March 10, 2010
We all remember when we got our driver's license. It's one of life's great moments, a giant step toward adulthood.
Decades later comes a related rite of passage that generates considerably less enthusiasm: the day you stop driving.
Most older drivers are aware when that time is approaching. They recognize their diminishing skills; maybe they have a close call or sometimes can't find the way home. Most relinquish their keys or make concessions to age and adjust their driving patterns.
But others, no matter how many times they get lost, blow stop signs or get honked at by fellow motorists, want to keep that grip on the wheel.
"I think most people understand the point when it's unsafe for them to drive," says Moraine Byrne, senior vice president for Covenant Retirement Communities, a nonprofit organization that sponsors the website, havingtheconversation.com.
"They're more often afraid they might hurt someone else. They make the decision on their own or cut way back."
Giving up driving can be difficult. People fear a loss of independence and the ability to participate in longtime activities. They worry about being able to do their shopping, visit friends or keep doctor appointments. All good points, all needing to be addressed during any family discussion.
"Unless there's a real emergency, I recommend the family plan to start the conversation slowly," Byrne suggests. "Ask questions, [don't] come in with a set plan in mind, but come in with an open mind so the parent doesn't feel they're being attacked. You really need to have several conversations, unless there is an emergency situation. You have to have respect for a parent's position."
Jodi Olshevski, a gerontologist and assistant vice president of The Hartford Advance 50 Team, a group of experts on aging that works with the Massachusetts Institute of Technology AgeLab, says that sometimes the conversation should not be about taking away the keys, but about finding ways to encourage safe driving.
"We're trying to promote options for people who are concerned about their driving," she says. "I think that as gerontologists we realize that driving is such an important activity, a link to being independent and a social connection. And all of those things are necessary for an individual to age well."
Before any discussion or decision, it's important to go for a spin with dad or mom to assess his or her driving skills.
"Rather than assume the parent is an unsafe driver, ride with them," Byrne says. "They may be doing much better than you think they are. Age doesn't really have anything to do with this."
Also a good idea: an assessment by a trained occupational therapist.
"There are two parts; it's a pretty in-depth evaluation," explains Olshevski, who says the website safedrivingforalifetime.com has a link to help find an occupational therapist.
"The first part is a clinical assessment, and that includes an evaluation of a person's cognitive abilities, their motor function, just their physical status. The second part involves an on-the-road test, where an occupational therapist gets in the car and observes the driving.
"Once those two pieces are done, the therapist sits down with the driver and talks about what can be done to keep them safe on the road for as long as possible."
When the evidence is in, the family may realize that stopping cold turkey isn't warranted. If a person's skills are only starting to erode, there are alternatives.
Curtail higher-risk driving situations, for example. Recent research from the MIT AgeLab and The Hartford found that 69 percent of drivers older than 75 and 58 percent of those 65 to 74 self-regulate their driving. That means avoiding driving at night or rush hour, taking only familiar routes, limiting trips to a certain distance, and keeping off expressways and highways.
Then there are classes where older drivers can brush up on their skills. AARP (aarp.com) offers a classroom and online course aimed at older drivers.
"I've known several people who have taken it who said it helped them remain focused and helped them to think differently," Byrne says. "I've looked at the course work, and it looks like a tremendous program."
Stress fitness. Research by the National Institute on Aging, published in 2008 in the Journal of General Internal Medicine, suggests that physical conditioning helps maintain the performance of older drivers, decreasing errors by more than a third.
The test subjects participated in an exercise program to improve flexibility, coordination and speed of movement relevant to driving.
Even with those efforts, a driver's deterioration is sometimes unmistakable. Pop cruises the expressway at 25 miles an hour, or pulls into the garage without bothering to open the garage door first.
Problems can also be less obvious. Has pop's insurance rate increased? Has he received recent traffic tickets? Inspect the car; are there fresh and/or unexplained dents? Does driving leave him exhausted or frazzled? Does he take medication that might affect his driving?
In advance of the talk, have a plan to deal with the inevitable changes in your parent's lifestyle. Find out what resources are available, which home-care agencies might provide transportation, whether public transportation is an option, and which family members can help.
"If your parent says, 'OK, let's give up the car, but how am I going to get to the dentist or doctor or church?' you need to find ways so the parent is not isolated," Byrne says.
One last point: The discussion with mom or dad will almost certainly be only an ice-breaker. And that's good.
"As you're having this conversation, it's going to lead to many other conversations," Byrne says.
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