Health & Wellness

Dad, can you drive? Knowing when an elderly parent needs to stop

More than 40 million Americans will be driving this Thanksgiving to spend the holiday with friends and family. Many adult children will be worrying about whether mom or dad is going to arrive safely.

How do we know when it's time to take the car keys away from elderly parents? Worries about older relatives driving spike around the holidays, says Jake Nelson, director of traffic safety advocacy and research for AAA. But age alone doesn't make a driver unsafe.

Today
Age alone isn't the only risk factor for driving.

“Seniors as a whole are the safest age group on the road, the least likely to speed, the least likely to drink and drive, and the most likely to use seat belts,” says Nelson.

The at-fault crash rate doesn’t start significantly increasing until people are in their mid-70s, he says, and even drivers in their 80s have crash rates about half that of teenagers.

Medical conditions and how well those conditions are managed should determine driving fitness for an older person, says Nelson.

“My mom was about 83 when we first started having concerns,” says Jim DeSimone of Wyckoff, New Jersey. “She had a heart condition and she was getting dizzy spells, and I was afraid that she would have an episode while she was behind the wheel.”  

So DeSimone began a series of discussions with his mom about the possibility of giving up her car.

Twenty-eight states and the District of Columbia have special license requirements for the elderly, from vision testing to more frequent renewals. But even those extra steps might not capture problem driving. 

Instead, the holiday get-together can be a good time for children to make their own assessment. 

It’s not always obvious when a senior driver is a danger on the road. “You need to sit in the car with your parent and drive around with them,” says Adrienne Gruberg, the founder and president of The Caregiver Space, a non-profit supporting caregivers.  

Some questions to consider. Does he or she: 

  • Drive below or above the posted speed limit
  • Appear disoriented
  • Get honked at a lot
  • Have trouble seeing traffic signals

According to the AARP, signs that it's time to stop driving include: 

  • Almost crashing, frequent close calls
  • Getting lost, especially in familiar locations
  • Trouble following traffic signals, road signs and pavement markings
  • Slow response time
  • Becoming easily distracted or difficulty concentrating
  • For more warning signs go to AARP

The driving discussion should never be a confrontation, says Nelson.  

Instead, Nelson suggests beginning with: "Mom or Dad, if or when you can no longer drive, how do we keep you mobile, how do you get around?" 

Also, come up with alternatives before approaching a parent. For seniors who can afford it, that could mean a taxi service or Uber. For those on a budget, options include public transportation, volunteer drivers and government ride programs for seniors. AAA maintains a website, searchable by zip code, for alternative transportation options

That’s the approach DeSimone took with his mom. He and his three sisters live close by. They divvyed up driving responsibilities for shopping, errands and doctors appointments. When DeSimone showed that to his mom, she agreed that driving herself was probably no longer a good idea.

“Once she realized that she wasn’t going to suffer by not having the car because we would be taking her everywhere she needed to go, she stopped giving me any argument at all,” says DeSimone. “Her biggest fear had been being trapped in the house.”

If there's resistance, it might be time to enlist the help of the parent’s doctor.

“The doctor has the right to write to the state licensing agency expressing his concerns about the continued driving of the parent, and the state has a right to revoke the license,” says Gruberg.  

But, again, don't go to the doctor without talking with the elderly driver first. 

“It can seem hostile to bypass the conversation and go directly to the doctor, and it can damage the relationship between children and the parent,” she warns.

Sometimes, help is all that's needed. Maybe it’s simply a matter of making adjustments to the car itself. AAA runs free Car Fit events across the country, where anyone can show up with a car to have staff run through a 12-point checklist to properly adjust car seats and mirrors. 

Or an elderly parent might benefit from additional training. 

Melissa Dappen is the senior occupational therapist at Rush University Medical Center’s Driving Rehabilitation Program in Chicago. Doctors refer elderly drivers to Dappen’s program, often at the initiation of concerned family members. She, along with a driving instructor, will evaluate the senior’s driving abilities in a specially equipped car with two sets of brakes. They’ll take them on local roads, to commercial districts, and even on the expressway, if Dappen feels it is safe.

“The problems I see most commonly are not picking up on cues in the environment,” says Dappen.

That can mean not understanding that when the "walk sign" is counting down near zero that the traffic light is about to turn yellow.  

“Or they may be paying attention to the car in front of them that is changing lanes but may not notice that they themselves are drifting into the other lane," says Dappen.

Many times, she can offer on-the-road training, working with seniors on such strategies as scanning the environment and expanding the stopping distance behind another car. She can talk with the family about cutting down on distractions, “like a spouse constantly talking in the passenger seat,” she says. She can help adjust the car seat and mirrors.

Many other hospitals around the country have similar programs. Government and private insurance does not cover this training, which can run anywhere from $300 to $600.

“It is important to identify problems early because we can start teaching the older adults strategies early on, and it can become more of a routine for them,” says Dappen.

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