Holly Bacon was there a year ago when her mother, who suffered a minor stroke and received a diagnosis, was told by a doctor that she could no longer drive. There was a risk, he explained, that the 82-year-old might have another stroke behind the wheel. "She just sobbed," recalls Bacon, 54, a dairy farmer in Amherst, Wis.
Her father, a retired trucker, has also been unable to drive since the first of two strokes damaged his vision three years ago, when he was 85. Getting grounded wasn't easy for the man who routinely drove family and friends to church or Veterans of Foreign War meetings. Bacon says, “He’d say, ‘What good am I? I don’t know why I’m here.'" Giving up the car keys can feel like the end of independence for someone who has spent a lifetime behind the wheel.
As more Americans live longer, they're also facing longer stretches of life without a driver's license: Women now outlive their ability to drive by seven to 10 years; for men, the average is six years, says Elizabeth Dugan, a gerontologist at the University of Massachusetts in Boston.
Most drivers age 75 and over, she notes, voluntarily cut back on driving at night or in bad weather or heavy traffic. "People don’t expect to drive until the day they drop dead," Dugan says. But even those who make such prudent decisions may be reluctant to give up driving altogether. That's why Dugan advises families to start thinking well in advance about the day when a loved one may need to be told that he or she can no longer get behind the wheel. "Think of it as a process you’re helping them to move through," she says, "from starting to think about it, then finding ways to stay safely on the road, then cutting back and finding alternative transportation."
Take Precautionary Steps First
The first steps: Ask loved ones how they’d like to handle the issue when the time comes, pay close attention to their driving skills, enact measures that accommodate for their declining skills and make driving easier, and be ready to step in if and when it becomes necessary.
The no-cost CarFit program from the American Occupational Therapy Association, AAA and AARP is a good place to start. Trained technicians and health professionals at CarFit Checkup events around the country help ensure that drivers "fit" their vehicle properly for maximum comfort and safety. A CarFit check takes approximately 20 minutes, and the group reports that more than a third of drivers who take part need to make at least one change, like adjusting their seats, mirrors or steering wheels. AAA and AARP also offer online self-evaluation tools and refresher driving courses for their members; AAA's website also has free information to help older drivers manage such challenges as slower reaction times; driving at night; and being aware of how certain medications may impair driving skills. Another step is to ask an occupational therapist who specializes in driving issues to take a parent or loved one for a ride and suggest ways to make driving easier for him or her, like modifying a car with a pedal extender. Such evaluations and modifications can make both the elderly driver and the family feel more secure, and raising these concerns before a crisis can also establish a path toward eventually giving up the keys.
Watch for Warning Signs
Recent crashes or tickets for moving violations are the strongest indications of declining road skills, but any noticeable change in vision, mobility or mental acuity is a red flag for seniors. If you notice any of these telltale signals, consult a doctor to discuss whether it's time to get the driver off the road.
Other ominous signs include recent near misses; dents and scratches that point to parking trouble; difficulty handling turns or keeping the car in the proper lane; and frequently getting lost. These "yellow flags," Dugan says, should prompt a discussion about planning the end to a loved one's driving career, as should any significant change in their health.
How to Have the Talk
Many drivers with declining skills don’t plan ahead, even if they know they're impaired, according to a 2011 study led by Fordham University researcher Amy Horowitz. Her team recruited 381 adults age 55 and over who were still driving despite age-related vision declines, like macular degeneration. Nearly all had cut back on their driving to some extent before participating in the study. A year later, though, about half said they had never considered transportation alternatives and had no plans to retire from the road. Horowitz's team also interviewed each subject's friends and family members and discovered that the drivers consistently rated their driving skills more highly than their passengers did.
Another sobering fact: While older drivers actually have fewer accidents because of the precautions they take, they are much more likely to die if they do get into a crash. For example, car crashes are nine times more likely to be fatal for drivers 85 and over than for drivers 25 to 69.
If you need to talk to a parent or loved one about turning over their keys, plan on multiple discussions and avoid forcing a dramatic confrontation. If a poor driver continues to resist, Dugan suggests appealing to their deepest values. “Sometimes you need to get them to imagine the worst-case scenario," she says. "To a doctor, you might say: 'All your life you’ve healed people. Now your legacy could be a fatal crash.' If a financial legacy is important to the person, you could say, 'All your savings could be wiped out with one accident.'"
Finally, Dugan advises reminding the driver that he or she may have already made other difficult lifestyle transitions successfully. Be sure to point out specific relatives or friends who no longer drive but have figured out other successful ways to get where they need to go. And plan to talk about the availability of friends and family to offer rides, as well as such alternatives as public transportation and free or low-cost supplemental transportation programs or shuttle services.
Horowitz's research found that seniors were more likely to quit driving if, like Bacon's mother, they were advised to do so by a doctor. But drastic steps are sometimes necessary. If someone suffering from dementia needs to stop driving immediately but refuses, some caregivers may simply take the keys out of a purse or even remove the battery from a car.
Bacon’s parents now live in an assisted living facility eight miles from her farm. After the car sat untouched for nine months, her father arranged to sell it in January for a small sum. One of Bacon's sisters felt sure she could get a better price, but Bacon demurred: "I said it was more important that he be in control."
Her mother, however, still resents her doctor's intervention. "She’ll say: 'I don’t understand why I can’t drive. There is nothing wrong with me.'" When Bacon repeats the doctor’s argument, her mother insists that she knows other people who drive in similar circumstances.
"Maybe," Bacon tells her, "they don’t have people who care enough to keep them off the road and make sure they’re safe."