You knew this day would come. You have knots in your stomach because you’re about 99.99% confident it isn’t going to go well. Approaching someone we love and sharing our concerns with them regarding their ability to drive isn’t easy. I can almost guarantee they’re going to remind you that they’ve been driving (insert number of years here) and they are perfectly capable to continue to drive. Taking their keys feels like taking their independence, and no one wants that on their conscience. However, driving cessation can be necessary to ensure safety of both our loved one and all other drivers on the road. Whether the decision to discontinue driving is one they have made themselves or one that has been made for them, it is usually difficult and brings unwanted change into their life. Before I get into the solution to your worries, let’s get a more in depth look at the components involved in this decision. Don’t let the next few paragraphs scare you off – it gets better, I promise.
The Impact of Driving Cessation on Older Adults
A group of researchers, most from Columbia University, organized a 2016 study which examined existing research on the impact of driving cessation on older adults (identified as 55 or older). They found that owning a car and driving were both highly correlated with independence and life satisfaction, which probably comes as no surprise. It is their other findings that I think are most important to consider:
- Driving cessation nearly doubles the risk for depressive symptoms in older adults.
- Driving cessation is associated with poor physical functioning due to less participation in activities outside the home, which are replaced with activities inside the home. These indoor activities do not benefit productivity or physical health such as the previous outside work, volunteerism, or social activities did prior.
- Driving cessation is associated with a gradual reduction in the size of social networks (including friends and relatives) of up to 51% in a 13 year period which is a direct result of decreased availability to or access to alternative transportation.
- In general, former drivers feel a decreased capacity to interact with society. They are likely to replace former social activities with solitary leisure or completely abandon the activities altogether. This type of decline appears to impact women more than men.
- Former drivers present with decreased cognitive abilities per assessment performed using the Mini-Mental State Examination compared to current drivers.
- Older adults who discontinue driving are nearly five times more likely than current drivers to be admitted to long-term care facilities, such as a skilled nursing facility or assisted living facility.
In summary, driving cessation was reported by the study “to be associated with declines in general health and physical, social, and cognitive function and with greater risks of admission to long-term care facilities and mortality.” Despite these alarming findings, the authors also discovered reduction or cessation of driving in older adults can have safety benefits as well. One study they examined “reported a 45% reduction in the annual rate of crash injury in medically unfit drivers after they received warnings from their physicians” (Chihuri, Mielenz, DiMaggio, Betz, DiGuiseppi, & Li, 2016).
Therefore, driving cessation is completely necessary when operating a motor vehicle truly becomes unsafe for our loved ones. If we determine it is time for them to hang up their keys, we must initiate some thorough planning with family, additional caregivers, and local transportation in order to ensure once driving has ceased our loved one can still actively participate in his or her current social activities outside of the home, including social outings with friends or family, doctor’s appointments, grocery shopping, pharmacy trips, volunteerism, church, or anything else that they value.
Determining the Right Time for Driving Cessation
Skills necessary for driving safely include both physical and cognitive components. There are a few warning signs you can watch for when it comes to your loved one’s driving abilities. If you begin to notice poor attention or delayed reaction times, these declines may also influence their ability to drive and respond to unexpected situations quickly while on roadways. An older adult may exhibit signs of or make statements indicating they are not as confident in their driving as they were in prior years. They may have increasing difficulty keeping up with the flow of traffic in reference to speed (too fast or too slow), switching lanes, or navigating new or updated roadways. The older adult’s driving record may include recent traffic violations or tickets.
The older adult may be experiencing frequent episodes of hitting curbs during turns or while in reverse. There may be evidence of small collisions, such as scrapes or dents on the car or garage, mailbox, etc. which are unexplained. Maybe you experience too many “close calls” for comfort while riding as a passenger in their vehicle, or find they seem to aimlessly drive around without having a clear destination or remembering where they were supposed to be going. All of these signs, especially in combination, can indicate that it may be unsafe for your loved one to continue driving.
It’s Time – What Do You Do Now?
You’ve done your research and you are confident it is time to sit down with your loved one to discuss driving cessation. Now what? A good place to start is by consulting with your loved one’s primary physician regarding their professional opinion. They may refer you to a driving evaluation by a driving rehabilitation specialist and can also provide a thorough assessment of physical, cognitive, visual, and hearing skills necessary for safe driving. These assessments can lead to the physician initiating the conversation of driving cessation, which takes some of the pressure off of you.
A driving cessation plan should be created well in advance. Creating a plan for gradual transition to driving cessation is most beneficial. This process can begin by developing a list of the places your loved one most frequently drives to. This typically includes (at minimum) the grocery store, pharmacy, bank, post office, hairdresser/barber, medical or dental offices, exercise facility, and locations of social activities. Next, you can determine the availability of alternative transportation. Will family be readily available for planned and spontaneous transportation? Does the older adult have friends who are safe and actively driving who would be willing to assist? Are there local transportation options in place? Once you have established this plan, follow through on it and revisit it often.
Tips for “The Talk”
The actual conversation with your loved one may be the most important piece of this all. It must be approached in a sensitive and respectful way. It can be helpful for the conversation to be initiated by someone whose opinion the older adult tends to value and often is viewed as less confrontational with one or two people present, as opposed to a room full of intimidating family members.
Choose “I” statements such as “I am worried about your safety while driving” instead of “you” statements such as “you are not a safe driver.” Generalize the statements by recognizing that aging affects each of us differently and many older adults begin to notice they prefer not to drive at night, during times of high traffic, or outside of familiar areas.
Be prepared for a negative reaction and remind yourself that the reaction is directed at the situation, not at you. Put yourself in their shoes and be empathetic to how they must feel. Change is never easy, but definitely becomes more difficult with age. Come prepared with some positive outcomes and highlight these during the conversation. It may be helpful to ask a friend of your loved one who has stopped driving to speak with them and provide comfort. You should also ensure the older adult has been allowed a chance gain familiarity and confidence using alternative transportation prior to complete driving cessation.
Be patient! The road to driving cessation may include multiple conversations and will take time. Try to work together with your loved one as much as possible. Remember that the focus of the plan is purely on their safety and enhancing their independence.
For more resources on the topic of driving cessation and driving rehabilitation, seek out your Area Agency on Aging or check out the resources below.
Resources for Older Adults and Safe Driving
AAA: https://seniordriving.aaa.com/tools-additional-resources/
AARP: https://www.aarp.org/auto/driver-safety/driving-assessment/
CHORUS: https://www.roadsafeseniors.org/
NHTSA: https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/812228-cliniciansguidetoolderdrivers.pdf
References:
Chihuri, S., Mielenz, T. J., DiMaggio, C. J., Betz, M. E., DiGuiseppi, C., Jones, V. C., & Li, G. (2016). Driving Cessation and Health Outcomes in Older Adults. Journal of the American Geriatrics Society, (2), 332.
Rakow, K. (n.d.). We need to talk: The difficult driving conversation. AARP. Retrieved from https://www.aarp.org/auto/driver-safety/info-2016/when-to-stop-driving-in-older-age.html.