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Published By Right at Home on December 08, 2020

For most adults, driving is an integral part of life. But as we grow older, age-related changes in our senses and mobility can make us less safe behind the wheel. Driving requires the ability to concentrate, to make quick movements, to anticipate what’s ahead, and to make split-second decisions. Common health conditions, such as osteoporosis and arthritis, make it harder to steer and look out for other cars. Changes in memory and thinking can seriously narrow the margin of safety on busy streets and highways. Even sleep disorders, more common as we grow older, can raise the risk of errors during driving.

Side effects of certain medications, such as blurred vision, fatigue, dizziness and confusion, also can make it unsafe to drive, raising the risk of a crash by 300%. According to the U.S. Food and Drug Administration, these drugs include opioid pain relievers, drugs to treat anxiety and depression, muscle relaxants, cold and allergy remedies, medications for motion sickness, and CBD products.

When should seniors give up the car keys?

Family members often are the first ones to notice that a senior loved one’s driving skills have declined. Perhaps the senior has had accidents or received traffic tickets, or family notice unexplained dents and dings on the car. They might notice that their loved one stops at green lights, is unsure when pulling into traffic, or regularly draws honks from other drivers.

Then a conversation starts—and experts tell us that the talk doesn’t always go well! Seniors may be defensive and even secretive about their driving, and families worry but don’t know what to say. Here are tips to make the conversation easier and more constructive:

Establish trust through expression of respect. “I was nervous about driving at night,” reported Carl, age 82. “But I thought if I mentioned it, my sons would pressure me to give up driving entirely! So I kept my fears to myself.” The temptation to “parent our parents” can be a strong one. But remember, your loved one is an adult. Present yourself as a facilitator and a problem solver, not a dictator. When you offer your help, begin with “How can we be sure you’re safe while still keeping you independent?”

Begin the conversation early. Sometimes a sudden health crisis means it’s time to stop driving. But often, it’s a slow process so seniors don’t notice that their abilities are slipping. Research from AAA shows that in 83% of families, the driving discussion only starts after an accident or other crisis. It’s so much better to talk about it long before need. University of Colorado School of Medicine’s Dr. Emmy Betz suggests that seniors and their families create an “advance directive” for driving, in which the senior agrees to hand over the keys if their doctor or family believe they are no longer able to drive safely.

Seek the opinion of experts. Making appointments with your loved one’s doctor and any specialists they see is a good first step. Your loved one’s doctors can judge whether your loved one’s mobility, sensory or cognitive health challenges could make them unsafe behind the wheel. Have your loved one’s doctor or pharmacist review all the medications your loved one takes. Driving rehabilitation specialists, such as occupational therapists, can observe and evaluate your loved one’s skills behind the wheel.

Don’t begin the conversation with “It’s time to give up the keys.” There may be interim steps to allow your loved one to drive longer. Driving experts recommend these “Five As”:

  • Attention to medical problems might include new glasses, hearing aids, physical therapy, and exercise to build up arm and leg muscles and increase flexibility.
  • Adult driver’s education classes can help improve your loved one’s driving skills, and teach them ways to accommodate their limitations.
  • Adapt driving habits—for instance, by only driving during the daytime, in familiar areas, or on roads without a lot of traffic.
  • Adaptations such as larger mirrors, a thicker steering wheel and better visors make the car a better fit for seniors with arthritis, limited range of motion or vision problems.
  • Auto shop! Today’s cars have improved safety features, such as collision and lane departure warning systems, backup and side mirror cameras, and highly adjustable seats. (If these gadgets seem intimidating to a senior accustomed to their old car, training is available.)

If your loved one shouldn’t be driving … but still is

Sometimes even all the steps above aren’t enough, and you’re pretty sure your loved one’s driving is a danger to themselves and others. What can you do if they won’t listen to you, the doctor or even a driving specialist? Older drivers might need to take a behind-the-wheel test in your state in order to renew their license, which might take the matter out of your hands. In all states, law enforcement officers and doctors can report suspected unsafe drivers to the licensing office or department of motor vehicles; many states also allow concerned citizens to make a report. (You can learn your state’s policies here.)

Have a list of alternatives at the ready

Giving up driving at first may be emotionally devastating to your loved one. Listen to and acknowledge their grief and fears, and be ready to offer some transportation alternatives right away. Brainstorm the options, which might include mass transit (bus, train or subway), taxis, ride hailing services, or special transportation services for older adults.

If circumstances allow, begin with a test period, where your loved one relies on alternate transportation for a period of time. After adjusting to the new normal, they may be ready to give up the car—perhaps to a grandchild or other young relative. “I realized I was feeling a lot of anxiety about my driving,” reported Lillian, age 78. “Now, even though I can’t just hop in the car any time I feel like it, I feel a lot more relaxed. I let the bus driver do all the work!”

Be aware that especially these days, when public transportation services may be curtailed, your loved one’s alternative transportation might be you. This can be workable, especially if you can share the driving load with other family members. Express to your loved one your willingness to help in this way, lest they fear being a “burden.”

Many families also take advantage of professional in-home care services to help keep older loved ones active and independent. Caregivers can provide transportation to medical appointments and the pharmacy, to a senior’s volunteer gig, to their faith community, or anywhere else they want to go.

Having a caregiver lend a hand also can help normalize family relationships. “If I want to go to the store, I’d rather have the caregiver take me than ask my son!” said Reg, age 91. “My son is always willing, but he’s busy. For the caregiver, this is their job, and it’s great to have the company and know if I need any help, it’s available.”

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