Driving can become a difficult topic to navigate as loved ones age.
You may wonder if an elderly family member or friend can, or should, be on the road. More dings or dents may appear on their car. They may have been in a fender bender. Maybe you’ve seen them miss a traffic sign.
Although taking away the keys can lead to complex emotions and is different for everyone, there are tips and recommendations to help guide your decision.
Family members can look out for driving behaviors that signal an older driver may not be safe, including not being able to check for blind spots, hitting the wrong pedals, neighbors commenting on unsafe driving practices or getting lost on the way to familiar places, said Dr. Timothy Burke, a physician at The Wright Center.
During annual well or Medicare visits at The Wright Center for patients 65 years or older, there’s a mini mental health exam. Burke said the test can also indicate whether a patient is safe to be on the road.
Along with signs of cognitive decline, there can be physical warning signs. Burke explained that not being able to turn the head or neck, slowness of motor skills, delayed reaction time and vision impairment are all telling of possible inability to drive safely.
Burke said his patients usually accept the situation as best they can but it’s one of the hardest things for them to do.
“They feel like they’re losing their independence,” Burke said. “Think about if you’re driving for 70 years, and then you have to plan how you can get some other car? In general, people don’t want to be a burden to others, and you feel trapped at home.”
Driving can become a difficult topic to navigate as loved ones age. You may wonder if an elderly family member or friend can, or should, be on the road. (ISAAC DIAZ / STAFF)
The transition can be difficult on family members and it can be hard to know where to start. To start a conversation with your loved ones, Burke suggested asking how they feel about driving or if they’re nervous about it. Talking to them about possibly harming others is important.
“It’s not that we’re just worried about dad running into a telephone pole, but what if he hits something and there’s a person and then they’re injured?” Burke said.
Burke also said going for a drive with them and observing how they act and then having a conversation afterward can be helpful.
“I think starting to have that conversation as we age, before we get to the point where it’s unsafe, is good,” Burke said. “Almost like we do with advance directives. When we get to that point, what’s our game plan? I think the more family support there is, the easier it is for the older adult.”
State law mandates that physicians report at-risk drivers to PennDOT.
Burke said he has never had to make that call as patients are typically understanding.
System in Pennsylvania
Leanne Trindel, PennDOT Driver and Vehicle Services press officer, explained that in Pennsylvania, there’s a system in which 1,900 drivers who are 45 years and older are randomly selected each month for a physical and vision exam seven months before their driver’s license renewal.
These random medical examinations, in combination with the mandatory medical reports, are how unsafe drivers are flagged.
After doctors or police officers report an unsafe driver to PennDOT’s medical unit, the unit then collects medical documentation from the driver and starts an evaluation process.
Depending on the situation, Trindel said there may be driving privilege restrictions that are added or deleted, a license recall or restoration, or a request for more information or a driver’s exam. In some cases, no action is required.
If a driver refuses to surrender their license after they’re obviously unfit to drive, Trindel said concerned friends or family members can report them by sending an email or letter explaining the medical conditions that make the driver unsafe. Reports must include the driver’s full name, date of birth and address.
Although the reports are confidential unless required by court, PennDOT does not accept anonymous reports.
A difficult discussion
Dr. Joe Anistranski, physician at Geisinger 65 Forward Health Center, said telling a patient they may not be suitable to drive anymore can be difficult.
“It’s very hard to not be able to drive, especially around here,” Anistranski said. “Depending on the medical problem the patient has, I’ll just try to bring it up tactfully. A lot of patients will come in and just tell me they won’t drive at nighttime anymore because they have more trouble.”
Anistranski said checking how patients are walking in to appointments and what their reaction time looks like sometimes leads him to ask how they got there that day and look into whether driving could be a problem.
When approaching the subject with patients, Anistranski said he’s usually lucky enough to have known them for long enough that they realize he has their best interests in mind as well as everyone else on the road.
Another thing that can make things easier, he said, is a test in which an occupational therapist rides in a car with a patient and can assess whether they should be driving.
“You would have a nice, objective report to be able to show the patient,” Anistranski said. “They got in the car and said you didn’t pay attention to the signs or react well.”
Anistranski emphasized that patients and patients’ families shouldn’t be afraid to call their doctor if they’re worried. It can be helpful for concerned family members to come with their older driver so they can have a conversation all together, he said.