elderly woman drove through the lobby of a local retirement community.
Luckily no one was hurt…
Despite accidents, a diagnosis of dementia and poor eye site, the department of motor vehicles continues to issue a license to your elderly parent; their doctor dodges the topic. Your siblings all have different approaches and opinions; arguments ensue. An accident occurs and you’re relieved no one is hurt. You’re hopeful the keys will be handed over but they aren’t. The worry and sleepless nights continue.
Where do we start? Assess the situation!
Before you start this conversation, do some investigating and clearly define your concerns. If your mom or dad is open to this discussion and voicing their own concerns, you can download your aging driver self assessment here!
If your elderly parent denies their driving is a problem, you’re going to have to assess for yourself how critical the situation is, facilitate conversation and reach out to professionals for help.
From your perspective, consider the following statements and clarify specifically what our concerns are before you start the conversation!
- I no longer feel safe driving with mom or dad
- I notice my elderly parent or loved one limiting their driving
- There are unexplained dents in their car
- I’m concerned about medication use and driving
- Accidents have been reported to me
- Traffic violations have been reported to me
- I’ve suspected a time or two that mom has gotten lost while driving
- I witnessed mom or dad running a stop sign
- I witnessed dad sitting at a stop light/sign for a long period of time
- Friends and family are voicing concerns to me
- My elderly parent has received a diagnosis related to dementia
- My mom has suffered a stroke
- My dad has received a diagnosis related to vision (macular degeneration, retinopathy, glaucoma)
- My elderly parent suffers from depression, anxiety or other mental health disorder
- I’ve noticed mom or dad having a difficult time getting in and out of the car
- Falls have been reported or witnessed
- My elderly parent has complained of dizziness
Strategies For Starting the Conversation
After you identify your concerns, you’re ready to get serious about talking with your elderly parent about safe driving. Whether you do this as a family meeting or individual conversation, here are some strategies that will make the conversation less threatening and more productive.
- Start from a place of empathy and understanding. Be a good listener and take their concerns seriously by stating that you plan on being there for them as they make this transition.
- Be upfront “dad I noticed there’s a dent in your car, how did that happen” or “mom, your neighbor Gladys has voiced concerns over your driving. Why do you think she would say that?”
- Realize that your mom or dad may become upset or defensive. This is understandable and to be expected. DO NOT respond with arguments or talk them out of their feelings.
- Don’t bring up your concerns while your parent is driving. The last thing they need is more distraction. Wait until you have their undivided attention before starting the conversation.
- Don’t start this conversation without an understanding of what the issues are. Complete your worksheets and be clear on how you want to present this in very specific terms.
- Don’t expect your first conversation about this to be your last. If your elderly parent doesn’t want to talk about it back off and wait for another time. Continue to listen, support and look for opportunities.
- Appeal to your mom or dad’s sense of responsibility to others on the road. Ask them to consider how they would feel if they were responsible for an accident that killed another person.
- If your elderly parent is suffering from cognitive deficits, don’t expect them to be the voice of reason and/or to express good judgement. Also, consider taking notes for them so they can refer to them later.
This is not the time to practice avoidance. This topic is too serious, the stakes to high to stick your head in the sand. It’s a public safety issue that could have dire consequences. If you’re struggling to intervene or your elderly parent refuses to listen, you’ll need to turn to professionals for help.
Where to Turn for Help
If you’re lucky, your situation will be clear and your elderly parent pro-active. But for many, this is not the case. In the United States, the elder and senior services network is modeled the same from state to state but there are subtle differences. You’ll need to do your due diligence and research resources in your local county.
The American Medical Association has encouraged physicians to discuss safe driving with patients by providing guidelines and assessment tools. I don’t know that I’ve ever experienced a doctor discussing this with any of my clients or family members. Typically the discussion starts when we call the doctor to voice concerns. Here’s some tips for working with your elderly parent’s physician.
- Doctors technically can’t share information with you unless you have power-of-attorney, health care proxy, guardianship or consent papers signed. However, you can share information with them so don’t hesitate to voice your concerns.
- Attend a doctor’s visit with your mom or dad to facilitate the conversation and ask questions specifically related to health status and driving. Ask specific questions about conditions that make it difficult to drive. Is mom’s eye sight good enough for her to drive safely?
- Ask the physician what types of cognitive screening they have completed and what the results were. This includes questionnaire screens as well as scans. If none have been completed, ask them to administer the “clock test”. Ask “is there anything from a memory stand point that indicates dad shouldn’t be driving?”.
- You can start by working with the primary care physician but don’t hestate to ask these questions of any specialist your mom or dad are involved with. Cardiologist, ophthalmologist, neurologist should all be able to shed light on your elderly parent’s ability to safely drive.
- If it’s clear your mom or dad are unsafe to drive, ask the physician to write a medical statue report and send it to the department of motor vehicles. It’s probably best you make this request without your elderly parent present. This will facilitate the driver’s license being revoked.
- I’ve seen physicians write the order to cease driving on a prescription pad before or they may write an “official looking” letter. If your mom or dad have respect for their doctor this may be enough. OR they may totally dismiss their doctor but it’s worth a try.
- If you’re not satisfied that the doctor is taking you seriously enough, ask them for a referral to an occupational therapist or a driver rehabilitation program. These programs are few and far in between but they offer the most comprehensive approach.
When my clients are struggling with handing over the car keys, the first resource I turn to is an occupational therapist (OT). An OT takes the guessing out of the game and focuses on abilities. They identify challenges but also help problem solve solutions. Here’s some tips for locating and working with an occupational therapist.
- Having Medicare B pay for your assessment can be kind of tricky but it can be done. You’ll need a physician’s order and an OT that has the ability to bill Medicare B. This evaluation may not include a “behind the wheel” evaluation but based on the assessment the OT will have a solid clinical picture to determine if driving is safe.
- Find your OT first! Look for an occupational therapist that can bill under Medicare B on an outpatient basis. Call them, explain that you need help understanding if it’s safe for your dad to drive. Nine times out of ten that therapist will walk you through the process and be able to help you.
- If you’re struggling to find an OT, call your local skilled nursing community (nursing home). I recently made no less that 20 calls trying to find an OT in a rural area. I finally connected with the local nursing home and she did an amazing job for my client!
- It’s not uncommon for Physical Therapist to fill this role and they are certainly qualified to do so. Just be aware that they cannot address the cognitive assessment issues quite like an OT can.
For more information on how an occupation therapist can help visit the American Occupational Therapist Association Website.
Driver Rehabilitation Programs
Unfortunately, driver programs specifically focused on older adult’s are not easy to find. We have a few in Fort Collins, Colorado but, in general, they aren’t easy to find. The driving assessment encompasses all aspects of safe driving and, in general, more assistance with transition planning and locating resources. Here’s some tips for locating and working with a rehab program.
- These programs are typically private pay only and can cost between $200 – $500. When you call about services, it doesn’t hurt to ask if there is a sliding fee scale or grants available. It never hurts to ask.
- It can take approximately 2-3 hours to complete a rehab driving assessment. Plan accordingly and communicate the time frame with your mom or dad. Don’t surprise them the day of the exam!
- You may have to do some serious searching to find this resource but I encourage you to keep trying. Ask your mom or dad’s physician, local chapter of the Alzheimer’s Association, department of motor vehicles, area council on aging or internet search: older adult driving evaluation + county + state.
- Certified Beyond Driving with Dignity practitioners are popping up more and more. You might be able to find one by searching online. The practitioners have various backgrounds but specialize in this little piece of the pie!
If I had one piece of advice to give an adult child worried about their elderly parent’s driving, it would be to not give up trying to intervene. If your parent is truly not safe on the road, it’s similar to allowing a drunk driver on the road. Do your homework, talk with your elderly parent and reach out for professional help.
A caregiver coaching session would be an opportunity for you to pick my brain one-on-one about your particular situation. A session includes 45 minutes of my time along with an elderly parent assessment guide. It’s simple and affordable!
Have you had an experience with an elderly parent’s driving that you’d like to share? Feel free to leave a comment and help others!