Most of us do not give a second thought about the mechanics of driving. We have been doing it since our teens, and while we may no longer remember stopping distances measured in feet, we know from experience how much space we need in front of us to safely stop our vehicle. (The exceptions to this are “aggressive drivers,” who ignore safety practices in their desire to get ahead.) As we get older we understand that there may come a day when we will no longer be able to drive, but few of us look forward to handing over the keys of not only our car, but what feels like our independence as well. It seems like every year we hear on the news about some older driver involved in a tragic accident where pedestrians were injured or killed. These reports inevitably bring up questions about the safety of older drivers, so let’s look at this issue.
What does the research tell us? The CDC (Center for Disease Control) reported in 2008 that more than 5,500 older adults were killed and more than 183,000 injured in motor vehicle accidents. While these are large numbers, they need to be put into the context of the total number of older drivers. The CDC stated that in approximate same time period (2009) there were 33 million licensed older drivers. This means that the percentage of those injured or killed is very small. In another study the AAA (American Automobile Association) followed crash rates for a fifteen year period (1995 – 2010). The AAA found that the mileage- based crash rates for drivers in their 70’s was the same as drivers in their 30’s, and for drivers in their 80’s the mileage-based crash rate was the same as drivers in their 20’s. Does this mean that there is no cause for concern about older drivers? Not necessarily. The CDC also reported that the incidence of injury and death increases with the driver’s age. Furthermore, the physical changes that occur as people age, such as decreased reaction time, visual acuity, and medical issues like arthritis, all make driving more difficult. The AAA lists two key warning signs of when some type of intervention may be needed: having 2 or more traffic tickets or warnings in a two-year period, or having two or more collisions or near misses in a two-year period.
Resources for older drivers: Fortunately, there are resources for older drivers that can help ensure safety behind the wheel. Space does not allow for an exhaustive list, but one of these resources is the AARP Driver Safety Course. There is a charge for the course, but satisfactory completion may help you get a discount on your auto insurance. By going to their website, www.aarpdriversafety.org, you can find locations and times the course is being offered. There is also an option to take the course on-line. Another resource is provided on the AAA website, www.seniordriving.aaa.com. It is well worthwhile exploring the tips and suggestions they list. Certified Driver Rehabilitation Specialists can provide a professional assessment of someone’s driving ability and make suggestions that will increase that person’s safety behind the wheel. There are two organizations that certify these specialists. By going to their websites you can locate a specialist who works in your area; www.aota.org/olderdriver and www.aded.net. If these resources are used in a timely manner, older drivers may be able to safely extend their driving days.
What about dementia? Dementia in an older driver, especially as it progresses, is a real concern because the impaired cognition it causes can result in the driver failing to recognize and follow traffic signs and signals. An individual with dementia can become disoriented and lost, even on a familiar route. To further complicate the problem, because of the cognitive impairment, it is usually futile to try to reason with the individual about giving up driving. However, the first thing which should be done when dementia is an issue is to get that individual to his or her physician for a thorough medical evaluation. There are some causes of dementia, such as a urinary tract infection, that are reversible, and when the underlying condition is treated the dementia goes away. The second reason for getting the individual to his or her physician is that if the dementia is irreversible, as in the case of Alzheimer’s disease, the physician has an obligation to report to PennDOT any medical condition which impairs a person’s ability to operate a motor vehicle. Based upon the medical evidence, PennDOT can either require the driver to undergo further testing or it can revoke the person’s driving privileges. Unfortunately, due to the impaired cognition and impaired memory that comes with dementia, the solutions to keeping that person from driving will likely involve one of the following: taking the keys away, replacing the keys with keys from a different vehicle so the car cannot be started, disabling the car so it cannot be started, or removing the car altogether. None of these options are likely to be accepted without protest from the older driver with dementia, but they may be the only way to keep that person from driving.
What do I do when I can no longer drive? Fortunately there are resources to help people who no longer drives get to those places they used to drive to themselves. Each county in South Central PA has transportation services for Senior Citizens. Contact your local Office of Aging for information on the service available in your county. In addition to the county transportation, some churches and civic organizations help seniors with transportation. Many agencies that provide private-duty care will also provide transportation. Of course there are taxis, and in some areas, public bus service. Some people rely on a network of friends and family. For many people it is through a combination of these resources that they manage without driving.
While it may seem as though driving is a “right,” Pennsylvania makes it very clear that it is a “privilege.” Safe driving is possible for older drivers, but if we do not want to lose that privilege, we need to make sure that we, and our family members, utilize the available resources to remain safe drivers as we age.
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REGISTER HERE for LONG-TERM CARE PLANNINGPower of Attorney
A Power of Attorney can be used to give another person the right to sell a car, home, or other property in the place of the maker of the Power of Attorney. A Power of Attorney might be used to allow another person to sign a contract for the maker of the Power of Attorney (the person who makes a power of attorney is called the “principal”). It can be used to give another person the authority to make health care decisions, do financial transactions, or sign legal documents that the principal cannot do for one reason or another. With few exceptions, Powers of Attorney can give others the right to do any legal acts that the makers of the Powers of Attorney could do them themselves. A General Power of Attorney gives the “power of attorney Agent” or simply “Agent” (the legal name of the person who is authorized to act for the principal) very broad powers to do almost every legal act that the principal can do. When Elder Law Attorneys draft general Powers of Attorney, they still list the types of things the Agent can do but these powers are very broad. People often do general Powers of Attorney to plan ahead for the day when they may not be able to take care of things themselves. By doing the General Power of Attorney, they designate someone who can do these things for them.
Normal Powers of Attorney terminate if and when the principal becomes incompetent. Yet many people do Powers of Attorney for the sole purpose of designating someone else to act for them if they cannot act for themselves. It is precisely when persons can no longer do for themselves that a Power of Attorney is most valuable. To remedy this inconsistency, the law created a Durable Power of Attorney that remains effective even if a person becomes incompetent. The only thing that distinguishes a Durable Power of Attorney from a regular Power of Attorney is special wording that states that the power survives the principal’s incapacity. Even a Durable Power of Attorney, however, may be terminated under certain circumstances if court proceedings are filed. Most Powers of Attorney done today are durable.
Yes. At the time the Power of Attorney is signed, the principal must be capable of understanding the document. Although a Power of Attorney is still valid if and when a person becomes incompetent, the principal must understand what he or she is signing at the moment of execution. That means a person can be suffering from dementia or Alzheimer’s Disease or be otherwise incompetent sometimes but as long as they have a lucid moment and are competent at the moment they sign the Power of Attorney, it is valid even if they do not remember signing it at a later date. At the time it is signed, the principal must know what the Power of Attorney does, whom they are giving the Power of Attorney to, and what property may be affected by the Power of Attorney.
Any competent person eighteen years of age and older can serve as an agent. Certain financial institutions can also serve. There is no course of education that agent must complete or any test that Agent must pass. Because a Power of Attorney is such a potentially powerful document, agents should be chosen for reliability and trustworthiness. In the wrong hands, a Power of Attorney can be a license to steal. It can be a big responsibility to serve as an agent.
For Medicaid
Medicare is health insurance and covers medical services such as physician appointments, therapy, blood tests, x rays, medical procedures and hospitalization. Medicare will sometime pay for rehabilitation in a long-term care facility for a period of 20 to 100 days, but not longer. In long-term care, Medicaid covers the cost of ongoing support services for daily functioning, such as room and board in a nursing home.
Medicaid is a federal program that is overseen by the Center for Medicare and Medicaid Services (CMS). In Pennsylvania, Medicaid is called Medical Assistance and is administered by the Department of Human Services (DHS).
In Pennsylvania, Medicaid funds are not available to pay for assisted living or personal care.
For Medicaid to pay for care in a nursing home, an individual recipient must be determined to need a nursing home level of care by a physician and the local Office of Aging. An individual whose income is not greater than three times the poverty level may keep up to $8,000 of total resources, but may otherwise keep only $2,400. The cash value of life insurance counts as a resource, but one car and a residential home does not count as a resource.
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Keystone Elder Law
At Keystone Elder Law, we believe that the physical, social, legal, and financial considerations of our clients all intertwine. We utilize an interdisciplinary approach to evaluate each area, which allows for the creation of a plan that addresses the concerns of the individual as a whole as well as the family. To this end, our model of practice includes a Care Coordinator (usually a nurse or social worker), whose expertise complements our team of attorneys.
When the road of life is smooth, decisions about legal and financial matters are easy to push aside for “a rainy day.” Planning ahead, however, will allow for more options as you view the map of where you’ve been and where you want to go. Don’t let a crisis limit your choices or derail your plans.
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