When to Ask for the Keys to the Car

Car driving is a lifeline for many seniors.  It is the basis for their independence allowing them to visit friends and family, access areas of activity such as shopping and participate in activities in the community — until such freedom risks their lives and others’.

When mobility issues interfere with driving the risks increase.  Add declining cognitive, vision and hearing issues to the mix and the risks multiply.  At that point, it is critical to get a professional assessment of driving skills.  Then the difficult decisions can be made around how much time, if any, a senior should be on the road.

The idea of age being the determinate of driving ability should be set aside.  Permission to drive should be based on ability, not age.  Too often family members are uncomfortable with an elderly person driving instead of ascertaining whether the elderly person is an unsafe driver.

And often adult children do not have the courage to address this issue honestly.  They will go to the elder’s physician and say, “Tell Dad that he can’t drive anymore” without any factual basis.  Older people are, generally, safe drivers.  At the very least, they are experienced.  Bullying them into giving up the keys can have devastating psychological impacts.

Rather than having a family member arbitrarily shut down driving, a better approach is to have a professional third party assess the driving fitness of the driver in question.  The assessment should go beyond the actual driving skills but include ancillary questions relating to vision, hearing, arthritis and other questions of physical ability.  If physical factors impair driving and are made clear to the senior in question, it is more likely that he or she will give up the keys more willingly.  It allows the senior to have a greater say in the decision.

In cases of a medical event like a stroke, it is often best to establish a driving hiatus or “vacation” until the longer-term effects of the event have been determined.  Then return the keys only after they have been cleared by a medical professional and have completed driving competency tests.

Another approach is using the clinical frailty scale, an assessment of a senior’s strength, fitness and ability to perform daily tasks, to make a judgment call.  The tool can help determine how physically fit a person is to drive.

Finally, before taking the keys away, a negotiated middle ground may be the answer.  For example, limit driving to daylight hours or secondary roads rather than expressways.

Driving for seniors is a source of pride and freedom.  When taken away, it can have profound impacts on mental health and overall happiness.  When that step is necessary, reasonable replacement measures are necessary to keep the whole family happy.

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