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Should your loved one be driving?

Senior Driving

Should your loved one be driving?

Should your loved one be driving?  If your answer is they shouldn’t, what can you do?

One of the biggest issues we see working with families and our own personal experience is the senior’s driving ability.  As we age, naturally our driving ability is negatively impacted.  At some point, it’s time to give up driving because the person poses a safety problem to not only themselves but to others if they continue to drive.

The solution?  Simple in action but a nightmare in execution.  Ask them to turn over the car keys.  The typical answer is NO.  Not going to happen.  Why? Losing independence.  They no longer can go where they want to and when they want to.   I get it. I myself would have a problem with giving up the keys.

So, what can you do?  Well, one thing not to do is to just drop it.  Sooner or later an accident could happen, so the goal is to try to avoid this situation as best you can.  From my own experience, the “son talking to Mom” route is a bit problematic.  The best course of action is to get help from professionals such as the DMV and the primary physician and or eye doctor.  I’ve talked to doctors and spoken to the North Carolina DMV.  

To kick off this blog, I’ll describe what I learned and hopefully those of you reviewing the blog can use this information and share your experiences:

1. If you are concerned about someone’s driving, submit a “Medical Request for Driver Re‐examination.” In North Carolina, any family member or close personal friend can submit this form and initiate a driving re-examination.  I thought only a doctor could do this.  Not true.  Anyone can make this request by submitting the form to the DMV.  The URL on the NC DMV site is http://www.ncdot.gov/dmv/forms/.  Scroll down to the Medical Evaluation Program section.  You can download the form “Medical Request for Driver Re-examination”.    You will see on the form you must indicate if you are a:

a. Physician
b. Eye Specialist
c. Other

If you are a family member, you would select the “Other” option.  The DMV will ask you to note your affiliation with the person (i.e. Son, Daughter, Friend of Family, etc.) The correct fax number to submit is 919-861-3284 or you can mail it.  I strongly recommend that you talk to the loved one about this so that they know it is coming.  It’s a tough decision, but in my opinion, the correct one.  If your loved once can truly drive then it’s okay to get a professional verification. 

2. Once the form is submitted and received by the DMV, a formal letter will be sent to the person you have designated on the form called “Special Examination”.  The DMV stipulates the person in receipt of the special examination letter has 30 days to go to the DMV to meet with a driving examiner for a driving examination.  If the examinee does not comply, the DMV will suspend their license, designated as a medical cancellation.  If they try to drive with the medical cancellation in effect, they run the risk of having their license being taken away indefinitely.

3. Let’s say your loved one does go to the DMV with the special examination form.  A driving license examiner will be assigned and meet with the senior.  The driving license examiner will determine the depth of the re-examination.  Depending on the judgment of the examiner, they may ask the senior to take only the written test, take only the driving test, or possibly both.  The examiner has the authority to take the license away on the spot.  However, this is the exception rather than the rule.   The DMV often requires the senior to meet with their primary physician and fill out a medical report.  The report can be found on the DMV web site and is called “Medical Report Form DL-78”.  The senior designates the physician who will review their physical condition.  The DMV requires that they have 12 weeks from the meeting with the examiner to complete the Medical Report Form.  If they don’t comply, their license is suspended after 12 weeks.

4. The senior meets with the physician.  The physician has the authority to determine if the senior should be able to continue to drive.  If the physician believes the senior should or shouldn’t be permitted to drive, they complete the form and indicate as such.  The physician then sends this form to the DMV.  Once the DMV receives the form and it says the senior should not drive by physician’s order, their license will be suspended.

I encourage you all to call the DMV to confirm the steps I’ve described above.  It was very enlightening and empowering to know that anyone can initiate a re-examination of driving skills process.  My next step is to call the NY DMV where my Mom resides to understand if a similar process exists.

Okay, so you win this battle.  The logical questions from the senior are “Now what?  How can I get around?"  This is where your research and knowledge of transportation options needs to be done ahead of time.   Thinking locally here in Raleigh and Cary here are some thoughts:

1. Home Care Agency – Agencies like ours have driving as a key service.  When we work with a family, we identify transportation needs and try to organize a weekly schedule to help our seniors get to appointments, events, grocery shopping etc.  We recently emphasized this service with our Facebook Ad “Trial Home Care: Leave the driving to us”.

2. Resources for seniors – On page 72 of the 2015 Resources for Seniors directory is a listing of various low cost transportation options for seniors.  TRACS (Raleigh) and C-Tran (Cary) are two popular public transportation options to check out. The directory can be downloaded at their site.  Visit our site and you can download the directory directly and visit the Resources for Seniors Site http://www.awareseniorcare.com/resources

3. Church and Community groups – Many times local groups, organizations and Churches have transportation support groups

4. Cab service – the easiest but the most costly but it’s always an option

Give Me the Keys, Please (This section courtesy of Sandi)

Being the caregiver of a parent creates new challenges daily. Slowly, the parent becomes the child and the child becomes the parent. And neither are happy. The parent resists help and direction from the person they used to tuck into bed at night and had to leave a night light on for. While adult children often experience a combination of resentment of the responsibility they have to assume as well as the fear of their parents anger towards them and the changing roles. In no situation is this more front and center than when a child has to finally take the car keys from a parent or a loved one with dementia.

The surrender of the car keys is often perceived as the end of the line where independence is concerned. The fact that the person with dementia may have had a number of fender benders, get lost regularly and lose their car in parking lots frequently is of no concern to them. Giving up the keys means being at the mercy of others. Those in possession of their car and keys will fight to keep them.
Fortunately for me, I never experienced this aspect of caregiving with my mother because she never learned to drive. Which was a hassle growing up, but a relief as a grown up.
I have absolutely no advice on how to take the keys away from an Alzheimer’s/dementia patient who is not on board with your observances of their driving. I do, however, have five compelling reasons for taking the keys away. (You may also want to remove the car from the premises as well. You never know when extra sets of keys may be lurking within their reach.)

According to Georgia Regent’s University 1st Alzheimer’s Symposium, 207 drivers have been lost over the past ten years. Out of those 207 drivers:
·         32 were found dead
·         116 were found alive, but 35 of those were injured
·         The main cause of death was drowning or exposure

But even worse, was:
·         70 of those drivers have never been found.

In other words, 70 families and countless loved ones have no closure; have no idea of the fate of the person missing; and in reality, will probably never know. No viewing, no obituary, no funeral. And what kind of condolence cards do you send someone who is living this nightmare? There are no words for it.

I cannot imagine living with the question eternally in my mind about the fate of a parent, spouse or sibling.

Ask others who have had to take this step with an Alzheimer’s/dementia patient. (One woman in my support group had the car “stolen” in the middle of the night. She asked for help from local police and staged a police report. Then she just kept doing the driving until her husband assumed this had always been normal for them.) In spite of all the advice you may receive on how to accomplish this, one day it will simply need to be done.
In all likelihood it will not be a pleasant experience. But you will sleep better at night knowing where they are and not wondering where they are.

Transportation is a key item to address for living well at home.  Our experience has been to work with the family to make them aware of the options and implement a combination of options if the senior is unable to drive.  We position the plan as “Assisted independence”.  If the senior can still go when they want to go, driving themselves or not, I believe this is a successful solution.

Please share your experiences with you loved one’s helping them give up the keys.  What’s worked?

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