• Is It Time to Stop Driving?

    IMAGE Mary G., 72, was the primary caretaker and chauffeur for her 78-year-old husband who suffered from declining vision and heart problems. Although Mary was in excellent physical and mental health, she started having small fender-benders on a fairly regular basis.
    Mary's family soon noticed the dents and scratches on her car and suggested she have her reflexes tested. When the tests showed some decline in responses, they discussed how she might get along without a car. Mary and her husband decided to sell their suburban house and take an apartment in the city, which offered more public transportation options. It turned out to be a wise decision. Mary's family worked downtown, and they even came to visit Mary and her husband more frequently.
    "Giving up driving for a senior citizen is a major event, almost like when a person first gets a license," says Scott Spier, MD, chief of the Division of Psychiatry at Mercy Medical Center in Baltimore, Maryland. It represents a loss of mobility, which leads to a sense that independence, competence, and well-being are compromised.

    Knowing When to Hang Up the Keys

    Are you concerned about your own driving ability or your loved one's ability? Barbara L. Spreitzer-Berent, gerontologist and president of Quest Learning Resources in Detroit, Michigan, offers these questions as way to start evaluating driving skills:
    • Has there been a pattern of close calls, violations, or minor collisions?
    • Do you have trouble spotting pedestrians, signs, or other objects?
    • Are you surprised by passing cars or do you brake harder than normal for hazards, stop signs, or stopped traffic?
    • Have you gone through red lights or stop signs? Have you backed into or over things or run into curbs?
    • Are you having trouble coordinating hand and foot movements?
    • Is the glare of oncoming headlights causing more discomfort?
    • Do you have trouble turning your head, neck, and shoulders as you back up?
    • Are you more nervous behind the wheel?
    • Do you experience increased anger or frustration while in the car?
    • Are you quickly fatigued from driving?
    • Do you lose your way, even in your own neighborhood?
    • Do you get lost or make poor or slow decisions in traffic?
    • Have you ever hit the accelerator instead of the brake?
    • Are other drivers honking, tailgating, or passing you aggressively?
    • Do you take medicine that may impair your driving? (If you are not sure if the medicine affects your driving ability, talk to your doctor or pharmacist.)
    Too many "yes" answers could mean that you or your loved one may not be able to handle the vehicle in an emergency situation. Experts also say it is not a good idea to rely solely on the state testing agency that tests drivers and issues driver's licenses. If a driver has reflex problems, he may be able to squeak by and still pass the test.

    Checking Driving Ability

    To get a better idea of driving skills, rehabilitation centers and insurance companies offer tests that objectively rate driving ability. Moreover, some senior centers, hospitals, retirement communities, and civic organizations offer driver improvement programs for seniors who never really learned good motoring habits—but are perfectly capable of doing so.
    The primary care doctor can also let you or your loved one know when it is time to think about giving up the car. The doctor will consider muscle strength, eye sight, reflexes, and general overall health, along with questions about close calls in traffic.

    Talking to Your Loved One

    "When a relative notices the senior's car is chronically bumped and dented, it may be a good time to gently inquire about his driving skills," Dr. Spier says. But the best way to approach the topic, according to Spreitzer-Berent, is tactfully. Do not just blurt out: "You're 87 years old, Dad. You're just too old to drive anymore!" Instead, try: "Dad, I'm a little worried. I noticed a lot of new dents and scratches on your car. What's been happening?" You may even find that Dad is relieved to talk about it.
    If early symptoms of Alzheimer's disease or dementia become evident, Dr. Spier suggests it may be kinder to hide the car keys or even disconnect the battery so the car cannot start. It may also be helpful to get a letter from the doctor, stating that your loved one should not drive for safety reasons.

    Getting Around Without a Car

    Buses, taxis, and vans operated by senior citizen centers, hospitals, municipal transportation systems, and retirement centers are very helpful. Many seniors also count on family and friends for rides. Dena S., a woman who stopped driving about two years ago has a standing "date" with her 25-year-old granddaughter.
    "She picks me up on Saturday mornings and I have a list of errands that I need to do. We finish up around noon and I take her to lunch. It gives us an opportunity to catch up on family gossip, her life, and it makes me feel young again."
    For seniors on a fixed income, giving up the car is also cost effective. "When you add up all the costs associated with owning your own car, it is usually much more cost-effective to take a taxi," says Dr. Spier.

    Staying Flexible

    Not all seniors need to give up driving, though! "Numerous national studies paint a more positive picture of mature drivers than many expect," says Spreitzer-Berent. The AAA Foundation for Safety points out that age should never be used as the main reason why a person needs to give up driving. A range of other factors, like vision, hearing, and reflexes, should be taken into consideration.
    And if you or a loved one does have the skills to continue driving, try these exercises from AAA to help improve flexibility:

    Chin Extension Exercise

    • Keep head facing forward. Bend your head forward, touching chin on chest.
    • Bring head back to center. Tilt head backwards as far as comfortable.
    • Repeat five times in each direction.

    Neck Rotation Exercise

    • Turn neck as far right as comfortable.
    • Turn neck as far left as comfortable.
    • Repeat five times in each direction.

    Trunk Rotation

    • While sitting, turn your trunk as far right as comfortable. Twist at the waist. Try not to move your hips.
    • Repeat the same action, but turn to the left.
    • Repeat five times in each direction.
    Do not do these exercises if you feel discomfort. Use your judgment. The important thing is to recognize your individual needs as muscles, reflexes, and attention span gradually slow down with the aging process.
    Do not do these exercises if you feel discomfort. Use your judgment. The important thing is to recognize your individual needs as muscles, reflexes, and attention span gradually slow down with the aging process.

    RESOURCES

    AAA Foundation for Safety http://www.aaafoundation.org/

    AARP http://www.aarp.org/

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca/

    Ontario Ministry of Transportation http://www.mto.gov.on.ca/

    References

    Alzheimer's: when to stop driving. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/alzheimers/HO00046. Updated June 24, 2010. Accessed July 18, 2011.

    Drivers 65 plus: check your own performance. AAA Foundation for Traffic Safety website. Available at: http://www.aaafoundation.org/pdf/driver55.pdf. Accessed July 18, 2011.

    How's my driving? Michigan.gov website. Available at: http://www.michigan.gov/documents/ElderlyDriving%5F0909%5F84709%5F7.pdf. Accessed July 18, 2011.

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