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Tips on Dealing with Someone Who Should Not Be Driving

HOW AND WHEN TO STEP IN

By Babara H. Hance

Deciding whether an older person should continue to drive is a major source of conflict within families, especially between parents and adult children. The concern about driving grows when an elder is diagnosed with dementia or Alzheimer’s disease.

Hardly ever does a person willingly turn in his or her car keys. Driving is the one element in an older person’s life that keeps him feeling independent. But accidents involving older drivers are a growing cause of injury and death. Usually, we start to see indications that older drivers are having problems when they become scared of night driving, or of driving on highways or busy streets.

If they get confused about street signs, directions, and traffic lights, those are more causes for concern. Each older person, however, should be assessed as an individual, not as part of a group.

The aging process brings physical changes and illnesses that can affect a person’s driving ability, such as vision and hearing loss, decline in mental acuity, slower response time, slower reflexes, reduced physical strength, weakened concentration, and memory loss. Also, interactions with medications can have these effects on an older person who doesn’t have any other medical issues. Any one of these changes can alter someone’s ability to drive and/or handle a car. Some older persons are receptive to limitations on driving, while others are in total denial, and will not even consider restrictions.

In cases of dementia or Alzheimer’s, it is extremely difficult to convince the victims of the risks or dangers of driving. They cannot remember the accident they just had, or your explanations for it. They cannot accept or understand that they have a disease, never mind the idea that they shouldn’t be able to drive.

Taking those car keys away is something no one wants to face. Where does the responsibility lie? With the physician, who has diagnosed dementia? When the doctor spends only a short time with the patient, and he’s treating several problems at once, it’s very hard to assess the impact that the person’s dementia has on driving. Or with the policemen, who stop older drivers and witness their confusion? Or with the mechanic who frequently repairs lost side view mirrors or dents in the fenders of the cars of older drivers? Or with the banker, who frequently witnesses their cars bumping into other cars in the parking lot? Or with the caregiver, who sees many reasons why the person should not be driving? Or is it the responsibility of each state to mandate regular road tests after a certain age or diagnosis?

How do you discourage the person from driving? How far do you go with the gentle approach?

Steps to Take:

First, if you are concerned about a person’s driving ability, it should be assessed. Many states have special tests that will determine visual acuity, ability to judge distance, and physical response time. If an older person fails a test, ask the tester for something in writing that you can leave with the person, and refer to when necessary.

Check to see if the person has a valid license, up-to-date registration, insurance, and so on. Very often, older people will neglect to renew their documents, which will give you a reason to approach the subject for discussion and appropriate action.

Look for difficulties in driving. Does the person forget how to go to and from familiar locations? Does he or she drive at an inappropriate speed, or show signs of confusion or anger when trying to make decisions while driving?

Seek help from others. Talk to the person’s physician, and ask him or her to advise the person not to drive. It is always more effective when a professional delivers the advice than it is when a loved one does it, especially if it’s an adult child. The motor vehicle department, the family attorney, insurance agent, or pharmacist may be able to help.

Offer to hire someone to drive your loved ones on regular, designated days and times. Suggest that they could sit back and enjoy the scenery. Give that driver exclusive access to the keys. Be forewarned, however: We have had more than one client figure out that, if he contacts the car dealer with the problem of a lost key, he can get replacement keys. Also, reduce the need to drive by arranging delivery of groceries, medicines, and meals, and have the hairdresser make home visits.

Disable the car by removing the battery, distributor cap or starter wires. There is also a kill wire, which can be installed by a mechanic. With this mechanism, the car can be started only by throwing a switch.

If all else fails, remove the car, sell it, or put it in storage. If the car is sold, insurance premiums will drop, and the savings will help defray the cost of a driver or taxi cab.

Remember, the person will probably see all of this as an attack on her autonomy, mobility, and, believe it or not, her very existence. For all concerned, this decision can be very painful, awkward, embarrassing, upsetting, and things can turn extremely ugly. I’ve always found it helpful to add something to people’s lives when they lose this privilege. Focus on the things they can still do, and what they can enjoy. Reiterate that they still have the freedom of the open road, but someone else will now have to deal with all the stress of driving. They may actually feel relieved.

One more note of caution: Family relationships can become deeply strained. Some family members may be in denial, or disagree with the resolution. Everyone needs to focus on the key issues – the autonomy of the older person and the safety of everyone around them. Usually, the reason for the disagreement among family members is that some have not had the opportunity to assess the problem.

Sometimes, when I have family meetings and there is one difficult member who cannot agree with the others, I invite him or her to be a passenger in the car with the older person driving. Another effective method is to ask, “Would you let your children or grandchildren be a passenger in the car while the older person is driving?” Or, “Would you want your loved ones riding a bike in front or along the side of this car, or playing on the sidewalk?” Or, “Would you jog in front or along the side of this car?” The answer is usually a resounding no.

The safety of all concerned is the key factor.

Excerpted from Don’t Buy Green Bananas by Barbara H. Hance. Copyright © 2004 by Barbara H. Hance Associates, Inc. All rights reserved. Excerpted by arrangement with Barbara H. Hance. $16.95. Available in local bookstores or click here.