We third-third-ers fortunate enough to still have parents spend a fair amount of time justifying what we do or do not do for them. We seek to validate our decisions, constantly in my case – with ourselves, our siblings, our spouses, our parents themselves, and our friends. Of these, I find our friends are at once the most comforting and the most honest.
Take, for example, the hot button issue of driving. It was a friend who, after I offered my usual justification for failing to take the keys away from a man who’s 86, blind in one eye, and recently suffered a couple of fender-benders (*“He drives very slowly, so I don’t think he could kill anyone else; and he drives a Cadillac tank, so I don’t think he will kill himself”*) asked, “What about a child on the way to school? Or a toddler unleashed from his parent’s hand in a grocery store parking lot?”
Okay. The next time I see him, I’d better broach the subject. The fact that he’s not speaking to the last person who spoke up responsibly is a bit of a deterrent. But he’s been angry before. Many times. Besides, according to the literature of aging, his anger is an appropriate, understandable response. Confronting Age’s own limitations is tough enough; that anyone or anything would threaten the independence and mobility his car represents is a huge psychological last straw. So huge that when one Googles “taking away car keys, elderly,” there are, instantly, a half million cites. My favorite is a reference to the author of a book called Elder Care Made Easier who admits that taking away the keys from her parent was “among the most serious and complicated issues” she ever faced.
The facts remain: Drivers over 75 have the second highest rate, after teenagers, of fatal crashes per miles driven. The fatality rate for those drivers over 85 is 9 times higher than the rate for drivers aged 25-69. Drivers over 65 are more likely to be severely injured and/or most likely to be involved in multi-vehicle crashes.
Why? Older drivers lose eyesight, hearing, and cognitive function. Some take complicating medications. Some have chronic diseases and/or physical impairments. The most common cause of car accidents involving the elderly is cognitive decline -- even a momentary a loss of memory, judgment, and/or understanding can be lethal.
So how do you start this conversation? I am reminded of parenting lectures I attended during which a distraught and frustrated parent would remind the parenting expert that while she had tried his or her recommended words or techniques, her 3 year-old had not read the book and was not responding in accordance with the plan. My father has not read this book, either, and I know there is not an approach out there that will ease us into this discussion.
In fact, however, he has, on his own, judiciously curtailed his driving. He doesn’t drive the superhighways – no more trips to the airport. He doesn’t drive after dark. He drives slowly, and only on familiar roads. He is very, very, very careful. (He will drive you very, very, very crazy if you’re behind him or in a hurry.) So he has already taken care of the first step the experts recommend. Second comes an agreement to give up driving if (more likely, when) any number of other things happen – if, for example, his eyesight changes, or his doctor recommends that he not drive, or if he has (another) accident of any sort. The key at this point – and the challenge to us -- is to take away the car without taking away his transportation. Can we arrange for family members, friends, public transit and/or hired help to get him where he wants to go? If we live nearby, are we willing to take on the job ourselves? If we live across the country, can we do the requisite research and interviews, even spend a week with him learning the new ways he can get around? It seems to me we need to recognize the enormity of what we’re asking of him – and respond in kind.
Actually, taking away a parent’s car keys is not a conversation; it’s a process. Painful, difficult, and ultimately necessary because it is, literally, a matter of life and death -- from both points of view (he will say he’d rather die, or he might as well die if we take the keys away). The responsible adult child has the most leverage in the negotiations, but you don’t have to go it alone. Physicians can and should help. (The American Medical Association has published The Physician’s Guide to Assessing and Counseling Older Patients.) AARP offers a Defensive Driving Program (1.888.227.7669). You may want to read How To Say It to Seniors by David Solie, or Elder Care Made Easier by Marion Somers. You can find additional resources online at eldercare.gov., and sometimes a helping hand at the Department of Motor Vehicles which will, in many states, respond to requests (even anonymous requests) that an older driver’s driving be tested.
As is always the case with these touchy subjects, I feel like Janus, looking in both directions. Even as I struggle to figure out how to keep my father safe and vital, not driving and yet out in the community playing bridge and grocery shopping, I am at the same time looking for new ways to transition into these advanced stages of aging myself (years from now, of course!!) so as not to cause my own children the same anguish and painful confrontations.
*How successful have your conversations about your parents and their driving been?
What resources have you found most helpful?
Have you made any commitments of your own to spare your children these decisions?*
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