Know When to Put the Brakes On Elders Behind the Wheel

Telling seniors it may be time for them to stop driving can be one of the most difficult milestones in the caregiving process. Just as it does for teen-agers, driving represents freedom and independence for seniors — the ability to visit friends, go to the movies and shop without having to rely on anyone else.

Because of the emotional nature of the issues involved, it is important to include seniors in the discussion rather than dictate a decision to them.

It is also useful to consult with family members, doctors and other health care professionals, and people the senior respects, such as clergy and friends. Seniors might get defensive and even angry when you broach the subject, but safety concerns demand you raise it nonetheless.

How does aging affect driving ability?

Safe driving demands the complex coordination of a host of skills. Many physical and mental changes that accompany aging can diminish the ability to drive. These include:

• A slowdown in response time

• A loss of clarity in vision and hearing

• A loss of muscle strength and flexibility

• Drowsiness caused by increased use of medications

• A reduction in the ability to focus or concentrate

• Lower tolerance for alcohol

None of these changes alone automatically means that seniors should not drive. But caregivers need to regularly evaluate a senior's abilities and assess whether the person needs to alter driving habits or stop driving altogether.

A checklist on safe driving

Be on the look-out for telltale signs it might be time for a senior to stop driving. When they are behind the wheel, do they:

• 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 judge distances between cars correctly?

• Become easily frustrated and angry?

• Appear drowsy, confused or frightened?

• Have one or more near misses?

• Drift across lane markings or bump into curbs?

• Forget to use left- and right-turn indicators?

• Forget to turn on headlights after dusk?

• Ignore signs of mechanical problems with the car?

• Have difficulty turning head, neck, shoulders or trunk while in traffic or parking?

• Have too little strength to turn the wheel quickly in case of emergency?

• Lose their way repeatedly?

If the answer to one or more of these questions is "yes," you should explore whether medical issues are impacting their driving skills.

Medical issues to consider

Caregivers need to know:

• Have seniors had their vision and hearing tested recently?

• Have they had a physical examination within the past year to test reflexes and make sure they do not have illnesses that would impact their driving?

• Are they taking medications or combinations of medications that might make them drowsy or confused?

• Have they reduced or eliminated their intake of alcohol to compensate for lower tolerance?

Adapting to changes

Driving is not necessarily an all-or-nothing activity.

There are many ways for seniors to adjust their driving so they do not pose a danger to themselves or others. Among them are:

• Avoiding nighttime driving

• Driving only to familiar locations

• Avoiding drives to places far away from home

• Avoiding freeways and rush hour traffic

• Leaving plenty of time to get somewhere

• Foregoing driving alone

Other forms of transportation

You might encourage the senior to rely more on public transportation. This will reduce their time behind the wheel and help prepare them for when driving may no longer be an option. Many cities offer special discounts for seniors on buses and trains, and senior centers and community service agencies often provide special transportation alternatives for seniors.

How to get them to stop

If you feel strongly that a senior cannot drive safely, you have little choice but to get them to stop. If they agree without an argument, wonderful. If not, you have several options:

• Stage an intervention. This approach, commonly used with substance abusers, involves confronting the senior 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 on the issue.

• Contact the local Department of Motor Vehicles and report your concerns. Depending upon state regulations and the senior's disabilities, it may be illegal for them to continue driving. The DMV may do no more than send a letter, but this may help convince the senior to stop.

• Take the keys, disable the car or move it to a location beyond the senior's control. Leaving the headlights on all night or disconnecting the battery are good ways to disable the car. But if the senior is likely to call AAA or a mechanic, you have no choice but to eliminate all access to the car. While these measures may seem extreme, they can save the lives of seniors, other drivers and pedestrians.

source caregiverzone.com