Last month I wrote about liability risk related to adult children. This month I’m writing about the other side of the age spectrum: older loved ones who are affected by age-related physical or cognitive impairment and still driving. It’s a difficult issue so I thought the best way to address it would be head-on.
Earning a driver’s license and keys to a car are benchmarks in life representing independence and control. So it’s no surprise the idea of giving up that control in old age is maddening for most people. Yet the risk is very real: older drivers affected by age-related impairments can hurt themselves and others. Obviously they will be liable for damages if at fault, and if their medical history comes to light, they can be potentially held liable even if not at fault.
Anyone who drives needs the right insurance and right limits, but insurance isn’t the solution to this problem. They need to stop driving but far too many children or spouses don’t want to offend or hurt their loved one by keeping them from doing it.
To provide some expert insight into this difficult issue, I spoke with my friend and expert Kae Hammond for some help. Kae is founder and president of La Quinta-based Dementia Help Center and author of Pathways: A Guidebook for Dementia & Alzheimer’s Family Caregivers. If you are dealing with related issues, I highly recommend you buy Kae’s book (available at Amazon.com), and if you want further help, Kae’s contact information is listed at the bottom of this page.
Kae, how do we recognize it’s time for someone to stop driving? Are there unambiguous danger signs, or do we simply depend on the DMV?
Alzheimer’s and dementias effect more than cognitive abilities (e.g. memory). Vision, balance and reason are impacted as well. One must be very observant in assessing an individual’s level of functioning by closely watching their daily behavior outside of an automobile. Here are some signs that a person no longer has the necessary skills to drive safely. They:
- Have become less coordinated
- Have difficulty judging distance and space
- Get lost or feel disoriented in familiar places
- Have difficulty engaging in multiple tasks
- Are less alert to things happening around them
- Have difficulty processing information
- Have difficulty with decision-making and problem solving.
To be a safe driver, an individual needs to be capable in all these areas. Waiting for a license renewal date with the DMV may keep an unsafe driver on the road far too long.
How do we effectively give this message to someone without resulting in a defensive reaction? Or do we simply snatch up the keys?
That’s the million-dollar question and the one that distresses family members greatly. The person with declining cognition is very aware of their increasing limits. Honesty is important in this critical area; honesty infused with kindness and compassion. You may be surprised by how grateful they are to have the conversation and they will thank you for relieving them the burden of ‘keeping up appearances’. In other cases, they are angry for the circumstances that are bringing about their life changes and hate the idea of losing the sense of independence having car keys represents.
Acknowledging their feelings is paramount; agree this is all tragic. Reassuring them of your total support, including flexible and reliable alternative transportation arrangements, will help greatly.
Here are some other proven strategies to consider:
Level with the driver about their liability in the event of an accident. Once someone is diagnosed with any memory loss, they are liable for damages in the event they are at fault in an accident, and maybe even if they are not at fault. I’ve had several clients successful employ this tactic. They correctly note ‘they haven’t worked this hard all their lives to have it all lost due to the stubbornness of driving impaired.”
Another strategy is to have the primary physician write a prescription saying they can’t drive while on a certain medication; copy this Rx and keep it in an easily accessible place to remind them.
Again, depending on the individual’s state of health and mental capacity, you can switch the keys for ones that ‘look right’ but don’t work or physically move their car to another location to satisfy the “out-of-sight, out-of-mind” issue.
Use law as your ally backed by your physician. California Health & Safety Code (Section 103900) requires physicians to submit a confidential report to the county health department when an individual is diagnosed as having Alzheimer’s or related disorders. This information is forwarded to the DMV who will notify the driver of this physician-submitted report and require them to take a 3-part examination that includes a visual test, written test and interview. Based on the results of this process, their license may have restrictions applied, or be suspended or revoked. In this case, the doctor and/or DMV are the ‘bad guys’.
What resources are available to help a caregiver with this and other issues relating to dementia and aging?
When a family is faced with the diagnosis of Alzheimer’s or another form of dementia, it’s traumatic and life altering. And being the family caregiver/partner is a daunting, 24/7 all-consuming role. Your greatest ally will be accurate knowledge that includes an in-depth understanding about the disease you’re dealing with: patterns, characteristics, behaviors and how to manage it all.
The National Institute of Health (NIH) is an excellent disease-specific resource with a user-friendly website. Call upon national associations dedicated to Alzheimer’s, Lewy Body and Parkinson’, for their support, resources and programs.
I wrote Pathways: A Guidebook for Dementia & Alzheimer’s Family Caregivers and then created Dementia Help Center as the direct result of my family’s trials and tribulations with Alzheimer’s. I learned, first hand, it’s what you don’t know that you don’t know that costs you time, energy, money and pain. As prevalent as these diseases have become, there are very limited full-service options that can provide a comprehensive roadmap for families.
With solid, evidence-based expertise in caring for those with Alzheimer’s and related dementias, every member of our team has walked in your shoes. We are an objective, impartial sounding board and provide expert counsel for both short- and long-term needs. Our services include coaching/consulting, family facilitating, advocacy, and workshops, planning strategy, placement and care management.
Kae Hammond is founder and president of Dementia Help Center; author of Pathways: A Guidebook for Dementia & Alzheimer’s Family Caregivers and host of “Care for the Family Caregiver” on 95.9FM The Oasis, every Sunday at 7AM. She is a national speaker, workshop leader and National Alzheimer’s Association certified support group facilitator. For more information, call (877) 699-3456 or visit www.dementiahelpcenter.com.