When is it time to consider taking away the car keys?

Here’s a little fun fact for children of aging parents…

 

Seniors have the highest crash death rate per mile driven, even though they drive fewer miles than younger people.

In almost every industrialized country in the world, people are healthier and living longer than ever before. As a consequence, our aging parents are likely to outlive their ability to drive safely by an average of 7 to 10 years.

According to the most current government and insurance industry studies, seniors are far more likely to be injured or killed in traffic crashes than any other age group. Experts believe this is largely due to age-related vulnerabilities, such as underlying chronic medical conditions and more fragile bones. Medical conditions like heart disease, diabetes and other illnesses make it more difficult for older drivers to recover from their injuries.

Here are some sobering facts to think about regarding our aging parents ability to drive safely:

  • 80 percent of people in their 70s suffer from arthritis, which makes turning, flexing and twisting painful.
  • Weaker muscles, reduced flexibility and limited range of motion restrict our aging parents’ ability to grip and turn the steering wheel, press the accelerator or brake, or reach to open doors and windows.
  • More than 75 percent of drivers age 65 or older report using one or more medications, but less than one-third acknowledged awareness of the potential impact of the medications on driving performance.
  • Per mile traveled, fatal crash rates increase beginning at age 75 and rise sharply after age 80. This is mainly due to increased risk of injury and medical complications, rather than an increased tendency to get into crashes.
  • Since older drivers are more fragile, their fatality rates are 17 times higher than those of 25 to 64-year-olds.
  • More than 58 percent of deaths in crashes involving drivers over age 65 are older drivers themselves and 12 percent are their passengers. Twenty-eight percent of these deaths were occupants of other vehicles, bicyclists and pedestrians.  

Most Recent Statistics (2015)

Total drivers over age 70:           25,303,555

70-74             10,232,234

75-79             6,833,757

80-84            4,521,433

85 +                3,716,131

 

Here in the US, the National Highway Traffic Safety Administration says that 6,165 people age 65 and older were killed in traffic crashes in 2015. This represents 18 percent of all Americans killed on the road. In addition, 240,000 seniors were injured in traffic crashes in 2015.

The problem is not just an American one. In the past several months alone, elderly Japanese drivers have been wreaking havoc across the country: breaking through median barriers into oncoming traffic, plowing over pedestrians crossing the road, and smashing into other cars. In all these cases, somebody was killed.

In Japan, National Police Agency data show drivers aged 75 and over were connected to 459 fatal accidents last year. That’s 13 percent of Japan’s total, which is almost double from a decade earlier.

In one of the worst recent incidents, an 87-year-old man crashed his light truck into a group of children walking to school in Yokohama, killing a 6-year-old boy and injuring two others. This year, a 74-year-old woman, after jumping the median, crashed head-on into a car driving on the opposite side of a highway, killed a man.

Just this past month, two people in their 80s were killed when their car collided head-on with a large truck inside a tunnel in Gifu. Police reports said the couples car likely crossed the center line.

Giving up the car keys can be tough for people who live away from public transport or are the only driver in the household. For many, it’s also an issue of independence, of giving up personal freedom and reconciling with old age.

Losing the right to drive and the independence that accompanies it may also hasten physical decline and contribute to dementia, says eldercare expert, Hiroshi Takahashi, a former professor of welfare policy at the International University of Health and Welfare Graduate School—a conclusion shared by my colleagues in the UK, Europe, Australia, New Zealand, South Africa and here in the US, Canada and Mexico.

In preparation for this article and for Episode 28 of the Parents Are Hard To Raise Broadcast, I sifted through mountains of material gathered by my producers. Although I’m a strong advocate for independence and aging in the community, the stories I read of the carnage caused by unfit older drivers were certainly sobering.

Among the stack were the accounts of 86-year-old George Weller, who drove through the Santa Monica farmer’s market, killing 10 and injuring 63, and an 81-year-old Florida woman who failed to yield when merging onto a highway, smashing into a bus carrying a group of seniors out on a day excursion, killing at least two and injuring dozens.

When older people are involved in fatal crashes, the Insurance Institute for Highway Safety reports, their victims are most likely to be themselves and their equally elderly, frail passengers.

Intersections are particularly risky for aged drivers. According to a study in the journal Traffic Injury Prevention, intersection crashes accounted for about fifty percent of the fatalities in accidents among drivers 85 and older. Based on my own experience with older clients, my guess is that limited visual acuity and depth perception might play a role. The study found that when drivers 70 to 79 were involved in intersection collisions they tended to misjudge whether or not it was safe to proceed. However, those 80 and over simply didn’t see the other car coming.

Insurance industry and highway safety statistics show, once people turn 70; their car accident rates start to rise. After 80, however, the rate skyrockets. Octogenarians have a higher collision rate per mile traveled of any age group, and their rate of fatal collisions per mile traveled is the highest of all drivers.

The problem is that there’s no clear solution for what to do about older drivers. As many of us children of aging parents know, it can be agonizingly hard to get older drivers who are no longer competent to fork over their keys.

More than one half of U.S. states impose restrictions on license renewals for older drivers. In Alaska, drivers 69 and older must renew in person, not by mail. The District of Columbia requires a fitness-to-drive statement from a physician starting at age 70. In Illinois, those 75 and over must take a road test. In Iowa, the renewal cycle is accelerated from every five years to every two years for drivers 70 and above. In New Jersey, where my parents Annette and Joe live, there are no such restrictions, which may explain why there are so many new “drive-through” buildings that were never designed to be as such, in areas populated with retirement communities. In fact, on the main highways and byways that transect the central part of the state where senior communities outnumber all others, the instance of single vehicle fatal collations involving octogenarians is a chart-topper. Lawmakers, who depend heavily on the senior citizen vote to stay in power, tend to avoid the issue of age restrictions on driving privileges. As a result, we’ve got more and more new “drive through” bakeries, convenience stores, banks and shoe stores in the Garden State.

The Institute For Highway Safety reports that those 70 and over drive less than half as many miles annually as middle-aged drivers.

This and tons of other studies I’ve read confirm what I see in my own practice—many older people tend to self-restrict their time on the road by no longer driving at night, avoiding freeways, or staying home during bad weather. My mom is one of them.

That’s the way we wish it would work all the time—self-recognition and the support of caring family leading the older person to accept it’s time to let someone else do the driving. But, unfortunately, this is not always the case.

Many older people, including my dad, don’t go gently into the idea of hanging up the car keys and summoning up an Uber to get to the grocery store. This is a more common scenario for those of us who live in a more suburban and rural setting where public transportation is meager or non-existent, and when the parent we’re dealing with has driven all of their lives and is fiercely independent.

In dealing with a parent who simply refuses to stop driving even though they can’t see, hear or react well enough to operate a car safely, some of my more frustrated clients have resorted to subterfuge tactics like: disabling the car, filing down the keys, and canceling the vehicle registration.

But just as we found out when we got caught sneaking into the house after curfew hours… our parents are oftentimes smarter than we give them credit for.

After a lifetime of being law-abiding drivers, an aging parent who feels trapped may go rogue. Over the years I’ve had plenty of wily eldercare clients sneak out of the house and continue to drive without a driver’s license, car registration, or insurance coverage. But more than a few times I’ve seen well-intentioned yet a bit overbearing children rush in and snag mom’s driving rights away without due reason.

Don’t rush to judgment

Before making any decision it’s important to have all the facts. And it’s always best—when possible—to gather those facts firsthand. See what the situation is for yourself. Don’t rely on second hand information. It’s a balancing act—you want them to be safe, yet both you and they want and need them to have their independence. A good place to begin is with the basics.

The Centers for Disease Control and Prevention here in the U.S. offers some advice to help keep older adults safer on the road:

  • Encourage your aging parents to exercise regularly in order to increase strength and flexibility.
  • Asking their doctor or pharmacist to review medicines–both prescription and over-the counter–to reduce side effects and interactions.
  • Have their eyes checked by an eye doctor at least once a year, and be sure they wear glasses and corrective lenses as required.
  • Have them try to restrict their driving to daylight hours and in good weather.
  • Help them plan out and learn the safest route with well-lit streets, intersections with left turn arrows, and easy parking.
  • Encourage them to planning their route before driving.
  • Remind them to leave a large following distance behind the car in front of them.
  • Avoid distractions in their car, such as listening to a radio, talking on their cell phone, texting, and eating.
  • Encourage them to consider potential alternatives to driving, such as riding with a friend, using public transit, taking a cab or an Uber…which you can show them how to use to get around.

A car has different meaning for different people

For our aging parents, who might need to limit or stop driving, a car has different meanings. For some, it’s part of who they are as a person, for others it’s just a means of getting places.

For the person who just want’s to get from place to place and doesn’t really care how they get there, giving up driving may be no big deal. But for those who tie their meaning and sense of independence to driving, getting them to give up the car keys might be a rougher challenge.

Whatever the case, you need to understand and acknowledge what driving means to your parent.

For our parents, as was the case for many of us, the ability to drive marked our passage into adulthood. But, at some point in our driving lives, we may need to begin thinking about and planning for a life without driving.
For our aging parents, giving up driving can be a significant life change.

Like my Mom, many older adults voluntarily limit driving in response to changes, as they grow older. For example, my Mom stopped driving at night, in poor weather conditions and in heavy traffic. Recently she’s even begun having my dad pull the car out of the garage for her (but only after a few “mishaps” with the sides of the garage door).

Not driving in bad weather, at night or in rush hour traffic is one thing. Giving up the car for a short time is very different from never driving again.

In my experience, older people who are forced to give up driving altogether often feel:

  • Depressed
  • Angry or frustrated
  • Socially isolated
  • That they are a burden to family members
  • Fewer opportunities to engage socially

It’s important to be able to try to understand your parents’ feelings about losing their ability to drive. You need to put yourself into their shoes…

Take a few moments to go through the following exercise

Read the following questions and then take a moment to write down your responses on a sheet of paper.

First… Suppose you just found out that you wouldn’t have a car for the day. What’s your initial reaction?

Would you stay home, or would you try to arrange alternative transportation?

How easy would it be for you to get around?

Would you have to depend on a friend or a family member for a ride?

Do you know the bus, train or subway schedules in your area?

Is there even a form of public transportation in your area?

How much extra time will you have to leave for public or other form of transportation?

Would not having a car for the day cause a major change in your schedule?

Now… picture what it would be like if you just found out that you won’t have a car for an entire week?

How will you get to and from the places you need to go, such as work, the supermarket, the doctor’s office, a birthday party?

How would losing the ability to drive affect your freedom?

Finally… try to imagine you’ve been told you have to give up driving all together.

Think about your answers to the previous questions…

How would this change your life?

Now… Write down a few words that would describe how you’d feel if you could never drive again.

What words did you choose?

Angry?

Frustrated?

Uncertain?

Trapped?

Isolated?

If you wrote these or similar words you’ve expressed the same feelings your aging parents might feel about giving up driving.

Understanding and Empathy are the keys to good communication

It is important to understand why, for your aging parents, losing the ability to drive contributes to strong negative feelings.

When older adults stop driving, it usually means they:

  • Take fewer trips outside the home
  • Have increased and permanent dependency on others for transportation
  • Worry about becoming a burden to others
  • Have less opportunity to engage socially

You want to encourage your parents to share these feelings with you, even if they feel angry. It is important for you to remember that while these negative feelings may be directed toward you—the messenger, they generally are really more about the message itself. Nobody wants to admit they can no longer do what they used to do.

Listen to your parent and show that you care

Older adults who stop driving experience a sense of loss often accompanied by feelings of depression or isolation. They often feel and express these emotions when approached about their driving.

As a concerned child of aging parents, the best thing you can do is listen to and validate their concerns.

You may experience strong emotions when talking to your parents about driving. You might even begin feeling angry or frustrated or start to feel guilty for depriving your parent of the freedom of driving. You may be afraid to start a conversation. You may even be avoiding it altogether.
Don’t postpone the conversation because you fear a negative reaction or worry about the additional responsibilities you may have to assume.

If you have a valid safety concern, it is better to start having conversations than to wait. Hurt feelings—yours and your aging parent’s—are a normal part of conversations about limiting or giving up driving. When they emerge, stay calm, acknowledge them, try to become as informed as possible and focus on using productive discussions to defuse any negative emotions.

The first step to planning successful conversations with your parents is to start with discussions that acknowledge their feelings and show genuine concern about what driving, and its loss, may mean to them.

Ask open-ended questions (questions that can not be answered with a simple yes or no answer, but instead require a more detailed answer), and then listen closely to the answers.

Don’t ever try to offer solutions or suggestions until you first gain a real understanding of what driving means to your aging parent.

Allow your parent the opportunity to express their frustrations about the possibility of limiting or giving up their driving. Let them know you understand and share their concerns. Let them know you are there to help them in any way you can.

Ask them to suggest some viable solutions.

Conversations like these will help in letting your parent know that you understand and care about their feelings and needs. They can also serve to encourage the family to seek solutions that address underlying needs; and help you find solutions that adequately address your parent’s overall needs.

Early, occasional and candid conversations like these establish a pattern of open dialogue and can reinforce driving safety issues without the strain of asking someone to change his or her driving behavior.

These kinds of discussions allow time for the older adult to ponder their new reality, consider his or her driving skills and then make their own appropriate modifications.

Frank and open conversations like these can ease the eventual transition into not driving.
Below are some examples of how your parent’s attitude toward driving can help you both arrive at viable solutions.

  • If the car is only a means of getting places- focus on arranging transportation alternatives that allow the person to maintain appointments, social engagements, and shopping needs.
  • Owning a car or having it “available” may be more important to your parent than driving it. In that case, one solution might be to keep the car parked at the house or maybe have the car available for others to use.
  • Discuss transportation alternatives that allow your parent to have some control over scheduling, such as using taxi cabs, Uber, Lift or paying a neighbor to be a driver.
  • Help your parent learn to plan ahead. Having prior arrangements is easier for those providing transportation, and increases the chances of having your parent’s transportation needs met.

What warning signs should you look for in older drivers?

It’s important to personally observe your aging parents behind the wheel so that you have a better idea of their driving skills and are able to notice changes and patterns of driving behavior that may indicate their safety has become at risk.

Older drivers often bring up their own concerns about driving by:

  • Expressing personal concerns about driving safety
  • Beginning to limit where and when he or she drives

Signs like these may help you decide when it is time to observe driving behavior and begin having open discussions about driving.

At the risk of sounding like a broken record (a phrase lost on Millennials), it is important to personally observe changes in your parent’s driving behaviors over time so you can approach them with factual information and responses.

Making assumptions without first making observations makes it difficult to come up with reasonable and appropriate solutions. The wrong reaction can cause hurt feelings and create resentment.

Driving changes are generally not instantaneous. Observing your parent’s driving routinely over extended periods of time will help you determine solutions that correspond to his or her actual situation.

Take a ride with your aging parent

When you are in the car with an aging parent look for changes in his or her driving skills. As you observe your parent on the road and track changes in their driving over time, you may start to notice patterns of behavior that may lead to a potential problem.

Observing driving habits long before you think there is a serious problem allows you to establish a baseline understanding of your aging parent’s driving skills.

So what should you be looking for?

You are looking for patterns of more frequent mistakes or serious driving errors, like confusing the gas pedal with the brake or getting lost in familiar areas.

When you see these, it is time to talk with your aging parent about limitations or in some cases transitioning away from driving.

Family members and close friends are in a good position to know how a person’s driving abilities are changing. They may be the first to see the general warning signs that a driver’s ability may be impaired.

For example, you may begin to notice your aging parent:

  • Having more scrapes on the car
  • Swerving or driving over curbs
  • Having difficulty with left turns
  • Driving at inappropriate speeds
  • Maintaining an increasingly widening distance from the car ahead, or following way too close.

Driving changes may be small or may be serious, but should be observed and tracked regularly so they can be used in framing conversations and finding solutions.

Here’s a list of Warning Signs for Older Drivers provided by The Hartford Insurance Company:

  1. Decrease in confidence while driving.
  2. Difficulty turning to see when backing up.
  3. Riding the brake.
  4. Easily distracted while driving.
  5. Other drivers often honk horns.
  6. Incorrect signaling.
  7. Parking inappropriately.
  8. Hitting curbs.
  9. Scrapes or dents on the car, mailbox or garage.
  10. Increased agitation or irritation when driving.
  11. Failure to notice important activity on the side of the road.
  12. Failure to notice traffic signs.
  13. Trouble navigating turns.
  14. Driving at inappropriate speeds.
  15. Not anticipating potential dangerous situations.
  16. Uses a “copilot.”
  17. Bad judgment on making left hand turns.
  18. Near misses.
  19. Delayed response to unexpected situations.
  20. Moving into wrong lane.
  21. Difficulty maintaining lane position.
  22. Confusion at exits.
  23. Ticketed moving violations or warnings.
  24. Getting lost in familiar places.
  25. Car accident.
  26. Failure to stop at stop sign or red light.
  27. Confusing the gas and brake pedals.
  28. Stopping in traffic for no apparent reason.

Differentiate Between Common Mistakes and More Serious Safety Risks

Less serious or infrequent warning signs might indicate a need to limit driving. These signs include:

  • Incorrect signaling
  • Scrapes on car
  • Decreased confidence while driving
  • Failure to notice traffic signs

More serious or frequent signs might mean the need to stop driving immediately. These signs may include:

  • Confusing the gas and brake pedals
  • Getting lost in familiar areas
  • Confusion at highway exits
  • Failure to stop at signals or red lights

Use Your Observations to Frame Conversations

You should observe changes in your aging parent’s behavior and determine if driving will become a problem. You can also use those observations to help voice your concerns while reducing hurt feelings and increasing the success of your conversations.

When you use your observations to frame conversations, you:

  • Show that you care about your parent’s safety as the driver, his or her passengers and others on the road
  • Provide concrete examples of unsafe driving behavior that help you to react appropriately and reduce emotional sensitivity
  • It is important to remember that conversations about driving should not take place while the older driver is behind the wheel!

In summary:

  • Driving changes happen over time. This gives you the opportunity to observe your aging parent’s driving and customize solutions to the needs of his or her unique situation.
  • Make frequent, specific observations of your aging parent’s driving so you can address patterns of driving behavior and include them in your planning and conversations.
  • Unsafe driving behaviors range from minor mistakes to serious safety concerns. Use the above Warning Signs for Older Drivers checklist to help you track an older driver’s skills over time.
  • Write down your observations while they are fresh in your mind, focusing on specific actions that will help you come up with appropriate solutions.
  • Engage your aging parent in self-evaluation and use what he or she discovers in making decisions about the future.
  • Use your observations to help build consensus with family members before having a conversation with your aging parent.
  • Casual conversations are not the same as guided observations. Conversations that include actual observations rather than general opinions are less emotional and more successful.

One Comment

  1. counterthink November 21, 2017 at 9:43 am - Reply

    This is a great help for those of us struggling with the question, when should our parents consider giving up driving. Thank you Diane!

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