How to talk to an elderly parent about driving
You've decided that it's time to talk to your loved one about her driving abilities. What should you do to prepare ahead of time? How should you bring it up? What do you do if she continues driving after your conversation?
Before the conversation
Don't wait until your parent's driving abilities are in question. Having conversations about driving before there are overt warning signs will help to identify when and how driving can be modified. It will also make the conversation easier for both parties since guidelines and expectations have been established.
It is often helpful to introduce the topic as "driving retirement" instead of "hanging up" or "taking away" the keys, says Lissa Kapust, MSW, LICSW, a social worker for DriveWise, a comprehensive driving assessment program at Beth Israel Deaconess Medical Center in Boston. According to Kapust, this term is less intimidating and sounds more like a natural stage of a person's life.
But as family, it's important to remember that taking away the keys means more than not driving -- it is a loss of independence and symbolizes (an often irreversible) decline in health and autonomy. The discussions are most successful when you come up with strategies that will enable your loved one to remain as independent as possible.
Having the conversation
Discussing driving can be stressful for everyone involved. Try to understand the difficulties your loved one is facing. You'll also want to consider your parent's personality and lifestyle and choose strategies that best fit their needs. Kapust offers these tips that may help to start the conversation:
- Choose the best person to bring up the topic. It may be better to have one person bring up the topic, particularly if there is a sibling or family member who is adept at addressing sensitive topics. Would your loved one respond better to a spouse, child, caregiver, or good friend? More importantly, everyone should be on the same page and reinforce the message of safety while addressing concerns about lost independence and isolation.
- Do not be confrontational. Taking a confrontational approach can cause your parent to become defensive. Being supportive and understanding will likely make the discussion easier and result in a better outcome.
- Use specific examples. Draw on specific instances from your time spent with your loved one driving in the car. Bring up times you were nervous, such as difficulty at a stop sign, with an intersection, or merging lanes. Also bring up any recent accidents or other behaviors that caused concern.
- Choose the right time. It may be easier to have the conversation after a major event such as an accident or change in health status. However, this does not mean you should wait until a major event occurs to begin the discussion.
- Take the focus away from the senior. Some seniors may respond better if a greater focus is put on factors other than the driver's abilities. For example, if there is an accident (whether it is the elder's fault or not) an older person may more vulnerable and less able to recover from injury following an accident.
- Put it in the context of other loved ones. "Do you feel safe driving your grandchildren?" or "I wouldn't know what to do if you were hurt in a car accident" are two ways that to get your parent to think about the impact on the rest of the family. "It can also help to identify a family member who would benefit from the gift of the car," says Kapust. For example, a senior may be more likely to give up the car if she knew her granddaughter could use a car to bring to college.
- Remain calm. Even if your loved one is upset or angry, remaining calm and supportive is important. It's likely that your parent is dealing with a complicated set of emotions. Getting angry will only make the situation more difficult.
- Focus on alternatives. Demonstrate that losing the car does not mean losing the ability to travel. Have an easy-to-understand alternative plan of travel that your loved one can review and consider. This can include a schedule of times family and friends are available as well as public transportation options.
If your talk didn't work
Although most people will eventually listen to a caring loved one's concerns about driving, some seniors will continue to drive. This is especially true for people with dementia, who are not aware that their driving abilities have declined. Here are a few options of what to do when the conversation is not enough:
- Speak to a medical professional. Some people who do not listen to their family will heed the recommendations of their doctor. Kapust says that "medicalizing" unsafe driving can make it easier for the senior to accept driving retirement. When the problem is presented as a medical issue the senior is less likely to take it personally and they are, therefore, more likely to accept it as something beyond their control. It is usually helpful to express your concerns to the doctor before your parent's appointment to ensure the doctor is aware that driving is an issue that needs to be addressed. In certain states, a doctor can report to the Department of Motor Vehicles (DMV) if she or he believes it is unsafe for the senior to drive. The DMV will then require the senior take a driving evaluation or revoke the senior's license, making it unlawful for him or her to drive.
- Schedule a driving assessment. Driving assessments (health status, medications, recent record, observable differences) can be used to confirm to a senior that she should not be driving or needs to modify her driving habits. According to Kapust, the best evaluation programs include a social worker who provides both an evaluation and ongoing support. A social worker can help both the senior and the senior's family to navigate the emotional and practical impacts of driving cessation.
- Look at it in terms of cost. Calculate how much car maintenance, insurance, and gas costs. This amount can be compared to how much other methods of travel (such as the alternatives you already planned) cost. In extreme cases, a lawyer can be consulted to show how much money a serious accident may cost. According to Kapust, it can help to explain that if an accident occurs following formal documentation of concern about the driver's abilities, insurance may not cover the cost, which could wipe out the senior's savings and assets.
- Take away the keys or the car. If all else fails, it may be necessary to physically take away the keys or the car. However, this is a very confrontational approach and can cause conflict. It should only be used as a last resort if the safety of the senior, or others, is in jeopardy.
Although addressing driving concerns with a parent or loved one is not easy, it is better to have the conversation proactively than wait until a crisis occurs. Keep in mind that your parent is probably struggling with major life changes. Sharing your concerns in a calm and supportive manner will increase the likelihood of finding solutions that balance the importance of safety with her need for independence.