“Just Do It”- Take the keys

“JUST DO IT” – Take the keys

 

keytake

 

It’s not as easy as that, I know. However someone has to be the bad guy for the greater good. I’m not sure what’s more difficult, taking the keys away from someone that has cognitive decline and they cannot rationalize the safety reasons or having the conversation with your loved one who is still sharp as a tack mentally, but physically just cannot safely drive anymore. Either way, the conversation has to be had.

When it is time, you will know, but too many avoid the conversation and look the other way or simply wait and hope someone else in the family will take on the responsibility. It is a HUGE responsibility however and when you identify it, you need to act quickly. Avoidance can lead to catastrophic situations; I have seen it to many times. There are so many unfortunate, avoidable accidents by seniors that have taken many lives.

How will you know when it’s time? What are the identifiers?

Those are difficult questions to answer because everyone is different and each senior will age at a different pace. Disease, dementias, physical abilities these things are all factors that affect our ability to be good, safe drivers. A few key indicators that should be red flags are;

  1. Visual impairment or decline. Driving has a lot to do with depth perception. It affects your ability to determine how close things are to you. It impairs your ability to rationalize how fast something is coming towards you. Not to mention street signs or being able to see road hazards or construction detours.
  2. Physical limitations. Many seniors struggle with disease such as Parkinson’s or Arthritis or simply a decline in physical capability. This can have a profound effect on reaction time, moving from gas pedal to break or simply holding down the brake pedal. Even steering or surrounding awareness can be affected. If you can’t turn your head enough to see traffic or to change lanes to get off at your exit that can lead to a very bad situation.
  3. Increased short term memory loss. If you are repeating yourself over and over and your loved one is not retaining information over short periods of time, it’s time to take the keys. How will they remember where they are going in five minutes or where they came from?
  4. Medication changes. This one is missed a lot but has led to a number of accidents. Many medications cause drowsiness or fatigues that can affect our decision making and driving ability in many ways. If your loved one has had a change in medication and they appear more tired or have less energy than usual, go for a drive with them. (Maybe down an unoccupied county road with no traffic) See how they do.

How do you have the conversation?

Saying things like, “Mom, I’m doing this because I care” or “Dad, I love you and don’t want to get hurt” are nice sentiments, but no matter how true these statements are, your parent or loved one will most likely not buy into this reason. They will be mad; they may say mean and hurtful things. Remember this is a symbol of their independence, they know that this is just the beginning of something they have dreaded for a long time. This is more than just taking their keys away; this is a life changing event for them.  They are thinking, next stop nursing home….Do it anyway.

I remember my mother getting the call from my grandma as she was using the phone in a stranger’s apartment.

“I’m lost, I have no idea where I am, I thought I was going the right way but nothing looks familiar to me, please come get me.”

Those were very, very scary words.  My grandmother at the time was in the early stages, of what we later found out was Alzheimer’s.  Just to think of what could’ve happened and how many different scenarios ran through my mind just gives me chills.

Driving is a freedom, it is a symbol of independence, and it is the only thing most seniors still have that allows them to feel that independence and one of the things they feel they can still control. You need to be mindful of that and have respect for that when approaching the conversation. Unfortunately, many don’t realize or are not going to admit, that they are slowing losing control or ability. All the senses and instincts that we need to have to make us good drivers; hearing, vision, reaction time are all things that the elderly start to lose first. Not to mention the cognitive losses that many seniors struggle with such as; occasionally memory lapses, retention and reasoning skills.

It is a sensitive subject. You know your loved one best. Ask them honestly if they feel they are still safe to drive. Ask them if they would be willing to take a drivers safety course and if they feel they could still pass it. Have them drive you somewhere, see if you notice any concerns. Put yourself in their shoes, would you want someone telling you that you can no longer drive? Being respectful is the key, especially with someone whose cognition is not impaired.  They will argue every reason with you to maintain that independence. Just keep referring to the safety factor.

Some people are surprised at how easy it is. Some seniors are actually happy to give up the keys. Maybe they have recognized it for a while themselves. Many seniors who have identified this on their own will say things like “I don’t want to put up with driving in the weather anymore.”  I have seen where families use the strategy where they will offer to start picking up their loved one and taking them to appointments, grocery shopping etc. The idea is to try eliminating the need to have to use their vehicle and that it’s okay to depend on others. But you have to be able to be there. That may be hard for working families but it has worked. Many seniors don’t like the idea of being trapped without a way to get somewhere or leave their home, if and when they chose to. Try to find or incorporate alternate options for them.

Many people struggle with when and how to have this conversation and it’s definitely a real challenge. If you just can’t bring yourself to take the keys or be the “bad guy” then there is always the option of getting the doctor involved. It may be easier for you and for them if the suggestion comes from their own doctor or maybe a pastor. Just someone they have grown to trust that is not family. I have seen both work successfully.  I hate to say it but there is also the threat of taking the license away. For some adults, not having a set of keys to use is easier than knowing they don’t even have a license anymore.

According to the CDC, a study in 2012 showed that an average of 586 older adults are injured in crashes on a daily basis and of that number 5560 seniors die from these incidents annually. After the age of 70 the risk increases. Drivers on the road after the age of 70 have similar crash statistics as youth unexperienced drivers in their early 20’s.

Due to the fact that we are living longer and therefore driving at a much older age, there have been many programs developed to assist the older adult in making safe and smart decisions when operating a vehicle. If there is little or no cognitive or physical impairment some of these programs can be very helpful.

Triple “A”, ( AAA ) has a website dedicated to senior drivers which I highly recommend; http://seniordriving.aaa.com/  the site provides useful tips and suggestions on how to evaluate your driving ability, understand changes in your mind and body and how to maintain mobility and independence. They offer Driver Improvement courses for seniors.

Still struggling with the keys? Here are some idea and suggestions that many people have tried with success;

  1. For those with a decline in cognitive status;
    1. If the keys are a simply just a symbol for them and they haven’t even driven in a long time, let them keep the keys… just remove or take away the car. If they ask where the car is, it’s in the shop or your son borrowed it etc. These are not lies; these are what we call Therapeutic Fibs.
    2. Take the keys and replace them with a different set on the same key chain.
    3. Park another car behind theirs so they can see it in the driveway, but can’t get out.
    4. Just do it.
  2. For those who are cognitive but have physical impairments;
    1. Be honest; have a serious conversation about your concern for their safety and the safety of others.
    2. Schedule a road test; if they fail then they can’t legally drive. This usually works. Ask doctor for a recommendation.
    3. Be prepared with options: commuting alternatives.
    4. Have a schedule ready to share where you will provide a day a week to help with errands or transportation to appointments.

Any way you look at it, in any situation having the conversation is not an easy task. Talk to other members of the family, clergy, doctors, talk to your loved ones friends, identify the real risks and concerns. Would a car with enhanced safety features, GPS, warning bells and whistles be enough for now? Maybe it’s as simple as that, maybe it’s not. Do your homework, read the articles. Go in prepared with ammunition and support.  Come up with a solution that meets everyone’s needs. The goal is to keep everyone safe and around just a little bit longer.keysssafety-first

 

Julie C Westcott, CDP

10/2016

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