You’ve grown concerned about your mother’s driving. She is now one of the 30 million senior drivers (according to the National Highway Traffic Safety Administration), and you’ve become more watchful. First, there are these serious dents in her car that she can’t explain. When riding along, you’ve had to remind her that stop signs were coming up. While driving she has seemed unusually distracted.
Senior drivers have more fatalities per mile driven than any age group except teenagers. Younger drivers crash more, but the crashes involving mature drivers are more likely to be fatal.
It’s time to start the driving conversation with Mom, but you’re afraid of her reaction.
Why all the fierce emotion when talking about senior citizen driving?
Remember when you got your first driver’s license? That sense of pride and freedom stayed with you. If you’ve ever had surgery and a driving restriction while you were recovering, you know how your sense of independence was curtailed. So to understand aging parents, just take that emotion and intensify it by the number of years they have been driving.
For senior citizens the fear that they may have to stop driving for good is almost too much to bear. The culture that we live in is built on mobility. Public transportation is often scarce for former senior drivers. Families often live at a great distance. And friends are scattered and may have their own physical challenges to deal with. The loss of the ability to drive as a senior citizen can feel like being trapped, isolated and alone.
Your first step might be to help your Mom develop some new ways to compensate for any deficits. There are often many simple things that elderly drivers can do that will make a huge difference. You can go over some these tips for older drivers with Mom.
Is there a way to talk about senior citizens and driving… and still keep the peace?
It’s important to remember that this is not an either-or proposition. This not simply a question of whether to drive or not-to-drive. Being a senior driver is not a crime. There is a wide continuum of function and ability on the driving – quit driving spectrum.
I recommend that you approach the conversation in STAGES that are appropriate to where your parent is on the continuum. Each Stage will be dealt with in a separate page. Each page will contain:
- a description of the major issues to be focused on
- major questions you should ask and things to look for
- links to other resources where you can get additional information
Ideally you begin this conversation before any issues have presented themselves. Establish your concern for the future and align yourself with being on the same team as your aging parent.
What to look for as early signs of change in driving habits. Self-assessment tools offered. Providing support to preserve maximum freedom.
Learn the signals that there are more serious concerns. What professional medical assessments could be suggested. Referrals to Driving Rehabilitation Specialists and adaptive devices for the car are discussed.
Critical questions to know when it’s time to hang up the keys. Methods to ease the transition are discussed. Alternative approaches if driving cessation will not be voluntary.
Planning ahead to maintain freedom. Creative transportation alternatives to driving.
Stage 1 – Rethinking the Driving Conversations with Aging Parents
Ideally, you begin the Driving Conversations long before you ever need them. Your parents are decent drivers, in reasonably good health, and things are going well. Now is the time to start. Why? Precisely because it’s not needed.
Most people wait until their parent’s driving has deteriorated to the point that they are no longer safe and a danger to themselves or others. Then, the conversation feels sudden, confrontational, and imposed upon the parent from outside. Rather than relinquish their freedom mom or dad will, by necessity, fight to keep their independence. This strain can slide into a painful conflict that could last for months. That’s why you want to start the Driving Conversations now.
Form a Partnership
Rather than set yourself up as the enemy, start talking now and reposition the driving conversations as a partnership. Let your mother or father know that you value their independence, their judgment, and their concern for safety and well-being for themselves and others.
For now, you’d like to invite them to look down the road into the future, and think through what happens when or if they need to retire from driving. You’d like for them to imagine and then describe how they’d like that process to go.
Questions You Need to Ask Your Parents at This Stage
- How will you know when it will be time to retire from driving? (not based on age, but functional abilities)
- How should we plan for the stages along the way? (What might be some stages of decline of function that they would want to watch for?)
- Would you be open to using some objective assessments, both self-assessments and professional, to help you stay safe?
- Who else should be involved in these conversations?
- If you don’t notice in time, who should be the one to finally tell you it’s time to retire from driving?
- How would you like that conversation to happen?
- If you eventually retire from driving, can we agree that our goal will be to work out a plan so that you can maintain your independence as much as possible?
Senior Citizens and Driving:
Stage 2 – What to do at The First Signs of Change
Senior citizens and driving skills do not stay at the same level. Through physical changes over time their driving skills will not be as sharp. Reaction times will slow. Intersections will be more confusing. They will be more cautious in heavy traffic. Sometimes, they become lost in thought or distracted.
You’ll want to stay involved in The Driving Conversations as soon as you notice a change, or your parent mentions a change. At this stage, often a refresher course on driving skills can offer a vast improvement. Here is an example of what one church group did by offering the AARP Driving Safety course.
You want your parent to be aware of the variety of physical changes and the effects medications or sleep deprivation can have on their driving skills. There are many senior citizens and driving issues and you want them to be able to compensate in order to stay safe.
This is a sensitive issue, so often there can be a very positive effect when groups of senior citizens are tackling the driving issues together. Maybe your parent’s church could do the same to help senior citizens and driving improve for the community.
Questions You Need to Ask Your Parents At This Stage
- Remember we started this Driving Conversation some time ago? Our goal is to make sure you’re safe, and to keep you independent. I just want to check in. So what changes have you noticed with your driving lately?
- Can I run through the questions on one of these assessments, like we did before, and see how it’s going?
- Have you had any changes of medications lately?
- When’s the next time you’re scheduled to see the eye doctor?
- One of the things I’ve found out is that there are some driving refresher courses that you can take that will often give you a nice discount on your car insurance. Could we check one out together?
Senior Citizen Driving Assessment:
Stage 3 – The Warning Bells for a Senior Driver
What do you do when the warning bells go off? How do you do a driving assessment? Dad seems confused at intersections. He’s going slower and slower and other cars are honking. The family starts making jokes about a senior driver, or just out and out refuse to ride with him.
You’ve noticed it, too. Complex traffic signals seem to confuse him. It takes him longer to interpret the traffic arrows and figure out which lane is correct. He seem hesitant when split second decisions are needed. He seems more and more tense when behind the wheel. Time for a driving assessment.
Turn to Professionals for Assessing Senior Citizen Driving
Resources for driving assessment have been designed by professionals. Some are available on online. One offered by AAA lets your aging parent get an initial assessment of the complex visual skills necessary for safe driving. This is much more than a simple eye test, though regular eye exams are essential. It will test the color separations, ability to recognize objects in motion, distance and peripheral vision.
Have your dad schedule an appointment with his Physician. Again, stress the fact to your dad that you want to make sure that he can continue driving safely for as long as possible. A doctor can evaluate whether medications are interfering with alertness or response times and need to be adjusted. A doctor can check for other medical conditions that could alter a person’s motor functions and driving ability.
If needed, a doctor can refer to a Driving Rehabilitation Specialist (DRS). A Driving Rehabilitation Specialist can make a more in depth analysis of your dad’s driving ability. A DRS will begin a driving assessment with an on the road test with your Dad actually driving. Based on the results, the DRS could make many suggestions that will improve your Dad’s driving safety.
For instance, he could recommend some limitations on driving, such as not driving at night, or on highways. A DRS can help to plan driving routes, for instance, ones that do not involve left turns(among the highest percentage of accidents in elder drivers). He can also refer to a specialized driver rehabilitation class that will design specific alternate techniques for your dad to use to improve his driving function and safety.
A DRS could prescribe adaptive devices, like special mirrors or steering grips, that will help compensate for eye sight deficiencies or limited ranges of motion. After a driving assessment, a Certified DRS can bring together many resources to help people who have had strokes, arthritis, low vision, or other conditions. These costs can often be offset by insurance or Medicare or Medicaid.
Questions You Need to Ask Your Parents at This Stage
- I’ve noticed you seem more and more tense behind the wheel. What situations really get to you when you’re driving?
- Can we work out a plan to get some professionals to help make sure that you can keep driving safely?
- Let’s make sure there are no problems with medication or something physical. A doctor can help. Can we make an appointment with your doctor for a physical that will help correct things that will interfere with driving?
- Would you be willing to follow suggestions from professionals that will help you stay independent?
Senior Citizens Driving:
Stage 4 – How do you help your aging parents know when it‘s time to retire from driving… and make it happen?
Senior citizens driving? Is it time? When do senior citizens know it’s time to retire from driving?
Retiring from driving could be one of the most difficult moments in your aging parent’s life. Ideally this conversation has been happening over some time. (See the 5 Stages of The Driving Conversations below.)
Regardless of the preparation, when a parent is no longer able to drive there is a time of readjustment and grief. Many things have changed that have led up to this moment and signal yet another major loss. But the key is to prepare to end senior citizens driving so that they can maintain as much freedom and control and choice in their lives as possible.
One senior in a study sponsored by AAA summarized the magnitude of the loss this way…“Can’t see, can’t hear, can’t walk, but I have my car.”
Why retiring from driving is so important
When it’s time to retire from driving, it’s a serious matter… often a matter of life and death.
Studies show that senior citizens driving have the highest fatality rate in car accidents. In part, because of the severity of the crashes, but also because frailty that comes from age makes it much more difficult to recover from the physical trauma of a car accident.
Along the way you have worked with your parent and professionals to evaluate not only their driving, but their mental and physical abilities:
- Mental – ability to make split second decisions, judgment and instant complex problem-solving, memory and ability to plan alternatives (in case of detours, etc.)
- Physical – strength and flexibility. Ability to move fluidly to control the gas and break, to turn one’s head and neck to monitor traffic, and for backing and parking
- Visual – senior citizens driving must read street signs, traffic signals, anticipating actions of other drivers, peripheral vision to see traffic coming from the side or what’s around when turning or changing lanes, changes of vision in different levels of light: bright sunlight, dusk, night driving
- Reaction Time – ability to make sudden changes in the flow of traffic, or react to unexpected actions of animals or small children
What NOT to do
The decision to retire from driving is NOT an ultimatum. It is not a single conversation as in “It’s time to have the talk.” Not by force as in “It’s time to take away the keys.”
Ideally this conversation is the next step in a process. Your aging parent has been a partner in monitoring and evaluating the changes in their own driving abilities and challenges.
Even if you did not begin this process well before you are observing serious changes in your parent’s driving ability, it’s best to attempt to move through the 5 Stages of The Driving Conversation in an abbreviated form. Rather than having these conversations about senior citizens driving over a period of years, you may need to have them over months or weeks, or even days. You want your parent to be in the position to say, “Yes, it’s time to retire from driving” for themselves. You want them to be your partner in creating this plan.
Questions You Need to Ask Your Parents About Senior Citizens Driving at This Stage
- Dad, it seems like you no longer feel confident behind the wheel. It seems that driving is becoming more of a struggle. What do you think?
- What are all the things we’ve tried along the way? It doesn’t seem like those things are keeping you as safe any more. (Pause and let him respond)
- The most important thing has always been your safety and your freedom. If we map out an alternate plan to get you everywhere you need to go, and try it for 3 weeks, would you be willing to suspend driving to try this plan?
After the trial:
- So what challenges getting around did you have during this time? Let’s make the plan better so you’ll have fewer and fewer problems staying independent.
You Can Preserve Your Parent’s Independence After They Retire from Senior Driving
Stage 5 of The Driving Conversations
After senior driving there is still work to do. Your goal is to help your senior parents maintain their freedom and independence after they retire from driving. If this is not provided for, experience has shown, there is a strong link between not driving, isolation, depression and a host of other concerns. There is also a definite link between independence and joy.
The Creator of the Independent Transportation Network, Katherine Freund said it this way,
“I think of mobility as something essential, like oxygen. This is going to sound hokey, but there are two kingdoms — plants are rooted, and animals are not. We need to be able to move. It’s fundamental to have mobility and to feel free. When the only way people can really get around is a car and then you take that away from them, they fight. It’s that basic.
“People are aging normally, but the transportation system is broken. By creating an alternative that is truly acceptable, I wanted to make it possible for people to make good decisions and feel good about themselves.”
Question 1. Where does your Mom or Dad need/want/like to go?
Make a complete list of everywhere that your parent would normally need to travel on a weekly basis. The card club, the hair dresser, grocery, lunch group, church. Then consider the places where they have irregular appointments, doctor appointments, banking, and the like. Finally, where do they like to go for fun? You can make alternate arrangements so these are not out of reach after senior driving.
Question 2. Who can help?
List every informal resource that is already available to your parents after senior driving: family in the area (don’t forget teen grand children that are safe drivers), close neighbors, friends that attend the same functions, rides offered through the church.
Question 3. What will really work?
Pair up the informal resource that’s available, how often they could COMMIT to doing it (reliability is essential for your parent). And then notice the gaps.
Question 4. What else could we choose?
What public transportation options are available and acceptable in your area. You need to check how the pick up happens, what the schedule is and wait times. How close does the route comes to your parent’s destination? How much does it costs? (and how do they pay for it? You don’t want an option that requires your parent to carry a large amount of cash.)
Question 5. Where are the gaps?
You want to make sure that the plan you make is realistic and workable. Don’t just put it on paper. Try out the route with your parent to see how far the walk is, or if there are steps or other issues that would present a barrier. Are there other creative choices in our community? There may still be some alternatives that you had not previously known about.
The goal is to recreate a customized transportation system so that your mother or father can keep participating in the things that bring them, life, vitality and some joy.
Other forms of transportation after senior driving
You have charted informal help from family, friends and neighbors. Next you checked available public and private transportation options like shuttles or taxi services. But there may still be other options. Look for STP’s or ITN’s in your community.
An STP is the Supplemental Transportation Network. It’s a network that extends across the country in all 50 states, (and Washington D.C. and Puerto Rico.) but is organized community by community. Their purpose is to provide alternative transportation to elders after senior driving, or perhaps who can drive only under limited circumstances (e.g. evening rides for those that can’t drive at night).
STP’s are designed to be more flexible than other forms of transportation. Taxi’s, for instance, are not available in all communities. The driver does not help you from door to door, or inside. It can be expensive.
Supplemental Transportation Networks are committed to service for the elderly. They can tailor what they offer to the specific needs of your parent. No need to walk to a bus stop, or even to the curb if they are unable to do that. They even have an option called “door-thru-door” meaning they would escort your parent from inside their house to inside their location to see that they got there safely. They don’t have a specific route or schedule that they are bound to, and they can make several stops if your parent needed to combine a doctors appointment with a couple of errands along the way.
Some of these programs use paid drivers, others use volunteers with their own cars. But all of the STP drivers are screened and trained to meet the specialized needs of the, often frail, elderly. These are excellent services after senior driving.
The Independent Transportation Network (ITN)
“ITN provides rides with door-to-door, arm-through-arm service to thousands of seniors nationwide. It’s a truly innovative solution with unique programs that allow older people to trade their own cars to pay for rides, and enable volunteer drivers to store transportation credits for their own future transportation needs. ITN’s Road Scholarship Program converts volunteer credits into a fund for low-income riders, and the gift certificate program helps adult children support their parents’ transportation needs from across the street or across the nation.”
The ITN combines not only creative transportation alternatives for senior citizens, but coordinates volunteers, community services and agency connections to do it. They use a customized software program to pool a data base and match drivers and cars with an elderly rider’s needs and schedule.