WHEN TO PUT THE BRAKES ON ELDERLY DRIVERS
Do driving skills of elderly drivers decline with age? Yes, but just like other age groups, driving skills
vary from one elderly person to another. Telling elderly drivers that it may be time to stop driving can
be one of the most difficult milestones for caregivers. Driving represents freedom and independence
for the elderly — the ability to visit friends, go to the movies and shop — without relying on anyone
else.
When the question of declining driving abilities becomes personal, the issues involved with elderly
driving are very emotional. Elderly drivers might get defensive — even angry — when the subject of
their driving abilities is raised. Thus, include the elderly person in the decision-making process if at all
possible, rather than dictate a decision to them. It can also be very helpful if both you and your elderly
loved one discuss the matter together with family members, doctors, and other people they respect,
such as clergy and friends. But, despite your best efforts, you may still have to make the decision to
stop for them for their own safety and the safety of other drivers and pedestrians.
HOW DOES AGING AFFECT THE ABILITIES OF ELDERLY DRIVERS?
Safe elderly drivers require the complex coordination of many different skills. The physical and mental
changes that accompany aging can diminish the abilities of elderly drivers. These include:
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A slowdown in response time
A loss of clarity in vision and hearing
A loss of muscle strength and flexibility
Drowsiness due to medications
A reduction in the ability to focus or concentrate
Lower tolerance for alcohol
Taken separately, none of these changes automatically means that elderly drivers should stop. But
caregivers need to regularly evaluate the elderly person's driving skills to determine if they need to
alter driving habits or stop driving altogether.
A CHECKLIST ON SAFE ELDERLY DRIVING
Watch for telltale signs of decline in the elderly person's driving abilities. Do they:
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Drive at inappropriate speeds, either too fast or too slow?
Ask passengers to help check if it is clear to pass or turn?
Respond slowly to or not notice pedestrians, bicyclists and other drivers?
Ignore, disobey or misinterpret street signs and traffic lights?
Fail to yield to other cars or pedestrians who have the right-of-way?
Fail to judge distances between cars correctly?
Become easily frustrated and angry?
Appear drowsy, confused or frightened?
Have one or more near accidents or near misses?
Drift across lane markings or bump into curbs?
Forget to turn on headlights after dusk?
Have difficulty with glare from oncoming headlights, streetlights, or other bright or shiny
objects, especially at dawn, dusk and at night?
Have difficulty turning their head, neck, shoulders or body while driving or parking?
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Ignore signs of mechanical problems, including underinflated tires? (one in 4 cars has at least
one tire that is underinflated by 8 pounds or more; low tire pressure is a major cause of
accidents.)
Have too little strength to turn the wheel quickly in an emergency such as a tire failure, a child
darting into traffic, etc.?
Get lost repeatedly, even in familiar areas?
If the answer to one or more of these questions is "yes," you should explore whether medical issues are
affecting their driving skills.
There are many ways for elderly drivers to adjust so they are not a danger to themselves or others.
Among them are:
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Avoid driving at night and, if possible, at dawn or dusk
Drive only to familiar locations
Avoid driving to places far away from home
Avoid expressways (freeways) and rush hour traffic
Leave plenty of time to get where they are going
Don't drive alone
HOW TO GET THEM TO STOP
If you feel strongly that your parent cannot drive safely, you have little choice but to get them to stop
driving. If they agree without an argument, wonderful. If not, you have several options:
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Stage an intervention. This approach, commonly used with substance abusers, involves
confronting the elderly driver as a group of concerned caregivers. The group should include
family members, health care workers and anyone else respected by the senior. The
intervention needs to be handled firmly but with compassion in order to break through the
senior's denial of the issue.
Contact the local Department of Motor Vehicles and report your concerns. Depending upon
state regulations and your senior's disabilities, it may be illegal for them to continue to drive.
The DMV may do nothing more than send a letter, but this might help convince your parent to
stop.
Take the keys, disable the car or move it to a location beyond the elderly person's control.
Leave the headlights on all night or disconnect the battery to disable the car. But if your loved
one is likely to call AAA or a mechanic, you have no choice but to eliminate all access to the
car. While this may seem extreme, it can save the lives of seniors, other drivers and
pedestrians.
HOME ALONE — ARE THEY OK?
CONFUSION AND DEMENTIA CREATE DANGER FOR SENIORS
As a caregiver, you may have to decide if it is still possible to leave an elderly person in your care
alone for an hour, an afternoon or an entire day. Will they be safe? Will they wander off? Will they let
strangers into the house? Will they turn on the stove and forget to turn it off?
Making this decision can be a complicated and emotionally wrenching experience for you and the
senior. For caregivers, it can be heartbreaking to recognize that the strong, self-sufficient adult they
have known for years is no longer capable of taking care of themselves. It also means a real loss of
freedom and flexibility and may require you to develop creative strategies to accomplish daily errands
and tasks. For the senior, it can be equally difficult to acknowledge and accept that physical,
emotional or mental changes have reduced their independence.
CHECKLIST ON BEING HOME ALONE
There are numerous factors to consider when making this decision. But first, recognize that loss of
sight, hearing loss, memory loss, confusion, incontinence and depression are not normal aspects of
aging. In many, if not most cases, these are treatable conditions. Failure to identify them as being
treatable could place elderly patients at risk of unnecessary functional decline. Have you or the senior
discussed the senior's problems with a physician? And, if the first physician dismissed them as being due
to old age, did you see another physician for a second opinion? (A surprising number of doctors don't
have the training to help seniors overcome their problems.)
It is important to balance the safety of the senior with the needs of both senior and caregiver to retain
as much independence as possible. As a result, you should include as many people as you can in the
decision-making process, even the senior. You may also want to consult with other caregivers, such as
family members and friends; paid caregivers who know the senior's abilities and limitations; and elder
care professionals such as doctors, nurses, and social workers.
The following questions can guide you in making the decision. If the answer to any question is "no," it
may no longer be possible for the senior to be left alone, even for a short period of time. Instead,
moving into an assisted living facility may be appropriate.
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Do they understand how to leave the home if necessary? Do they know where the door is
located and how to exit the building?
Will they stay home or near the house rather than wander off?
If they go outside, do they know where they live and how to get back inside?
Can they identify signals, such as smoke from the kitchen or fire alarms, that would alert them
to potential dangers?
Do they know how to access emergency services? Do they know how and when to dial 911?
Would they be able to communicate over the phone? Can they physically get to a phone no
matter where they are?
Do they have frequent life-threatening medical emergencies that require immediate
intervention? Do they know where any medication they might need is located? Can they reach
it? Do they have the capacity to select the right medicines in the correct amounts?
Do they have the judgment to identify who they should and should not let into the home? Will
they know to allow family, friends and emergency personnel into the home?
Can they prepare themselves something to eat if they get hungry? Do they know how to use the
stove, and will they remember to turn it off?
Can they get to the bathroom and use the toilet on their own? If not, have alternatives been
worked out?
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Are they afraid to be alone for an hour or more? Do they become clingy when caregivers depart
and make frequent telephone calls if they are alone?
If you decide that it is still safe to leave your senior at home alone, you should regularly reassess the
situation. Caregiving is a dynamic process — you need to be aware of any and all changes in the elderly
person's condition and abilities. Even if you think they can be left home by themselves, pay attention
to their desires; if they fear being alone, it could be a sign that at some level they know they are not
capable of coping with any emergencies that might arise.
Caring for aging parents is difficult. Take a look at this comprehensive checklist to begin your plan.
General Information
Has relevant personal information been gathered?
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Name, phone number, and address of parent
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Parent's date of birth
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Parent's social security number
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Name, phone number, and address of attorney, physician, geriatric care manager, or
other advisor
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Parent's legal state of residence
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Health status
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Marital status
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Family members available for support
Has the parent's financial situation been assessed?
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Expenses
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Assets
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Liabilities
Insurance Planning
Does the parent have life insurance?
Does the parent have long-term care insurance?
Does the parent have adequate health insurance?
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Medicare
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Medigap
General Information
Does the parent have an adequate amount of other types of insurance?
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Homeowners insurance
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Auto insurance
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Umbrella liability insurance
Estate Planning
Does the parent have an updated will?
Has the parent prepared advanced directives?
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Durable power of attorney
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Living will
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Health-care proxy
Has the parent prepared letters of instruction?
If the parent's estate is likely to be subject to estate tax, have ways to minimize estate taxes been
considered?
Has the parent made funeral arrangements?
Housing Issues
Is the parent's current housing situation satisfactory?
If so, have contingency plans been made in case a housing change is
necessary in the future?
Have the parent's wishes regarding housing been considered?
Have the child's wishes regarding housing been considered?
Does the parent currently need nursing home care?
Have alternative housing options been explored?
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Remaining in home (possibly with in-home care)
General Information
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Moving in with relative
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Assisted living
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Continuing care retirement communities
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Senior apartments
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Nursing home
Have adult day-care options been discussed and evaluated?
Financial Issues
Does the parent have enough money from income and savings to
sustain his or her lifestyle?
Is his or her asset allocation still suitable?
Is the parent able to make appropriate financial decisions?
Should the child's name be added to accounts?
Does Medicaid planning need to be considered?
Will the parent be dependent on the child for financial support?
If so, have the child's financial needs been considered?
Have distribution strategies been discussed and evaluated?
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Remaining in home (possibly with in-home care)
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Moving in with relative
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Assisted living
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Continuing care retirement communities
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Senior apartments
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Nursing home
Have adult day-care options been discussed and evaluated?
ELDERCARE RESOURCES
Websites
www.aarp.org
The American Association of Retired Persons (AARP) website has a wealth of information and
resources.
[email protected]
Nevada Aging and Disability Services Division
www.aoa.dhhs.gov
The Administration on Aging (AoA) is part of the U.S. Department of Health and Human Services.
It was set up to "remove barriers to the economic and personal independence of older persons and
to assure the availability of a range of appropriate community and family based services for older
persons in social or economic need." AoA supports a network of the state and Area Agencies on
Aging.
www.bhoptions.com
Behavioral Healthcare Options’ website has numerous articles and resources for a wide variety of
eldercare needs. Your company code is: SUU
www.caremanager.org
National Association of Private Geriatric Care Managers Provides free referrals nationwide and sells
a directory of members and managers.
www.eldercare.gov
Local information, referral resources, and contact information for state and local agencies, from the
United States' Health and Human Services Department
www.eldercarelink.com
An online free referral service helps you find qualified care providers quickly and easily. In addition
to receiving personalized assistance by completing an online needs survey, you can browse their
provider listings for products and services in your area.
www.ec-online.net/
Online assistance for people caring for aging loved ones.
www.nia.nih.gov
National Institute on Aging
www.nevadaadrc.com
Nevada Aging and Disability Resource Center serves individuals in need of long-term support,
caregivers, and those planning for future long-term support needs.
www.safeaging.org
National Resource Center for Safe Aging
Books
“How to Care for Aging Parents” by Virginia Morris. Workman Publishing, New York.
book no caregiver should be without.
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