When to take the keys from elderly drivers

You’ll always be their child, and they’ll always be your parent.

But at some point, in many families, the tables begin to turn. Children become caregivers for their parents.

In the complex, sometimes frustrating or painful world of family caregiving, one especially touchy subject can be when to tell Mom or Dad they can’t drive any longer.

And, when it comes to driving, you may get into a power struggle.

Here’s what to keep in mind:

Keep an eye on loved ones to spot potential problems early

Driving is crucial to independence, and most people are very resistant to anyone taking away their independence.

What makes it especially hard for families is that some people with early dementia are safe to drive.

When this happens, it’s tough for families and physicians to decide who has reached that point of being a danger to themselves or others on the road.

You’re not alone. Here’s where to find help

The National Highway Transportation and Safety Administration has an excellent guide for families and for physicians to help them make this determination.

Office tests that primary care physicians use have cutoffs, and those scoring below the cutoff are clearly unsafe to drive.

Test driving abilities in a clinical setting using the 4-Turn Test.

The 4-Turn Test, developed at The Ohio State University Wexner Medical Center, consists of having the patient follow the examiner along a short course in the clinic.

The course arrives at four separate intersections where the individual is told to turn right or left, for four total turns; twice to the right and twice to the left.

The patient is provided visual clues at each intersection to remind them where to make a turn. They’re then brought back to the starting point and asked to lead the way along the same path.

One study shows that, of the mild Alzheimer’s disease individuals who went in the wrong direction, 88% failed a behind-the-wheel assessment by a professional driving instructor. Of those making all four turns correctly, 92% passed the driver evaluation.

Get your loved one a driving evaluation

There are also centers devoted to testing elderly drivers to see if they’re safe, such as Ohio State’s Occupational Therapy Driver Rehabilitation Program.

Our program provides driving evaluation and skill development services for older drivers, including those with

• Early-onset dementia
• Alzheimer’s disease
• Parkinson’s disease

What to look for when you’re trying to assess a loved one’s driving skills

• Have a family member ride with or follow the individual at least once a month to evaluate for impaired driving judgment issues.
• Monitor the mileage on the car. If the mileage is longer than the short trips they’re taking, it could mean they’re getting lost.
• Look for any new dents or scrapes on the car, as this can show that there is trouble when driving.

Ways to ease into this transition

For many families, this is an extremely difficult conversation to start with a parent or grandparent.

Unsafe driving jeopardizes the safety of others.

One way is to briefly try to get the older driver to agree it’s unsafe for others on the road and, if they want to avoid hurting others, they should voluntarily stop driving. If they won’t, then talk to their doctor.

Get a doctor’s prescription.

One way a doctor can help is to write a prescription that tells the patient to “temporarily stop driving.” The doctor can explain that, while the patient is being evaluated or while a new medication is being tested, it’s best to hold off driving temporarily.

The last resort.

Families can also make driving impossible by hiding keys, disabling the car or even selling the car. If the situation is bad enough and the family won’t or can’t do these things, a doctor should send a letter to the state motor vehicles bureau informing authorities that the patient is an unsafe driver.

Make a plan and involve your loved one

Multiple studies agree that a medical recommendation for driving retirement has a strong correlation with depression. It can be helpful to work programs such as Ohio State’s Occupational Therapy Driver Rehabilitation Program to develop a “driving retirement plan” prior to stopping driving.

Studies have shown there’s a steep reduction in the incidence of depression if the patient is involved in the planning transition process, and a transportation plan is in place prior to the recommendation.

Families often are afraid to be the “bad guys,” even though this is truly the only safe option.

Remember that taking the tough action with Mom or Dad now is far better than dealing with the consequences of an accident due to unsafe driving later.