This is one of the more common challenges families face as loved ones age, because the car and drive symbolize independence to most people. The best advice is to start these conversations early, when possible. For example, discuss and make plans when a loved one gets a diagnosis of a chronic condition that may impact driving, such as Alzheimer’s Disease, Parkinson’s Disease, M.S. and conditions of visual or mobility impairment. It may help to talk about what others have done and explore some transportation options together.
In having a conversation with your loved one, consider your approach. Who might your loved one listen to about this issue? You may wish to discuss an approach with your siblings and work together. Sometimes this is best done during a transition or when something has changed, such as after a hospital stay or surgery. Think of these as “windows of opportunity”. A couple of good reference books about family discussions and approaching issues between the generations are: How to Say it to Seniors by David Solie and Another Country: Navigating the Emotional Terrain of Our Elders by Mary Pipher.
You may wish to talk to your loved one’s doctor about your concerns. If you serve as your loved one’s healthcare surrogate or have been given HIPPA permission for sharing information, you can likely at least provide your observations to help ensure the doctor is aware. Physicians will vary in their approach and involvement.
Some communities have professional drive evaluation services available. These may be found through local hospitals, the VA, Memory Clinics or public aging services. A drive evaluation can be particularly useful because it is a measurable test done by a neutral party. Evaluators may recommend modifications which will allow the person to continue driving safely.
If you reach an impasse with a loved one and have serious concerns (which most likely means there are legitimate things you have observed to cause concern), check your state’s provisions for reporting an unsafe driver. Many states have anonymous reports that initiate a review process. Contact the state DMV for more information.
In some cases, your loved one may continue to drive even if legal driving privileges have been revoked. This can be especially challenging, though local law enforcement may be able to help. It may be necessary to remove the car, especially for someone with dementia who may forget that driving privileges have been removed.
If a loved one is going to give up driving, it is essential to set up services so that he/she can still be involved in activities and not feel stranded at home. Staying as active as possible helps an elder’s physical and mental health and feeling dependent on neighbors and family can be detrimental to well-being. The services available in each community vary, but you can start with your local Area Agency on Aging or Department of Aging.
Most communities have some senior transportation services and for most individuals, a combination of friends and family helping along with services such as free and low cost public options, taxis and hired drivers can provide for the range of transportation needs. Keep in mind when looking at paid services that, according to the Dept. of Labor’s Bureau of Labor Statistics, car ownership costs are the second largest household expense in the U.S. Owning and operating a car costs an average of $8,000/year or about $600/month. Help make sure your loved one is comfortable with the services and make it easy for them to use them. For example, post the phone #s and explain any rules or limitations or help with set-up and paperwork.
A geriatric care manager can help your family through this process. From facilitating conversations to assessing the individual’s abilities, needs and options to setting up services, a care manager will have experience and resources in this area. An elder law attorney is another valuable resource, from planning ahead so your loved one has decision making provisions in place to initiating a guardianship process or exploring legal options when needed.
Shannon Martin, M.S.W., CMC
Aging Wisely, LLC
Clearwater, Florida 33756