According to AAA, there are signs you start to notice. There are more dings and scratches on the car. Your mom or dad is getting pulled over more and getting more tickets. They get lost on routes that are routine and familiar. They get honked at by other drivers. They get confused and disoriented while behind the wheel.
'Not a single one of those warning signs is necessarily a trigger, but the more you see, the more your dad should be reviewed by a health care professional,' said Jacob Nelson, the director of Traffic Safety Advocacy & Research with AAA. '[These signs] should serve as a wake-up call for all of us. If we're concerned about Mom or Dad, we have a legal obligation to do something about it.'
It all comes down to knowing when it's time to ask your mom or dad to give up the keys. Having that conversation is not easy. Nelson says it helps if you start talking about it sooner than later. November is Alzheimer's Awareness Month and while the need for dementia care or Alzheimer's care is not the sole reason to ask a loved one to stop driving, this month is a good reminder to have that talk.
'The earlier this conversation happens, the better,' he said. 'Hey Mom and Dad, you're fine right now, but can we talk a little bit about how you'd like to handle the situation in the future?' That way, Mom and Dad can contribute to that plan and they play a role in how the situation will be handled.'
Some people don't have that opportunity and need to have the talk about driving with their loved one without the benefit of preplanning. Nelson says the family should select a spokesperson -- one person to approach them.
'It should not be an intervention. You don't want the whole family to gang up on Mom or Dad,' he said.
He also says you want to drive with them ahead of time and take mental notes. That way you can stick to the facts during a conversation that is awkward for both sides.
'Remember to always keep the conversation on mobility. 'How can we keep you going to the places you need to go, but do so in a way that may or may not include driving?' Nelson said. 'If the focus is not on stripping independence away from that person, it's much easier to have.'
An adult child may also not have the answers. They don't know how to handle the added responsibility of having to shuttle Mom and Dad around. Or they may live farther away and simply aren't close enough to help regularly. Nelson says you should look around and find out what resources are available.
'You need to do your homework in advance so you can lay out what the options are for Mom and Dad,' he said. 'Comparing costs sometimes makes it somewhat easier. 'It can save $5,000 to $10,000 a year if I don't drive anymore,' Nelson said. In the end, you should focus on safety and that's how adult children can talk about it. 'You could not only hurt yourself, but you could hurt other people. What happens if you hurt someone else and they sue you? That could destroy you financially. We want to protect you and protect your retirement,' he said. 'But also for the caregiver, it's important to know that if you know and you don't do anything about it, you could be held liable. You could be sued.'
Sometimes involving a doctor helps. That's what Steve Gordon had to do with his mother.
'My mom was 85 and had early phases of Alzheimer's. With her increased short-term memory loss and bouts of confusion, it was clear she shouldn't be driving any more. My dad was 87 and was still good at getting around inside of his small area of town, but he had completely lost perspective on my mom's ability to drive. He just assumed 'someone' would tell them when she should no longer be capable of driving. That spurred my idea. I called my mom's doctor and asked him to write something that looked like a medical order taking my mom's driver's license away. The doctor was happy to do it. He receives requests like this quite a bit, especially from that older age group that will never question a doctor's order,' Gordon said.
A study published in the New England Journal of Medicine out of Canada found evidence that doctors can have a heavy influence on older drivers deciding whether or not they should hand over the keys.
Nelson agrees that tactic can help many families. 'We want people to talk to their doctors about their fitness to drive, and it some cases it will be a pretty obvious decision,' he said.
Nelson says the more people involved in the conversation, the more it can help That includes a local pharmacist, who knows what medications an elderly person is taking that can make it dangerous to drive, the family doctor, an occupational or physical therapist, or another medical professional.
'The more folks that can be involved in monitoring the health status of an older individual, the better off it will be,' Nelson said.
The problem isn't always so obvious.
'Older adults are among the safest group out there,' Nelson said. 'They tend to do an excellent job at limiting their driving to what's comfortable.'
Nelson says are the least likely to speed and are also excellent at self-regulating and self-policing their driving habits. They also avoid driving at high traffic times and don't take unfamiliar routes.
'However, there are older adult drivers who have a medical condition or take medications to treat a medical condition and those are the ones causing the traffic accidents,' Nelson said.
Nelson says older drivers are also among the most vulnerable. Because of their age, they are less able to withstand the forces a crash has on their frail bodies. If they do survive, it is harder for them to recover. They often have underlying medical conditions like a heart or lung disease that make it harder for the body to recover from a major trauma. The injuries they suffer in a crash can often exacerbate that condition and transform it into something much more life threatening.
'Older people are more likely to be killed in car crashes, but that doesn't have anything to do with their performance behind the wheel it has everything to do with their health status, their fragility,' Nelson said. 'There is a need for caregivers of older adult drivers to work with them, to plan ahead to the day where they may need to stop driving.
' Many states across the U.S. are putting regulations into place that requires more frequent testing of elderly drivers. However, there is not one law that covers the entire country.
'We don't necessarily think that there is a one-size-fits-all solution,' Nelson said. 'It's going to be different for everyone.'
Nelson says it's better to focus on the medical complications a person might have. For example, diabetes can affect driving. Additionally, a person who experiences seizures, or a person with dementia may want to stop getting behind the wheel.
'If my mom or dad were diagnosed with dementia, there's no longer a question of if they need to stop driving someday, it's a question of when,' he said.
AAA hopes states that require more testing start using more detailed questions. Not: 'Does your diabetes hinder your ability to drive?' but 'Do you have this disease?' That information then can get in front of a medical review board that can make a more informed judgment.
'It's easier to trigger additional testing, but only for those people who need it,' Nelson said. 'This isn't about getting older people off the road, it's about maintaining safety.'
