By Elaine Roberts Musser
If a driver is physically or mentally impaired to such an extent that it seriously interferes with the ability to drive safely, what should be done? According to California Highway Patrol Chief Mona Prieto, “There are 11 million drivers 75 and older in the United States. With the baby boomer population aging, in twenty years one in four drivers will be elderly. And studies by the Insurance Institute for Highway Safety find that older drivers themselves suffer the most severe consequences of their crashes.”
According to Dr. David Norene, an internist and geriatrician, “What happens when you age is that your reflexes tend to slow down. And you may not be able to react as quickly to events as you would otherwise. Sometimes medications are prescribed, which also can slow down a person’s reaction time and their thinking time. Also the aging process can effect vision and hearing. So I would encourage families and physicians to take note of these and address these problems before they become a serious problem.”
Should doctors see an illness, such as dementia, Alzheimer’s Disease, lapse of consciousness or poorly controlled diabetes, those are reportable to the county. That information is then forwarded to the Department of Motor Vehicles. Most likely the effected person’s license will be revoked as it should be, for everyone’s safety.
But how do you start the challenging conversation with your impaired loved one on giving up the keys to the car? It is difficult to be brutally honest with an elderly parent. Often adult children feel as if they are being disrespectful towards their loved one. It is not uncommon for an elderly father to have the role of being the one in charge. He stubbornly has no intention of giving up his authority or independence, even if it kills him or others on the highway.
But as Deputy Commissioner Joe Farrow points out, “It may be difficult, but it’s a conversation you need to have. This is a family issue to be sure, but it is a law enforcement issue as well. Running a red light, going through a stop sign is illegal and dangerous, no matter the reason.” Just ask Carolyn Roberts, an adult daughter whose mother was killed by an older driver. She feels strongly that “the vehicle is a weapon…if we are impaired physiologically… then we possibly should not be behind the wheel. And it really doesn’t matter what age.”
So how do you start the difficult discussion? Janice O’Brian, a woman whose father was diagnosed with Alzheimer’s Disease, explained, “My father is 73 years old, and about three years ago he was diagnosed with Alzheimer’s…So we had to create a plan, and now we make him dinner, we take him on …errands, things like that.”
Elaine Roberts Musser, an attorney and Yolo County Commissioner on Aging, notes if the elderly person does get into an accident, “The financial implications can be massive…You may be responsible for the other person’s medical expenses… As a legal professional, I believe it is the responsibility of everyone to determine whether a senior needs those keys taken away. That means if you’re an adult child of the elderly person, if you’re a doctor, even a friend.
Carolyn Roberts agrees: “You’re talking about a huge financial liability. The person who is killed, or the people who are… injured, could potentially sue the family for their life savings. And I hate to say that there is a monetary issue tied to this, but that is the reality.”
As Ms. O’Brian succinctly put it, “We didn’t want to have a defining moment like that. We were afraid to, if we waited until a time like that, we would feel guilty, we would feel like we had a legal responsibility, because we knew of…[my father’s] issues and we were still allowing him to drive.”
Deputy Joe Farrow summed it up best by insisting, “So don’t wait for a defining moment. Have the difficult conversation now, for the senior’s safety, for your safety, and your family’s safety, and everyone else on the road.”
The picture and faint type seem somewhat contradictory to the story. “AAA program for longer safer senior driving”?
The article is referring to two programs available through AAA:
1) Car Fit
2) Roadwise Review.
The Car Fit program actually allows you to drive your car up to an inspection site, and an expert checks if your mirrors and seat are properly positioned, lets you know if there are any assistive devices that might help improve your driving, and checks your mobility in general. Roadwise Review is a free interactive DVD, that allows a person to test their driving skills via computer. Both these programs are available through the Davis Senior Center.
The picture you see is of Captain Ike Iketani of the CHP, w members of the Davis Senior Citizens Commission, that appeared in a AAA magazine a couple of years ago. Thanks dmg, for running the picture!!!
For more information on senior driving, check out the following websites (hopefully they are all still active):
[quote]AAA
http://www.aaaseniors.com
AARP
http://www.aarp.com
Beverly Foundation
http://www.beverlyfoundation.org
California Department of Motor Vehicles
http://www.dmv.ca.gov/about/senior/senior_top.htm
California Highway Patrol
Older Californian Traffic Safety Program
http://www.chp.ca.gov
Click on Community/Senior Services/Older Californian Traffic Safety
Scroll down to CHP Senior Driver/Mobility Program
Click on “View Videos to help educate older Californian drivers”
(See members of the Davis Senior Citizens Commission talk about senior driving! Also check out the video of woman who’s mom was killed by an elderly driver – very sad and powerful video clip.)
Hartford Financial Group and MIT Age Lab
http://www.thehartford.com/talkwitholderdrivers/index.htm
Strength For Caring
http://www.strengthforcaring.com/daily-care/7642/taking-away-the-keys.html
[/quote]
I wrote this article some time ago for the Davis Enterprise, but for some reason it was never published. In light of the recent case mentioned in the Vanguard of the 78 year old driver who killed a woman, I thought this piece would provide some invaluable information. Most of the comments in the article come from a very powerful CHP video entitled: “Driving Change” (should still be on the CHP website), which talks about how to have the difficult conversation w an elderly person about giving up the keys to the car. I worked w the CHP in developing both the videos. Film footage was taken in studio and at a Transportation Safety Expo at the Davis Senior Center put on by the Davis Senior Citizens Commission (right after our commission survived the move by the City Council Subcommittee on Commissions to eliminate the commission!!!).
There needs to be a better evaluation process.
Children see tiny incremental changes over time and may or may not conclude it is time to stop driving. It is easy to miss the big picture if you see the person frequently. Another thing not discussed here is the implication of not driving – the older person loses independence and in fact so does the younger person to a lesser extent. Relatives should not be doing the evaluation because they have too many reasons to not be objective. I would like to see local Police (and or even Fire) involved in routine required driving evaluations – a non threatenting process that brings more independence to the evaluation.
I think this article is very relevant and touches upon a subject that is not in the news often enough until something tragic happens. Along with the aforementioned loss of hearing, eyesight and reflexes, some elderly go through a pysychological change. Alzheimers was mentioned and I think dementia was mentioned also. It reminds me of something I heard on the news about a month ago. An elderly man was living at an assisted living complex and he and two other residents decided to go have lunch some where in town. The elderly gentleman was the driver. All three were subsequently reported as missing after several hours. The next day they were found in San Diego with distorted amounts of confusion. The CHP helped them get back home. I could be wrong but I thought that the DMV had implemented mandatory eye and phsycological testing every 1-2 years after reaching a certain age. If not, maybe something like that should be implemented. We already have to renew our licenses at four years anyways.
I will offer two stories, in two posts. Some of you may recall a tragedy a few years ago that involved an elderly gentleman who’s ability to drive had been brought into question. I believe this was in Stockton, maybe Lodi, but down the valley somewhere not far from us. He had caused a minor accident. The local motorcycle cop who responded cited him and recommended a review of his license status. DMV contracted that review out to an “investigator” (totally inappropriate use of the term) based in Sacramento. His inquiry consisted of a single telephone call to the gentleman at question, and after that he cleared the case.
A year or so later, driving on the license that had been renewed without an office visit or face-to-face investigation, that same elderly gentleman killed that same traffic officer by running over his motorcycle in another accident. As I recall the cop was a young family man, so nobody should take any joy in the irony of that tragedy.
As reported in the Bee, the investigator said something like “He seemed coherent over the phone.”
If we are lucky to live long enough, there comes a time for all of us when we get to be too infirm or mentally incapable to operate a motor vehicle. As a planner, the saddest thing to me is that elderly people who are stuck in homes in suburban sprawl neighborhoods with no commercial uses or public services nearby are trapped without the ability to fire up that car. The economics of owning the large homes they raised their families in vs the cost of relocating work against moving to better located and sized dwelling units.
So this is a two-pronged problem. The first is licensing standards based on better observation of elderly drivers by properly trained investigators, and the second is to work to create true mixed use neighborhoods in America so elderly people can reach the destinations necessary for their daily needs on foot or with transit.
A coworker of mine is dealing with the challenge of having to convince her elderly father it is time to give up driving. He is evidentially not taking it well. I think, just like with our kids, we have to do the right thing even if it risks damaging our friendly relationship. It is more difficult with elderly relatives because there is generally less time for reconciliation. Hopefully, when the time comes to make these anger-causing, ethical decisions, we are no longer seeking acceptance, validation and proof of love from them.
I keep telling myself I will accept my inevitable age-related decline of capability with grace and acceptance… if only I can remember to do so.
Very, very thoughtful and insightful comments all.
[quote]There needs to be a better evaluation process.
Children see tiny incremental changes over time and may or may not conclude it is time to stop driving. It is easy to miss the big picture if you see the person frequently. Another thing not discussed here is the implication of not driving – the older person loses independence and in fact so does the younger person to a lesser extent. Relatives should not be doing the evaluation because they have too many reasons to not be objective. I would like to see local Police (and or even Fire) involved in routine required driving evaluations – a non threatenting process that brings more independence to the evaluation.[/quote]
In the state of CA, once you reach the age of 70, you must come in person to renew your license. At that time, you may be required to take a written test and/or a road test. From the DMV:
[quote]Senior Drivers in California
Updated on Thu, 4/28/2011
In addition to being a convenience and an enjoyable activity for many people, driving is also a symbol of one’s independence. As we age, there are a numerous factors that can affect our driving skills, and hinder our ability to safely operate a motor vehicle. The California Department of Motor Vehicles wants older drivers to maintain their driving independence as long as they continue to drive safely and confidently.
LICENSE RENEWAL FOR SENIOR DRIVERS
California drivers who are 70 years of age or older at the time their current driver license expires are generally required to renew their license in person at a local DMV office. In addition to taking a vision test (see below), you may in certain situations be asked to take a written knowledge test as well. In preparation for this, you can review the California Drivers Handbook and take practice tests before going for your license renewal.[/quote]
I should also note that if your doctor determines you have any condition that would impair your ability to drive, the doctor is required to report it to the DMV.
[quote]Another thing not discussed here is the implication of not driving – the older person loses independence and in fact so does the younger person to a lesser extent.[/quote]
Precisely. So it is important for 1) the senior to learn public transportation options and how to use them long before they must give up the keys to their car; 2) for families/friends to step in and possibly provide chauffeur services when the elderly person needs it; 3) develop communities that make getting around easier.
[quote]I think this article is very relevant and touches upon a subject that is not in the news often enough until something tragic happens. Along with the aforementioned loss of hearing, eyesight and reflexes, some elderly go through a pysychological change. Alzheimers was mentioned and I think dementia was mentioned also[/quote]
This is an excellent point. Often the senior may not even be aware/or may be in complete denial they have dementia/Alzheimer’s or that their reflexes are failing. That is why it is important to keep an eye on the driving abilities of loved ones, and have the “difficult conversation” w them to give the keys up to the car when the appropriate time comes (or turn them into the DMV as a last resort).
To stracy: Thanks for sharing that story. How awful, ironic, and tragic. The CHP videos I was involved w came out of another tragic case of the elderly man that plowed into a farmer’s market in CA w his car, killing 12 people and injuring many others. He stepped on the gas instead of the brakes.
[quote]A coworker of mine is dealing with the challenge of having to convince her elderly father it is time to give up driving. He is evidentially not taking it well.[/quote]
Many seniors willingly choose to give up driving when the time is right, especially if good public transportation is available. But other seniors are stubborn, and will not. I had a case one time, involving a woman who drove herself to the hospital rather than pay the cost of ambulance service, and t-boned a car just outside the hospital. Her legs were pinned by her own steering wheel, and her legs gave her problems ever after that. Yet she still insisted she would drive herself to the hospital, no matter how many times I advised her against doing something like that again.
[quote]I keep telling myself I will accept my inevitable age-related decline of capability with grace and acceptance… if only I can remember to do so.[/quote]
Amen! I think we all hope this for ourselves, but whether we actually achieve it is another story…
I realized my mother in law needed to change her driving habits at 82 – I told her she could no longer drive on any road over 35 MPH. So freeways and expressways were out. If she wanted to drive to our house (we usually went to see her) she had to take surface streets (10 miles) and she did not drive like the LOL from Pasadena so it would take her twice as long as a normal driver. I used to get rather angry at slow drivers regardless of age, but I have come to realize older people generally drive slow because that is the speed they should be going. Honor the old and give them a break (and a brake)!
Thanks for your stories about older drivers, Jeff and Alphonso. Time for the one closest to me. My father had a reputation as a car guy waaaay back when he was in high school in the ’30s. According to my long dead mother, he was not necessarily crazy, but fast and competent on asphalt or dirt roads.
We rarely missed an event at Riverside Raceway when I was growing up. He did some modest desert off-road racing in the ’60s, even though that wasn’t exactly the sport for a conservative banker to pursue. But he did teach me to drive on a beach in Mexico when I was 10 years old, and to powerslide a car on gravel or do a U-turn with the handbrake when I was maybe 13 or 14. Years before I could drive legally he would take me out in my poor mother’s Buick coupe and give me skid control lessons, teaching me to toss a car sideways and recover. He had local mechanics pull the stock engines out of our Jeeps and stuff in big V-8s out of wrecked cars to improve his low-level flying over sand dunes. So he was really into cars his whole life, a very good and capable driver, and safe. He never had an accident of any sort in his whole 60 or 70 years behind the wheel.
Then at about 80 years old he suddenly handed over his car keys and let his license expire. I could not believe it. He just said his peripheral vision was closing in, and his instinctive reflexes didn’t seem to be what they once had been. He had lost his edge and didn’t want to embarrass himself or hurt anybody.
In his case, living in one of those homes way out at the edge of suburbia with no services nearby, he was lucky. His wife was 15 years younger and still driving. So he retained his mobility. But later, as he grew more housebound, and she went on trips or visited family, he was often alone for days or weeks on end in the house. And then he had a bad fall that seriously injured him and that was the end of that.
Now he’s in a great care facility, doing his best to be cheerful about it, and driving only a wheelchair he scoots with his feet. I admire him more than ever as he has adapted to his changing circumstances. That began when he voluntarily gave up driving before anyone else could see his skills deteriorating.
But on most days the investigator in the first case I cited would say he seems coherent over the phone.
Steve.
Elaine,
I found this to be a timely article with importance for a number of issues facing our community that at first glance would seem to be unrelated but which I see as interrelated.
1) First the aging population of Davis has been sited repeatedly, and I admit to doing my share in this regard, so this is an issue of importance to me.
2) Downtown in general, and 5th St. In particular have car vs bike vs pedestrian safety issues. And yet we continue to consider ways to pack
yet more cars into the downtown area.
3) Our rural roads are major car vs bike hazards.
4) As a city, we are continuing to consider suburban, car dependent developments including the ConAgra site, with the consideration of a major component for the elderly and disabled .
These are all dangers that are likely to get worse, not better with an increasing senior population. My personal solution was to move into the core area within walking distance of downtown for that inevitable time when I will need to stop driving. I realize that not everyone has this option. So I feel it is incumbent upon us as a city to be more proactive than we have been to date in giving up the outdated suburban, car dominated lifestyle and move to a healthier, cleaner, safer and more sustainable model.
[quote]Honor the old and give them a break (and a brake)![/quote]
Excellent advice!
[quote]Then at about 80 years old he suddenly handed over his car keys and let his license expire. I could not believe it. He just said his peripheral vision was closing in, and his instinctive reflexes didn’t seem to be what they once had been. He had lost his edge and didn’t want to embarrass himself or hurt anybody. [/quote]
Bless your dad. This is a prime example of responsible seniors who do voluntarily give up their keys when appropriate. He certainly has AGED WITH GRACE. Thanks so much for sharing…
[quote]My personal solution was to move into the core area within walking distance of downtown for that inevitable time when I will need to stop driving.[/quote]
Another good solution. More importantly, you thought ahead, which is something all of us need to do…
ERM
I am hoping, that with our new city council, and new manager, we may be able to be more proactive and forward thinking as a community as well as individuals. My impetus to action in this area was from direct experience. My step father was continuing to drive at a point where his medical problems including sleep apnea with daytime episodes of falling asleep behind the wheel made him a real danger on the road. Eventually my sister just removed all copies of his car keys and eventually the car itself. Since they live in rural Washington state, this was a large burden on all involved. But as you pointed out, these steps must be taken, and should be worked out well in advance of the need.