Join Date: May 2003
How to Approach Elderly Parents About Their Driving?
Initiating a dialogue about safe driving
If you have concerns about your parents' ability to drive, addressing them promptly could be a matter of life and death. It may be tempting to procrastinate -- to talk to your parents next week or before the first snowfall, for example -- but think how you'd feel if your parents caused an automobile accident. They could be seriously or fatally injured, and it would be even worse if they took innocent motorists or pedestrians along with them.
Considering the possible consequences should help you overcome your hesitation -- but that doesn't mean it will be easy. It's awkward and painful to have to inform your elderly parents that they aren't capable of doing something as basic and essential as driving the car. For them, it's another humiliating reminder of their growing inability to take care of themselves and manage the tasks of daily life.
As difficult as it is, if you have reason to believe that your parents could be dangerous behind the wheel, it's important to deal with the issue sooner rather than later -- because later could be too late.
Back to TopBefore you talk to your parents about driving safety
It's a good idea to plan how you're going to approach the subject before bringing it up with your parents. Take time to consider how the situation looks from their point of view and what driving means to them.
In his book How to Say It to Seniors, geriatric expert David Solie points out that because elderly people face so many losses at this stage of life, they tend to rigidly control the few things they can. This struggle for control will almost certainly come into play where driving is concerned, because giving up the car keys could affect where your parents live, whom they see, and what interests and activities they can pursue. To you, this decision is a simple matter of good sense and safety; for them, it represents the end of life as they've always known it.
Elizabeth Dugan, a geriatric researcher who wrote the book The Driving Dilemma, reports that a colleague stopped using his car for two weeks before talking to his elderly father about driving safety. His carless weeks gave him firsthand experience of the inconvenience and lack of mobility that his father was going to have to endure. You may not want to give up your car before your talk with your parents, but you should give some thought to the emotional and practical issues they will face when they give up driving.
Preparing for the discussion also means approaching it with realistic expectations. If you assume that one discussion will neatly resolve the matter, you're bound to be disappointed. Given how charged the driving issue is, you need to think of this as a process that will take some adjustment and fine-tuning. Consider this a preliminary discussion only: a way to get the issue out on the table so it can be dealt with openly.
Finally, prepare for the discussion by considering your own role. Remember that it's not up to you to convince your parents that they must immediately cease driving, even if you think this is the best course of action. Unless your parents have dementia or are otherwise incapacitated (see below), you need to respect their right to make decisions about their lives -- with your input and support.
Back to TopHow to talk to your parents about driving safety
Plan your discussion for a quiet time of day, when you and your parents are relaxed and rested and no one has any deadlines or commitments pending.
When you introduce the subject, try to avoid coming on too strong, or you'll set the discussion off on the wrong foot. You may feel a keen sense of urgency, but if you jump right in with, "You have to stop driving, Dad! You're going to kill someone!" he'll probably either get angry or tune you out.
Remember that if you've noticed that your father's driving has grown erratic and sloppy, he's probably aware of it, too. You can be most helpful at this point by helping him express and work through his own concerns.
A good way to do this is to initiate the discussion with a question. For instance, if you know that your father has received a traffic ticket, ask him about it, and then follow up with another question like, "How are you doing with your driving, Dad? Are you finding it a little difficult to manage?"
At this point, your father may respond by pointing out all the practical reasons he can't stop driving (" What about my weekly golf game?" or "Your mother's physical therapy appointments are clear across town! "). Without directly answering your question about his driving ability, he's already making the case for why he can't stop. This is valuable information because it provides a glimpse of his own internal struggle: he knows that he's having trouble driving safely but can't fathom how he and your mother will manage without a car.
Encourage your father to discuss his concerns without immediately jumping in with solutions (" I'm sure Jack or Stan will be happy to drive you to the golf course." "The bus goes right by the physical therapy office. "). It's usually counterproductive to offer reassurances (" Don't worry, Dad, it will all work out fine. ") . Such responses may offer temporary comfort, but they won't help you or your parent explore the larger issues involved.
Instead, you can help your father express his fears by using "reflective listening," a technique Elizabeth Dugan recommends when talking about driving and other difficult issues with an elderly parent. Reflective listening -- which essentially means rephrasing what your parent has said -- conveys support and encouragement and helps the speaker gain insight about his experience.
To use reflective listening in the example above, you could say something like, "Dad, I know you're probably worried that giving up driving would mean you have to give up some of your usual activities." This type of response will encourage your father to keep talking about his worries and reflect upon them, which is an important step in working through major problems and transitions.
Back to TopDriving down memory lane
When reflecting about driving and its role in their lives, don't be surprised if your parents begin to talk about the past. They may reminisce about their honeymoon road trip to the Grand Canyon or recall how they saved up money for their first car or taught you how to drive. Resist the temptation to interrupt and get them back on track. Instead, try to encourage their reminiscences by asking questions or even requesting to see photos. Sifting through memories will help your parents come to terms with this life transition as they reflect on the role driving has played in their lives and gradually accept the fact that they'll soon have to give it up.
As the discussion progresses, ask your parents directly what they think they should do about driving. You may want to help them jot down some of the pros and cons of the alternatives they face. This approach will help them realize that there are actually some benefits to not driving (tremendous savings on auto insurance, car maintenance, and gasoline, for example). It also may help focus them on the stark consequences -- such as a fatal accident -- that could result from maintaining the status quo.
Depending on how everyone is feeling, this might be a good point to put the discussion on temporary hold. Agree to meet again in a couple of days, after you've all had a chance to reflect on the various options. (You might want to set a specific time to meet to ensure that it happens.)
Of course, there's no telling how your discussion with your parents will unfold, since that will have a lot to do with factors unique to your family's situation. But the discussion is much more likely to be productive and positive if you approach it with a genuine desire to learn more about your parents' experiences, ideas, and concerns.
Back to TopNext steps:
What to do before your parents give up driving
Identify the problem. If your parents acknowledge that they're having difficulty driving, find out the specific problems. Make appointments with your parents' physician and eye doctor, and be sure to ask about medication, side effects, and drug interactions. It's possible that the problem can be remedied with a change in medication or a stronger pair of glasses. Make sure their car is suited to their needs and physical abilities, and ask their doctors whether assistive devices might help address driving difficulties.
Discuss interim measures, if possible. Once you determine the source of the problem, you can decide what to do next. Your parents' physician may suggest that they limit driving to daylight hours or essential errands. If your parents are going to continue to drive at all, it's a good idea for them to brush up on their driving skills and the traffic laws by taking a senior driving refresher course. AARP, AAA, and commercial driving schools all offer such courses. Agree to revisit the decision every few months to see how it's going.
Help your parents explore other transportation options: whether or not your parents have to give up the car keys immediately, it's a good idea to help them become familiar with other transportation options. Take the bus with them if they're apprehensive and help them find out more about local senior transportation services. Encourage them to carpool with friends and other seniors.
Take a break if your parents refuse to address the issue of driving safety. They may become angry when you try to talk about driving or refuse to discuss it, so it's a good idea to temporarily drop the issue. There's no point in engaging in a battle -- it will only make your parents more resistant. Give the matter some time, and then bring it up again in a week or so. You may find that your parents become more receptive to discussing the matter over time, as they grow used to the idea and realize that the risks of continuing to drive outweigh the benefits.
If you're convinced that your parent poses an immediate risk to himself or others, be prepared to take action, whether he's receptive or not. If your parent agrees, go with him to talk the matter over with his physician. You can also request permission from your parent to talk to his physician yourself. (Under patient privacy laws, a physician can't disclose information about a patient's health without written permission from the patient, unless the person requesting the information has power of attorney.) If the physician shares your concern, she may be willing to talk to your parent herself. If this doesn't work, you can contact your local Department of Motor Vehicles (DMV) and, if possible, anonymously issue a safety complaint.
The DMV routinely gives older drivers driving and written tests as a requirement for license renewal. If your parent fails such tests, his license can be suspended or revoked. In some cases, the DMV puts restrictions on an elderly person's license, forbidding him to drive after dark or on the highway, usually because of vision problems. If the DMV receives a complaint about an elderly driver, either from a private citizen, a police officer, or a physician, the driver will be asked to submit to a medical evaluation. Depending on the results of that evaluation and further investigation and evaluation by the DMV, the elderly driver's license may be restricted, suspended, or revoked.
Dementia. If your parent has dementia, the driving issue is even more urgent. The effects and progress of dementia can be subtle, but they can also have a corrosive effect on decision making and good judgment. A person with dementia may believe that he can drive safely and insist on doing so, no matter how badly impaired he is. For these reasons, if your parent is diagnosed with dementia, he should receive a driving safety evaluation from the DMV. Some people with mild dementia can continue to drive, but if dementia is moderate to severe, the individual should stop driving altogether.
Be there. Wherever your parents are on the driving continuum -- whether they're still driving, driving with restrictions, or must give up driving altogether -- you can play a valuable role. Most elderly parents dread giving up their car because they fear that it will cut them off from their community and activities they enjoy. Your loving, active participation in their lives will reassure them that ceasing to drive doesn't have to sentence them to isolation and boredom. Make it a habit to check in on your parents often, just to chat or share some news. Offer to drive them to the activities they enjoy when you can -- or help find someone who can. Include them in family outings, like your children's school events or a day at the beach. Encourage them to try taking the bus on their next trip to the pharmacy, or to walk, if it isn't too far away, and offer to go with them if you can. Urge them to ask for rides from friends and to reciprocate themselves. Help them develop new routines and interests that don't require driving, like gardening, walking, or swimming at the local pool. Your support and involvement in their lives will make giving up the car a far less lonely and frightening prospect.