Elder CareTips:
Mastering The Eldercare Maze™

March 1, 2006

Last time out we talked about physical disabilities that can make driving difficult and/or dangerous as we age (Elder CareTips Feb. 15, 2006).
Because we are all living longer, the day we may have to give up driving is something all of us may sooner or later face.

Think about the day you first got your driver's license, and the exhilarating thoughts of freedom that coursed through you...until your father said "no" to taking the car on Saturday night. Now think how commonplace it's become to be able to get in the car and go - whenever and wherever you want to go. What would it be like to lose that freedom, and have to depend on someone else for transportation for the rest of your life?

Think on this, and have compassionate for the senior who stands at the precipice of losing that freedom.

This is not to say that if you fear for the safety of a driving senior - or the safety of those around him or her - that you shouldn't take steps to reduce or eliminate the driving. You should, and you must. Try to do it gently and with compassion. There is no way to do this without causing your elder a certain amount of pain, or even anger. But consider the implications if your unsafe elder continues driving:

  He or she might be badly injured or killed;

  Someone else might be badly injured or killed;

  Your loved one's estate might be exhausted by lawsuits;

  You will live forever with the guilt that you didn't act.

If you are certain that it's time for your elder to hang up the keys, first have a discussion with all your family members. If everyone isn't on the same "page" someone may undermine the plan without realizing.

Decide who among you may be the best to approach your elder. Sometimes it's the "son who can do no wrong." Sometimes it's the daughter who's always been the "responsible one." Sometimes its the family member who lives the farthest away and your elder hasn't had a reason to be angry with that person yet. Sometimes the physician will be willing to intervene and forbid driving (don't count on this, though).

Do a little research on the medical conditions your elder is managing, and the medications he or she is taking. Many medications will caution against driving, and this is more ammunition.

Before you have "the talk," research the transportation alternatives. If possible you want to be able to offer something beside family members as drivers so your elder feels as independent as possible under the circumstances. If there is senior transportation in your community, have all the information about how it works handy. Check with the local taxi services as well. See if they will set up an account for your driver for those little last minute trips.

(Hint: Cabs cost a lot less than most seniors think if you factor in the cost of maintaining the car, gas, license, registration, and insurance. You can purchase a lot of taxi rides with the savings from eliminating the costs of a car).

Sometimes giving up a driver's license is just as traumatic as giving up the car. Without a license we can be made to feel like non-persons, unable even to pay for our groceries by check. Offer to take your elder to get a State ID card to take the place of an expired license. They look quite similar to the driver's license. If you can trust your elder to not get behind the wheel, then he or she can continue to carry the license itself.

However prepared you are, this will be a difficult conversation. You are apt to be met with denial, argument, anger, even tears. You might be tempted to put it off just a little longer. Please don't. The safety of a lot of people may depend on you.

People with dementia seem to hear and remember the last work of a question or a statement better than what came before. You can actually use this tendency for the benefit of the person you care for:

"Many care partners tell me they use this 'last-word connection' to their advantage. They relate that this technique actually can help a person with Alzheimer's feel in control of decision-making. Here's how the technique works: The care partner asks, "Would you like to wear this green shirt today, or the one that's blue?" Nine times out of ten, the patient says, "Blue" -- simply because it was the last word he remembered hearing. If you ask, "For lunch today, do you want a tuna fish sandwich or cheese?" the response will be "cheese." The wonderfully habilitative part of this technique is that the afflicted person, who is prone to feelings of failure or defeat, now feels able to make choices."

From Learning to Speak Alzheimer's