What to do when mom or dad won’t stop driving - Cape Cod Healthcare

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Published on December 11, 2015

What to do when mom or dad won’t stop drivingWhat to do when mom or dad won’t stop driving

Brewster resident Dot Venning stopped driving when she realized her vision was deteriorating.

“I don’t want to kill myself or anyone else,” said Venning, who is now 84. “I have a little macular degeneration and the headlights at night were so blinding that a couple of years ago I thought it was irresponsible of me to go out and drive. I’d rather stay home and stay safe.”

She still drives during the day, but never on the highway because she can’t read the signs until she is right upon them. She relies on rides from friends to get to the places she needs to go at night.

Venning doesn’t understand why anyone would resist giving up driving when it becomes unsafe to do so, but one of the hardest discussions adult children and physicians have with senior citizens is about when to give up driving for safety reasons.

Even when told by their family members or doctor that continuing to drive is unsafe, it’s hard for most people to accept. Many resist the information and go directly against doctor’s orders, said internal medicine physician Rose Shorter, MD, at Sandwich Primary Care.

“People get very upset when we bring up the topic of driving because their independence is what is at stake,” she said. “It’s a gray area from a practitioners point of view because there are patients that I have explicitly told, ‘you may not drive anymore because it’s not safe,’ and they drive to my office the next time and then I’m not sure what to do.”

In extreme cases, she has had to report the patient’s potential danger to the community to the Registry of Motor Vehicles, but she prefers to take a more practical hands-on approach first.

“Usually I stick to the facts,” Dr. Shorter said. “I tell them I am concerned about their driving and what I know about their health. Often that’s not enough. Then I insist that they take some kind of driving evaluation or test at the registry. If you pass it I will say, ‘okay I was wrong,’ but if you don’t, we are saving you and the community from a disaster.

“Sometimes I point out that if you hurt somebody, your life is going to be forever changed.”

Safe driving in our older years is at the heart of Older Driver Safety Awareness Week, December 7-11, which is sponsored by the American Occupational Therapy Association.

There are many reasons why it might not be safe for older people to drive, according to Dr. Shorter.

  • Early dementia – These are the patients who are usually the hardest to convince because they are not looking at the issue rationally. They tend to revert to the statement: “But I’m a good driver.”
  • Vision and hearing problems – For patients over 65, Dr. Shorter recommends a yearly vision and hearing test since both are critical to driving safely.
  • Slower reaction and processing time – It’s a known fact that both of these things occur as people age. “Around here we have no leeway on our roads,” Dr. Shorter said. “There’s no shoulder on most of them and they’re windy. Plus there are a lot of other people who are driving drunk or who are young drivers and they make mistakes. Can you react to those mistakes fast enough?”
  • Medications – Anyone taking medication that could make them drowsy should follow the warning label on the bottle and not drive if there is a caution against operating large machinery.

“For people reading this story who might be having these problems, these are good things to talk about with your doctor because there are some things we can do to make it better so you can drive for a while longer,” Dr. Shorter said.

For example, if medication is the issue, you can talk to your doctor about switching the medication to a lesser dose or something that does not have sedative qualities. If you have stiffness in your neck or arthritis, you can be referred to a physical therapist who can assess your ability to drive and help strengthen the areas needed for driving safely.

Dr. Shorter offers the following driving safety advice to older drivers:

  • Take a driver refresher course. The rules have changed since you originally got your license and you may have forgotten some of the basic rules.
  • Remove all distractions from your car. You will drive better if you aren’t listening to the radio or talking on your cell phone.
  • Keep your windshield clean and clear of obstruction. Don’t have things hanging from your mirror that could distract you with movement or light.
  • Follow the four second space rule between you and other cars. It will keep you focused on the task at hand.
  • Start breaking earlier when you need to stop.
  • Save any emotional conversations for times that you are not in the car.

“If you’re compensating for a loss of a few of the senses, you have to maximize the others so you can keep full attention on what you are doing,” Dr. Shorter said.