Caregiver Connection: The Driving Conversation

Many caregivers dread the day they will have to tell their parents that it’s no longer safe for them to drive.  Many people equate their ability to drive with their independence, and are very resistant to “retiring” from driving.

Difficult though it may be, the reality is that changes due to Alzheimer’s significantly impair a person’s ability to drive safely.  Consider the following driving behaviors that are typical of people with dementia.

Early Warning Signs:

* Incorrect signaling                              * Trouble navigating turns
Misjudging distance                           * Moving into a wrong lane
* Confusion at exits                               * Parking inappropriately
* Hitting curbs                                        * Driving at inappropriate speeds
* Delayed responses                              * Not anticipating danger
* Increased agitation                             Scrapes or dents on car
* Getting lost in familiar places           * Near misses
Failing to observe traffic signs         * Car accidents
* Confusing the brake / gas pedals    * Stopping in traffic

If you have observed any of these warning signs, it may be time to begin the transition to “driving retirement.”  Here are some tips for making the transition a smooth one.

Reduce the Need to Drive:

An Alzheimer’s diagnosis doesn’t mean the person must stop driving immediately; if the person is not a risk to himself/herself or others, driving is best reduced over time rather than all at once. Some people with dementia are better able to adjust to not driving if others gradually assume more of the driving responsibilities.

* Arrange to have prescription medicines, groceries, and meals delivered.
* Have hairdressers make home visits.
* Schedule people to visit regularly.
* Arrange for friends to take the person on errands or to social or religious events.

Who Should Deliver the News?

When it’s time to share concerns about a person’s ability to drive safely, you may want to consider having some external authority weigh in on the situation, and reinforce your position.  Depending on the person, they may be receptive to the opinions of:

* Spouses: A Hartford/MIT survey indicates men prefer to hear from a spouse slightly more than do women.
* Doctors: Outside of the family, the opinions of doctors are often valued by older drivers.
* Assessment Programs: St. David’s Rehabilitation Center’s Adaptive Driving Program promotes independence through medically-based driver evaluation and training. Evaluations and training sessions including clinical and behind-the-wheel assessments are performed by a registered occupational therapist. To initiate the driving evaluation, the individual is required to have a physician’s referral and a valid driver’s license. Call:   512-544-5116
* Adult Children: Older drivers tend to be more open to adult children who live nearby. Women are more receptive than men to hearing from adult children.
* Police Officers: Typically, older adults strongly prefer NOT to hear about driving concerns from police officers; however, this might be an option for emergency situations.
*Department of Public Safety: An anonymous letter can be sent to the Department of Public Safety with a strong recommendation that the individual should no longer drive. The phone number to the TDPS is 512-424-2600.
* Insurance Agent: You might have your insurance agent counsel your loved one on the possible costs that the family could be accountable for if the person with a diagnosis of dementia, and a doctor’s recommendation to discontinue driving, caused an accident.

Approaches to Consider:

 *Try having a conversation about driving earlier in the disease process, when the person can have a reasoned conversation about driving, and while the subject is still hypothetical. Draw up a “driving contract,” specifying when certain conditions are met, they’ll retire from driving.

*Reinforce that you want them to be safe, but also remind them that unsafe driving is a danger to others. Suggest they imagine how they would feel if they caused someone else to be seriously hurt.

*Have a conversation about which activities are most important for them to continue to enjoy after they stop driving. Using your care team and the resources below, form a plan for getting them to these activities. Let them know that you will work with them to adapt to this change.

*”You’ve taken care of all of us for so long, please let us take care of you.”

Transportation Alternatives: 

*Drive a Senior – Formerly Faith in Action caregivers, this Central Texas nonprofit serves several counties in the Capital area with senior transportation services. Visit www.driveasenior.org to find the dispatch location nearest you.
* CARTS – Provides transportation in parts of Austin and 9 surrounding counties. Visit www.ridecarts.com to view schedules and coverage areas, or call 800-456-7433 or 512-478-7433.
* Capital Metro MetroAccess – Demand-response, shared ride service for people whose physical or mental impairments prevents them from using regular bus services. Visit www.capmetro.com/metroaccess for information, or call (512) 389-7501 for eligibility criteria
* Groceries To Go – Offered through Meals on Wheels and more, provides volunteers who do grocery shopping for homebound clients in Austin. Call 512-476-6325.
* Medi-Wheels – Also through MOWAM, transporting seniors 55 and older to medical appointments. 512-476-6325.
* Lakeway Service League – Provides transportation services in the Lakeway area Contact: 512-261-3514.
* Area Agency on Aging – 888-622-9111 or 512-916-6062.

Other agencies:
Dept. of State Health Services: Medical Advisory Board for Driver’s Licensing – www.dshs.state.tx.us/emstraumasystems/mabhome.shtm
Physician’s Referral Forms will be sent to DPS: 512-834-6738.
AARP: 888-227-7669 Driver Safety Program, or 800-424-3410, or www.aarp.org.

For other Support Services in your county, contact Alzheimer’s Texas at 512-241-0420.

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