Checklist: Seniors and Driving

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.

Home modifications and repairs

Home Modification and Repair includes adaptations to homes that can make it easier and safer to carry out activities such as bathing, cooking, and climbing stairs and alterations to the physical structure of the home to improve its overall safety and condition.

Why Is Home Modification And Repair Important?
Home modification and repair can help prevent accidents such as falls. Research suggests that one-third to one-half of home accidents can be prevented by modification and repair.

Typical Problems:

  • Difficulty getting in and out of the shower
  • Slipping in the tub or shower
  • Difficulty turning faucet handles/doorknobs
  • Access to home
  • Inadequate heating or ventilation
  • Problems climbing staffs

Possible Solutions:

  • Install grab bars, shower seals or transfer benches
  • Place non-skid strips or decals in the tub or shower
  • Replace with lever handles
  • Install ramps
  • Install insulation, storm windows and air conditioning
  • Install handrails for support

Home Care’s range of services

Home care services cover a wide range of health and social services for individuals recovering from surgery or an injury, those with disabilities and chronic conditions, or people with terminal illnesses.

Because of the extensive range of home care services it?s important to have your care manager complete a comprehensive assessment to help determine the best home care services to meet your specific needs and budget.

Because of the extensive range of home care services it?s important to have your care manager complete a comprehensive assessment to help determine the best home care services to meet your specific needs and budget. They will know which services are covered by Medicare, your Long Term Care Insurance policy, or which are considered custodial type services that will need to be paid for privately.
Home care services cover a wide range of health and social services for individuals recovering from surgery or an injury, those with disabilities and chronic conditions, or people with terminal illnesses.
Because of the extensive range of home care services it?s important to have your care manager complete a comprehensive assessment to help determine the best home care services to meet your specific needs and budget. They will know which services are covered by Medicare, your Long Term Care Insurance policy, or which are considered custodial type services that will need to be paid for privately
Registered Nurse (RN) – An RN is typically supervised or prescribed by a physician. An RN has two or more years of training and is licensed by the state. This highly skilled level of care includes trained professional services for individuals recovering from surgery or an accident, or with more complex medical needs which can be addressed in a home setting (such as wound care, injections, intravenous therapy, disease treatment and patient assessments).
Licensed Practical Nurse (LPN) / Certified Nurse Assistant (CNA) – LPNs has one or more years of nursing training. A certified nurse assistant (CNA) has a certain number of hours training in both hands on service and classroom work. Both these categories usually work under the supervision of an RN.
Home health aide – These home care workers assist people with activities of daily living such as getting out of bed or up from a chair, walking, dressing, bathing and toileting.
Homemaker / Companion – This category of home care worker typically performs light housekeeping duties including meal preparation, shopping, laundry, and clean-up. Depending on the level of training, this person may assist with organizing paperwork, or making phone calls. Such individuals are hired to help complete household tasks and generally do not perform personal, hands on care.
Occupational Therapist (OT) – An OT is trained to help individuals learn ways to cope with or compensate for limitations in performing activities of daily living. Often prescribed by a physician, an OT can help teach someone to use a walking device or other rehabilitative equipment. OTs can help train both the care recipient and caregiver in techniques to improve mobility or make household routines easier.
Physical Therapist (PT) – A PT is usually prescribed by a physician to assist a person with a disability or physical injury to improve physical functioning. PTs have extensive training in anatomy and musculature and can teach exercises designed to promote or restore strength. PTs may use equipment, training materials, massage or other techniques. A PT may also be useful in training caregivers in safe lifting or bending practices.
Speech Therapist – These rehabilitative therapists assist individuals with communication disorders resulting from disease, injury, surgical intervention or a stroke. Speech therapists help their clients regain lost speech, cope with aphasia, and learn special techniques to aide in swallowing, breathing, and muscle control.
Dieticians – These health care professionals provide nutritional counseling and guidance to help individuals manage the relationship between nutrition and illness (e.g., diabetes, heart disease, etc) or disability.

Checklist: Home Alone….. Are they Ok?

At some point in many caregiving situations, a moment arises when you must consider whether it is still possible to leave the senior in your charge 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 both caregiver and 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 the most basic tasks.

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

You have numerous factors to consider when making this determination. Because of the importance of balancing the safety of the senior with the need of both senior and caregiver to retain as much independence as possible, you should include as many people as you can in the decision-making. In addition to the senior, you might want to consult with other primary 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.

These questions can guide you in making the decision. If the answer to any of them is “no,” it might be time to consider the possibility the senior should no longer be left alone even for a short period of time.

  • 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 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?
  • 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 determine through this checklist and other means it is still safe to leave the senior at home alone, you should regularly reassess the situation. Caregiving is a dynamic process, and you need to be aware of any and all changes in the senior’s condition and abilities. Even if you think the senior can be left home by themselves, pay attention to their desires; if they fear being alone, it is often a sign that at some level they know they are not capable of coping with any emergencies that might arise.

10 Tips on Storing Medications

 

  • Be sure that medications are out reach of children or anyone who might misuse them.
  • Check to see that medications needing refrigeration are stored in the refrigerator in an area which they will not freeze and in where they cannot be easily reached by children.
  • Check to see that medications are stored away from light and heat, which can effect the chemical composition of the medication.
  • When someone is taking medicine, be sure that there is good light so that the medicine label can be seen clearly.
  • Medications should not be moved within the medicine cabinet or storage level. People expect medication to be in a certain place and do not always look at the label.
  • Medications should not be used if there is no label. If the label is torn or defaced, or the medicine is outdated, the medicine should be tossed out.
  • Be sure that medications that look like water or soft drinks are not put in containers from which children or others might drink.
  • Post on or by the telephone, the emergency phone numbers of important family members, the poison control center, and the rescue squad and the doctor.
  • If you’ve been instructed to dispose of medications, do not put them in the garbage or trash where children and animals can get them.
  • Store all medications in their original containers. Some medications can become less potent, or ineffective, if taken out of its original container.