Taking the keys: When seniors need to stop driving

Taking the keys: When seniors need to stop driving
Published on April 23, 2012 by
By Lois M. Collins, Deseret News

As they got old, Bill and Betty Lamb learned to make compromises so they could, for a time, continue on as if advancing age had no effect. He still drove on their beloved afternoon rambles, but he was no longer the only pilot, determinedly in charge and certain of his way. His wife kept track of where they were, telling him to turn here or there.

He was a “man you could have dropped from a helicopter anywhere and he’d have found his way home,” his daughter, Sandra Lamb, says. Except he was getting lost in familiar places near his Denver home. And when it got bad enough, she could no longer avoid the topic she’d long dreaded: It was time, she told her 82-year-old dad, to give up his car keys. It wasn’t safe for him or for others on the road.

“It was painful to see his reaction. I felt so sorry for him.” And for herself, too. He didn’t speak to her for almost two years. One day, living in Michigan, she got a panicked call from her mom. He’d found a spare set of keys, she said, and was loading the car with nonsensical items, getting ready to “drive home.”

She told her to call the police. Faced with their authority, he turned the keys over without a battle. He was done with driving, though he continued to fume. Driving may represent identity, independence and more to seniors. Giving up driving is an unwelcome rite of passage among the elderly, complicated by the fact that people age out of safe driving unpredictably. Some at 85 are well enough to continue without much problem, though they may prefer to stay in familiar territory or on slower streets. But dementia, macular degeneration and other maladies common in old age can make driving a very hazardous pursuit for others, at even younger ages.

It’s a potentially deadly dilemma for families. Stacey Hilton of Senior Helpers, an in-home senior care company, does a sobering recap: By 2030, 70 million-plus Americans will be at least 65, and more than 90 percent of them will be licensed to drive. Some will no longer be capable of doing so safely. She points to four accidents in March alone. In Massachusetts, an 89-year-old man who hadn’t renewed his license for 25 years is charged after killing a pedestrian. In California, a woman, 81, accidentally hits the gas and kills another driver and a pedestrian. Elsewhere in the state, a man, 85, hits a tree and dies. In Ohio, a woman, 69, goes the wrong way on the freeway and kills three college students and herself, and injures others.

Time to talk

But the “give me the keys” talk requires care, say both experts and adult children who’ve done it. It’s a conversation so fraught with land mines that AARP and the Hartfordand MIT AgeLab created a free online course explaining the emotional connections to driving and offering suggestions. It’s called “We Need to Talk.”

Hartford’s survey notes that adults in their 40s are the most apt to be concerned about an older family member’s ability to drive, but a third of those who are worried have not yet broached the subject with the older driver. They say they’re worried the driver will react badly, they don’t know what to say and they haven’t figured out transportation alternatives.

But before you rush to take away the keys simply because someone’s old, consider this tale from Bonnie Russell of Asheville, N.C.” My father is 89. Still driving. In fact, two years ago his defensive driving skills and fast reflexes (he’s an ex-pilot) saved us both from a bad accident after a woman cut in front of us on the freeway and then slammed on her brakes.” But she’s seen the other side, too. When she worked for a police department, she says, people occasionally asked them to take away their parents’ car keys. “The least painful way is to work out a deal with DMV to send out a notice for a driver’s license re-test — which they will fail. Some states will do so immediately. Others wait until the renewal date.”

On the AARP website, warning signs of trouble include being easily distracted while driving, hitting curbs, trouble merging, poor judgment making left turns and failure to follow traffic signs and signals. You look for patterns, not a single incident. Others add to the list. Being overly cautious or slow is dangerous. Medications can impair ability. Senior Helpers, which among other services offers drivers for hire, notes that sleep issues, common to the elderly, impair driving and slow reflexes. Jody Gastfriend, vice president at Care.com, says concerned kin should check recent driving records that, along with dings and dents, can warn that ability is fading.

A rough conversation

Marion Somers, known as eldercare adviser “Dr. Marion,” remembers her conversation with her own dad as the worst of her life. She lived in New York, he was in Florida, but she was the family’s “designated doer of taking away the keys.” She rode with him to see how bad his driving really was. It was awful. His skill had “diminished at an alarming rate.” She said she was concerned by what she’d seen, but mostly she was worried for him. “Could you live with hitting a child?” she asked. She put the focus on hurting someone else so he wouldn’t dig in his heels and shoo her away.

They made a list of the things he had to drive to do. Then they tackled them. It was not one conversation, but a series. She looked into public transportation options and found they’d take him half the places he needed to go. So they practiced getting there by bus to build up his confidence. They sold his car and put the money into a transportation account with which she paid his taxi bill each month. When it ran out, she paid it. “To not have to run down to Florida for some emergency caused by his driving was worth it to me,” she says. And they recruited friends for activities, like taking him to religious services.
Just saying that’s it, though, is not enough. Somers says to notify the Department of Motor Vehicles and the car insurance company, then turn in the license plates. Make sure the eyeglass prescription is right, that hearing is appropriate, as well. Sometimes, adjusting one of those solves the driving problem for a while. Her dad got a three-wheeled cycle so he could “toot around the community and be outdoors and independent.” She found a grocer who delivered when he couldn’t get out.

If you don’t live nearby, she says, check with neighbors. They know and they’re concerned. When you talk on the phone, really talk. And really listen. Most elderly learn to fake being fine because they fear losing independence. The fade is hard to maintain. “Mental deterioration on any level shows up within 20 minutes.”

“It is crucial to have your parents look at transportation alternatives well before giving up the car keys,” says John Z. Wetmore, of Bethesda, Md., producer of the cable TV series “Perils for Pedestrians.” “Do your parents know where the local bus routes go? Have they ever used the bus? Simple things like not knowing what the fare is, or how transfers work, can be embarrassing to a grown adult. It is easier to give up driving if they are already making occasional use of the alternatives while they are still driving.”

eHow.com recommends having a parent take a driver’s test — something most states don’t require. The results can make it easier for a parent with diminished capacity to accept that diving’s no longer a good option.
No time to waste

Eric Ward himself recognized as his 85th birthday approached that driving wasn’t safe and offered his daughter, Pat Hoyrup, his prized possession, a Lincoln Continental. She jumped on the plane from her Coupeville, Wash., home. “I didn’t give him time to change his mind.” She’d been wondering how to approach the topic.

Daniel Gray’s conversation with his mom took place when he picked her up after she’d been pulled over for hitting some mailboxes. She blamed medications but recognized “her driving days were over,” he says. “The following years were challenging, and I spent a significant amount of time ferrying Mom about, but I wouldn’t trade them for the world. I test drive cars and have great memories of helping Mom climb in and out of a wide range of vehicles in our travels, from a Camaro SS to a Mini Cooper convertible. Cadillacs to Prius, we had some great conversations.”

To do it right, “you can’t simply take away the keys,” says Gray, of Belle Mead, N.J. “They have to be hung up voluntarily, while there’s still some quality time left.”

After Ward gave his daughter his car, he downsized his world to the pieces he could reach on bike until little strokes took those wheels away, as well. Then he walked to the store and through his Midvale, Utah, neighborhood. Friends and relatives were happy to help him get where he needed to go.

He died years ago, but Hoyrup thinks about the challenge of age and driving still. She’s 72, living on an island that requires a ferry ride. Lately, she finds herself asking a friend to drive sometimes and she no longer drives in the dark. “At some point in time, we will need to move to a place where we’re close to stores; right now we live on five acres.”

Diane Dennis’ dad was sidelined by a massive stroke as he was driving. He managed to reach a gas station where someone called 911. Dennis, a nurse in Portland, Ore., was his designated spokesperson for medical issues. After the hospital, he was sent to a skilled nursing facility. He wanted to be home, wanted his life the way it had been. Dennis worked with the doctor and others to “leave him there long enough to convince him he needed help at home and could not drive any more.”

He never forgave her for “interfering with his independence.” They were estranged and she kept track of him only through other family members for the rest of his life.
“I chose to make the doctor’s office the determining factor for removing my dad’s driving privileges,” says Pamela Hoffine of Sweet Home, Ore. ”It just made it easier to appease my dad because the doctor, of course, is the expert and the ultimate professional in determining the safety and hazard contingencies linked with my father’s health.”

When Holly Deitz took her dad’s car keys away, she also bought an umbrella insurance policy “on the off chance he gets his hands on my mom’s keys. My very wise accountant clued me in on this very necessary but completely underutilized insurance product whereby if my father does get behind the wheel and does something horrible, there will be enough “easy money” for an attorney to get his hands on. That way the chance of my parents losing everything is much less,” she says.

Years after Bill Lamb died, Betty Lamb was forced to stop driving by macular degeneration. This time, daughter Sandra didn’t confront it directly; she let the doctor do it. It was less stressful for the family when he played the heavy, she says, noting that her cousin just disabled her elderly mom’s car and then put off the repair until being careless became the norm.

“My advice,” says Sandra Lamb, “is if you don’t have to be confrontational, it’s better. Losing the things you felt you had the skill to do and you have a long track record of doing — well, giving up those things is not easy at all.” She arranged lots of rides for her mom. “Her real fear was being isolated. Giving up driving, which gave her a huge amount of independence, was hard.” The sting was smaller when she saw she could still go and do and enjoy.

Lundy Wilder’s dad was a doctor who had saved well for retirement. When it because obvious he and his wife shouldn’t be driving, their four kids formed a united front to stress that if something bad happened while driving, they could lose all their savings to a lawsuit. Then they set up an account with an agency that sent a driver out every day. “Daddy complained, as did Momma, but we stuck to our guns,” says Wilder, of Gulf Shores, Ala. The solid front helped. They managed that by collaborating by phone, city to city. Her folks weren’t pleased, but they “went along with the program.”

Ultimately, they became close to the driver, who became their hired caregiver in their final months.

Tips on taking the keys

Have a checkup to see if vision, hearing or a medication accounts for the diminished driving skill. Those may be reversible. AAA and AARP offer classes for mature drivers to help retrain them to be safe drivers. The National Safety Council offers a safe driving test. Talk about the possibility they could hurt someone else. Many older adults are more horrified at the thought of hurting someone than they are at the loss of independence. Suggest taking the driver’s test to see if current skills are adequate.

Encourage a parent to talk to his or her physician, other relatives and trusted friends. If that doesn’t do it and you’re worried, contact the Department of Motor Vehicles in your state. The rules vary, but in some cases a license can be revoked, at least temporarily. Don’t forget to replace it with a state identification card.
As a last resort, remove access to the car. That’s tougher to do. But sometimes it works.

Make sure they use alternative forms of transportation occasionally before they have to give up the keys, so they’re not intimidated or uncomfortable. Point out that it doesn’t mean you can’t stay in your home as long as there are other transportation choices available. It also helps to live in a neighborhood with sidewalks and with stores and amenities close by.