Initiating a conversation with an older driver about his/her driving safety can create feelings of dread for family members. Not only is it uncomfortable to share with someone that it might not be safe to continue doing something that he/she has been doing for years, but if driving is restricted or stopped altogether, questions arise about how to continue usual routines and activities. New methods of transportation will be needed for maintenance tasks like grocery shopping and physician appointments, but transportation for social reasons is also important for older adults. Feelings of loss may result from changes to driving routines, and acknowledgement of those feelings can help preserve the older adult’s dignity.
There are some techniques which can make this conversation a little easier for both the family and the older driver. The content, timing, and method of how concerns are shared will impact the older adult’s participation in discussions and planning. Introductory conversations about driving before safety concerns exist can encourage everyone to begin to think about possibilities for handling “what if” situations in a non-threatening manner. They are also a good way to explore individual feelings about this subject, which can then be used to help guide future conversations.
Before beginning discussions about an older adult’s driving, family members should do their homework. Firsthand information is essential, so ride along with the older adult on routine trips to determine patterns of driving and the frequency with which warning signs of possible impaired driving are occurring. While one trip may be enough if a driver is exhibiting severe warning signs, often multiple trips over time will present a more accurate picture of the older adult’s driving skills. Take into account the different factors which may have an effect on driving skills on a particular day or to a particular location including traffic, weather, the route (main roads versus side roads), the car itself (does the size and design fit appropriately with the older adult’s physical size and functioning?), familiarity with the destination, the presence of other passengers, use of the radio, and possible personal stressors such as health concerns. Gathering the observations of others who have witnessed the older adult’s driving will help complete the picture.
An additional part of this homework assignment is to investigate potential transportation alternatives. Is public transportation a realistic possibility? Think about the routes and time schedules of public transportation, as well as the older person’s comfort level with using this mode of transportation. What is the cost? Where and how is access obtained? Do these factors fit the older person’s physical ability, lifestyle and needs? Other alternatives include family members or friends, use of a home care agency or private car service, or the availability of special options for older adults, such as those organized by a local church or senior service organization.
Once the homework is done, consider who is most appropriate to initiate the conversation and how to start it. The chosen individual should be someone who the older adult respects, has participated in gathering the information mentioned above, and can be firm but gentle when sharing sensitive information. Possible conversation starters can include a news story about a driving incident, a general statement about local road construction or traffic conditions, a question about another family member’s or friend’s experience with changes to driving routines, an observation about a recent event which occurred when the older adult was driving, or a compliment about voluntary changes to driving habits which have been made. The individual should use “I” statements to avoid sounding accusatory, such as “I’m concerned that your arthritis may be making it more difficult for you to drive.” If the cessation of driving is being discussed, using the phrase “retiring from driving” may be less provocative than “it’s time to stop driving.” As much as possible, allow the older driver to express his/her feelings and determine possible solutions.
When a high risk older driver does not recognize or acknowledge the severity of the situation, direct appeals related to safety may help, or the difficult step of removing the car from the premises may be necessary. It is preferable to attempt to gain the individual’s cooperation first, if the individual is capable of participating in decision-making and planning. Avoid hiding the keys or lying to the older driver in an attempt to avoid hurt feelings. If an attitude of mistrust develops, that may be more difficult to manage long-term than the initial anger over removal of the car.
When an older adult retires from driving, a decision must be made about what to do with the car. It may be beneficial to keep the car if family members have vehicles which would be difficult for the older adult to get into and out of. Giving the car away may create a stumbling block to obtaining public benefits to pay for care in a nursing home if this type of care is needed within five years of the gift.
For additional information about safe driving for older adults or having conversations with older drivers, Penn DOT has a free publication titled “Talking With Older Drivers” (publication 345), which is available on the website www.penndot.gov. The Hartford Financial Services Group also publishes a series of free driver safety guides which are available on the website www.hartford.com/resources under the link for the Center For Mature Market Excellence.
Karen Kaslow, RN