September 30, 2020 Elder Law

Psychological Issues and the Older Driver

The first step is to recognize the problem.

By Carolyn Rosenblatt

This article is a reprint from May 2020 Ingham County Bar Association Briefs magazine.

We have all seen news reports of elderly drivers crashing through plate glass windows or driving off the road when they had confused the gas pedal with the brake. Some of these incidents end tragically with those involved being injured or killed. Elder drivers are a serious problem, not just because of their age, but because of the issue many have with being unable or unwilling to stop driving for emotional reasons.

Perspectives of the Driving Issue

Imagine the justifications people can invent to allow dangerous, aging parents to stay behind the wheel: “She only drives to the store”; “He doesn’t drive at night”; and “He just drives to the doctor and to church.”

These are statements from family members whose elder is no longer safe to drive, but who is still driving. No one has the guts to ask Dad or Mom to stop. Because most accidents happen within three miles of home, the “only to church” or “only to the store” are justifications no safer than driving anywhere else.

The National Safety Council’s journal Family Safety and Health, in its fall 2012 article “Time to Hand Over the Keys,” gives us some information about what to do.

Research indicates that most people, when approached respectfully, will voluntarily give up driving. However, “most people” does not include the very stubborn, those in denial, and those elders with the kind of cognitive impairment that prevents them from actually understanding how impaired they are. With these folks, their families desperately need a strategy. Here are some ideas:

Recognize the problem. A car is a lethal weapon whether your elder is driving it a block from home or across the city. It is not a safer weapon because your elder is closer to home—that’s a fantasy. An eighty-four-year-old whose license had been restored after a stroke should not have been driving. He was behind the wheel when he accidentally hit and killed his best friend in the driveway of his own apartment building.

Be honest and respectful. If you’ve seen grandma careen across the street cutting off other cars, unaware of their presence, it’s time to gently ask her to give up the keys. Try a one-on-one conversation first. A kind approach can be very useful.

Add allies to your approach. Bring in a trusted friend, other family member, or anyone the elder trusts. Bring up the subject calmly and with acknowledgment that giving up driving is huge and that it means losing independence. Use an outside professional if this doesn’t work. A group discussion may offer the aging person a different perspective and help them realize that others are worried about their driving even though they themselves have thought it was fine. Sometimes impaired drivers are oblivious to their own impairments and to the dangers of their operating a vehicle. It comes as a shock or unpleasant surprise to hear of the concerns of family or friends. The group effort of others to get the aging person to stop driving brings the concerns home and may result in cooperation to give up driving, simply because of group pressure from trusted people in the elder’s life.

Make alternative transportation arrangements. If your elder lives in an urban area, many resources may be available for elders, from community vans to carpools from senior centers. Public transportation works well for some seniors who are able to understand schedules, keep track of routes, and manage a bus independently. Beware of putting cognitively impaired elders on buses. They may be confused and get lost. Rural dwellers must usually rely on family and friends to transport them. The burden on adult children who will have to take on the new and inconvenient responsibility to transport an elder around may stop them from facing the issue of a parent’s dangerous driving.

If the elder is too dangerous to continue driving, get rid of the car if you can. Sometimes, a caregiver can do the driving and the aging person keeps ownership of the car. That can work. But if there is no caregiver or someone else’s car is used to transport, the elder’s car is a sad reminder and a temptation you don’t want kept in the driveway. It’s too easy for them to get a duplicate set of keys made. And a cognitively impaired elder may forget that they are no longer supposed to be driving if the car is available without supervision in the home.

Use the law as a last resort. The primary care doctor may be of help if willing to report the danger or the need for reexamination to the Department of Motor Vehicles (DMV). When the doctor lets the DMV know that a driver should be reexamined in the form of behind-the-wheel testing, or that he should stop driving, the DMV is required to act. Some states allow anyone to report a dangerous driver and ask for license reexamination anonymously. When a driver has not passed the reexamination, their license may be suspended or revoked altogether. The driver can, in some instances, challenge the suspension by asking for a hearing. If things have changed, the driver may be able to get the license reinstated; however, a truly unsafe driver is not going to pass the test.

The courts also can be used to protect elders who are a danger to themselves or others. Guardianship can be used in extreme cases to give family permission to take the car away, as well as protecting an elder who no longer can judge what is unsafe. This last resort measure would only be useful if all other efforts to keep the elder safe have failed, and they are unable to care for and protect themselves in other areas of life.

What Doesn’t Work

Tricking the elder by sneaking and disabling the car is a less than honest approach. Taking away the car without notice is also risky and can result in an outraged elder who wants to retaliate. Forcing the issue should not be done unless the elder is a danger to others or himself and as explained above, you must use the law to protect both the elder and the public.

Some older drivers are fine, even at advanced ages. An example is Marge, ninety-two, who lives in a retirement community. She limits her driving to daytime. She is still quite sharp, has a great memory and sense of direction, and pays attention to what is on the road. She avoids freeway driving most of the time, unless she is very familiar with the route. She made the choice of limiting her driving without being asked by anyone. She’s in the minority at her age, as her mental ability, vision, physical ability, and hearing are all sufficient for her to drive safely. She also knows that the time will come sooner rather than later when she will choose to give up the car.

Asking an aging loved one to give up driving takes courage. It can draw extreme resistance, anger, and refusal. Facing that possibility requires a plan and perhaps a family conference before approaching a particularly difficult elder.

How Lawyers Can Help

A lawyer can play a key role in helping families to approach the elder in their lives about driving. If the aging person is your own client and you notice that he is having trouble maneuvering the car in your office parking lot, you’re on notice that you have an opportunity to help. If a family member advises you that your client has been diagnosed with dementia, again you have an opportunity to help. Driving with dementia is going to come to an end and there will be the need to give up the keys. If you are willing to approach the subject of giving up driving with an older client who needs to stop, the position of trust and authority that a lawyer has with a client can be a source of guidance.

Guiding a client to give up the keys can be something that the lawyer initiates and does one on one with the client or otherwise, depending on the elder and her family, in the context of a family meeting. The choice of how to handle the issue will depend on your relationship with your client, how impaired you believe they are, and whether they have demonstrated a willingness to accept your advice in the past. If an adult child or spouse of an older client has expressed fears about that client’s driving and you think the family member can be helpful, consider setting up a family meeting to address the problem.

Successful Family Meetings

A family meeting can help in that it can show the elder how more than one person shares the concern about their driving, and there is consensus that they should give up the keys. However, there are many things that could backfire in using this approach, so think it through and plan it as carefully as you would plan any case. As with other matters, preparation is a key to success.

In a sense, a family meeting with the goal of asking a dangerous driver to give up the keys is something like an intervention. That is, the common voice of family members and possibly close friends can strengthen the message the family wants the elder to get. The risk is that if badly handled, the elder may feel “ganged up on” and will react defensively, with anger or will withdraw from interacting.

Five Tips for Conducting a Good Family Meeting

Choose the Right Leader

 If you want a family meeting to succeed, you need to choose a competent leader to chair or facilitate the meeting. As a lawyer, you may be quite comfortable with settlement conferences, group meetings, or other situations in which you take leadership. But, if that’s not your strong suit, collaborate with family members you know to decide on the right person. If needed, you can enlist the help of a professional, such as a social worker, care manager, or family mediator to assist you.

Be Sure Everyone Is on the Same Page

If anyone in the group thinks it is okay for an impaired person to drive short distances, lose them fast. Visual, physical, and cognitive impairments that affect driving do not make it safer if the distance driven is short, as we explained above. The voice the elder hears must be unanimous.

Use a Low-Key, Respectful Approach

It is very hard for most people to face this change. It can help to acknowledge how hard it is to give up driving, and that you recognize how painful it is.

Figure Out a Plan for Alternative Transportation Ahead of Time

Have your materials ready. If there is a senior center-sponsored van service, for example, get their printed information as to how to contact them and arrange rides. If family will help with giving the elder rides, discuss the schedule beforehand. If the elder goes to church or a club every week, decide who will take them and pick them up. If the elder is not cognitively impaired and bus service is available, get the bus schedule and provide it. Offer these alternatives, with reassurance of the commitment to help.

Be Direct with Your Request

If you want the elder to stop driving altogether, ask for the keys. If driving is to be limited, discuss and request what you think is best. For instance, night driving is often a first limitation to which an elder will agree. Suggest that someone else can take the elder to activities at night, such as movies or social events. That person needs to volunteer and be available. If the car will not be used any longer by the elder or a caregiver, ask for the elder’s agreement to sell or otherwise dispose of it, giving it away, or whatever is appropriate.

The privilege of driving must always be balanced against the need for public safety. As family members, we owe it to everyone around us to take necessary steps to help our aging loved ones give up the car keys when they become dangerous behind the wheel. It is never okay to wait until there is an accident, as lives are at stake, even if they only drive close to home.

As lawyers, we have an opportunity to use our knowledge of the law and our skill in applying it to help our clients and their families move forward when it is time to limit or stop driving. Families may need our help. We are in a leadership role with clients, and we have the needed ability to advise them when public safety should take priority over the right to individual freedom. They may not be able to make that decision without our help and guidance.

Lawyers can initiate the conversation, make suggestions, meet with a client one on one, or offer to chair or facilitate a family meeting. We can use our influence, our position of trust, and our skill in offering advice in an organized way to help any older client through the transition from driving to giving it up when the time comes. We can use the power of a relationship of trust to encourage, reassure, and support the safest decision for an aging client.

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Author

Carolyn Rosenblatt has more than forty-five years of experience in her combined professions of nursing and legal practice. She is the cofounder of AgingParents.com and AgingInvestor.com, and she is the author of both The Family Guide to Aging Parents and The ABA publication Working with Aging Clients: A Guide for Lawyers, Business, and Financial Professionals.