Taking Away the Car Keys

Do you remember getting your driver’s license – that feeling of accomplishment, freedom, and independence? Now imagine the devastation of having someone tell you you can no longer drive, taking that feeling of freedom and independence away. For many seniors and their families, this emotional and difficult decision is a reality.

Driving is a complex activity, and as individuals age, their ability to manage this once almost automatic act becomes more difficult. At some point, they become a danger to themselves and to others on the road. Unfortunately, the drivers themselves are often the last ones to realize this. Caregivers and family members must be diligent in their observation of the elderly person’s driving habits and skills.

How does aging affect driving?

Several physical and mental changes contribute to diminished driving abilities. They include:

• Slower response times. Drivers react more slowly to other vehicles, pedestrians and animals.
• Vision problems. The inability to see lane lines, curbs and road signs, especially at dawn and dusk, poses a risk for drivers with vision loss. Other common problems include the loss of depth perception and a decrease in peripheral vision. Some drivers are also bothered by the glare from headlights at night
• Hearing loss. Loss of hearing, even a little, affects an individual’s ability to hear car horns, children’s voices, emergency vehicles or screeching tires.
• Loss of muscle strength. Just moving one’s foot from the gas to the brake takes muscle strength. Sometimes this movement needs to be made quickly.
• Medication side effects. Common side effects of medications often taken by the elderly are drowsiness and dizziness.
• Loss of flexibility. Looking over one’s shoulder when merging is necessary for safe driving.
• Inability to focus or concentrate. Many elderly drivers admit to being easily distracted and overwhelmed by all of the sights and sounds of traffic.
• Confusion. Getting lost is a byproduct of confusion.

There are many warning signs that alert caregivers to impending driving problems of their loved one:

• Getting lost while driving
• Frequent accidents
• Unexplained dents and scratches to the car
• Increased moving violations
• Difficulty changing lanes
• Driving at inappropriate speeds
• Forgetting how to operate the car
• Pulling out into moving traffic
• Trouble navigating turns
• Requiring constant cueing from a passenger to drive successfully

If you are faced with the task of taking away the car keys from a loved one, here are some ways to approach the subject.

• Express concern for the safety of your loved one. Present the facts, as you see them. Be aware that those with dementia often have difficulty reasoning and may not be able to understand or agree with your concerns.
• Enlist the help of your loved one’s physician. Many physicians can assist by providing letters to the Department of Transportation, stating the patient’s deficits and requesting that their license either be revoked or not be renewed. They also can provide an outside authority figure which family members often can not provide. Some physicians have even written prescriptions for a patient “not to drive.”
• Have your loved one complete a driver’s evaluation. Contact www.drivesafeinc.net or www.courage.org for evaluation available in Minnesota.
• Contact the local police or Department of Motor Vehicles to report concerns regarding drivers. This can be done anonymously.
• Disable the vehicle.
• Remove the vehicle from sight. For many with dementia, out of sight means out of mind.

For more information on driving concerns, log on to one of the following Web sites:

• AAA www.aaa.com
• Insurance Institute for Highway Safety www.highwaysafety.org
• National Highway Traffic Safety Administration www.nhtsa.dot.gov
• The USSA Educational Foundation www.usaaedfoundation.org
• A free online guide offered by The Hartford Insurance Company provides educational resources as well as checklists to help you determine if and when intervention is needed. Go to www.thehartford.com/alzheimers/105013final.pdf to download this guide.