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Health & Fitness

To Give Up or Not Give Up The Car Keys- That is the Question.

You have been seeing the signs but perhaps not wanting to recognize them. Your parent seems distracted when driving. He or she doesn’t always stay fully in their lane. Perhaps looses their way on occasion to a familiar destination. And if we are seeing less clearly when we drive at night at middle age, what does that mean for our parents? It may be time to have the discussion about when your parent or elder will need to give up driving.

The age when one should stop driving a vehicle is not mandated in any state. Different people have diminished capacity at different times in their lives and much of the timing is genetic, or caused by illness or medications. It’s a disheartening conversation to have with one’s parent, a complete role reversal that is a platform to numerous other emotional and practical discussions. This conversation is rarely easy and I have known few elders that have willingly handed over the car keys to their children or care givers without a fight.

The emotional toll is a large one. Losing independence and freedom is a hard step to take, most notably for those who live in communities without easily accessible public transportation options. For those who live in a community like Green Hill where we have transportation to area stores and recreation the decision to give up one’s car is a little easier. But for those still at home it is challenging.

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Noted on the AARP website, an overview of the National Center Senior Transportation Research to Practice, Driving Cessation and Dementia – 2010 report states that as of 2006 an estimated 30% of older adults diagnosed with dementia were still driving. The report states that “permanent driving cessation for elders is one of the most significant and deeply personal loses they will face.”

Warning signs to look for in your elder range from trouble parking and staying in car lanes, failure to notice traffic signs or lights, small accidents like fender benders, hitting stationary objects like mail boxes, getting lost or taking additional time to get to a destination.

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There are driving tests that seniors can take to gauge their abilities. Cognitive tests can be given by a doctor and driving tests given by your city’s Department of Motor Vehicles. Information for doctors on testing elders for driving abilities can be found through the American Medical Association and the National Highway Traffic Safety Administration who recently published the second edition of their Physician’s Guide to Assessing and Counseling Older Drivers (Carr et al., 2010).

If you decide together its time to give up the car keys there are a few things you should consider.

What are the transportation needs of your elder and how will you fulfill them? Review their calendars and habits to define those needs. Consider if there are family members or neighbors who can share in driving your elder to their activities. Your community may have senior busing services for medical and marketing needs. Check at your city hall for local resources. Perhaps there are other senior citizens in the neighborhood or community who have similar transportation issues and see if a carpool system can be arranged. If you live near your elder this arrangement is little different from the transportation needs of your children growing up. If you live far from your elder it may be time to consider a group residence or assisted living residence where transportation is included.

It is important to have a complete and thorough conversation with your elder about when it is time for them to give up driving and I suggest that you begin the conversation before they show substantial signs of driving impairment. If you can include their primary physician in this discussion it can be helpful to do so. “A neutral authority figure outside the family, such as a physician, could be helpful in making the case for transition.” (Byszewski er al.. 2010.)

It would be helpful to encourage your elder to participate in establishing the benchmarks that will determine when they should turn in the keys. Be sensitive to how they may feel about losing their independence and provide them with as many opportunities to express their independence in other ways. For example, choosing alternative methods to get where they want to go, or selecting new establishments that they might want to try that are closer to their homes or accessible by local public transport. Participate with them as they explore their new options. 

It is a stressful time of life for both the elder who is losing their independence, the messenger who must see that they do so and the caregiver who has to figure out how to transport the elder about their community. If the challenge of surrendering the keys is faced as a team the process can go more smoothly for all.

To read the full National Center Senior Transportation Research to Practice, Driving Cessation and Dementia – 2010  report visit http://www.aarp.org/content/dam/aarp/livable-communities/learn/transport...

Toni Lynn Davis MHA, CNHA is CEO/President Green Hill Inc., 103 Pleasant Valley Way, West Orange, NJ

 

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