The time will come when you will feel concern or even fear that your parents should no longer drive an automobile.

This is one of the most important deliberations, considerations and possible actions you will face as the family caregiver.

A person's age is not and should not be the reason for taking away the car keys. There are people in their 80s and 90s who hold licenses and drive actively and safely, while there are others in their 50s and 60s who are dangers to themselves and others when behind the wheel.

Driving abilility, as it is impacted by physical and mental condition is the first factor to consider.

Senior Health Issues that Impact Driving

Senior Vision Changes

Conditions such as cataracts, macular degeneration, glaucoma and diabetic retinopathy can hamper driving ability. Your parent's optometrist or ophthalmologist can identify vision problems, limitations, concerns and cautions. It is possible that some limitation in vision can be accommodated by not driving at dusk or night. Some conditions, such as cataracts and glaucoma, can be corrected surgically. If your mom or dad wears glasses, schedule an annual eye and vision examination to determine if vision has declined.

Senior Mobility and Physical Abilities

Driving takes dexterity, ability and strength in both arms and legs/feet to control the vehicle at all times. Consider any physical limitations. Consider, too, if an aging parent has shrunk a bit in physical size, where the solution may be to move the driver's seat forward and upward for both better control and vision over the hood of the car, and/or adding a pillow.

Mature adult drivers die in auto accidents at a rate higher than other age bracket because, at home, many do little or no exercise, not even a daily walk outside. Reaction time may be diminished in an individual with little to no physical activity. Therefore, if your parent currently does no physical activity to maintain or build strength, agility and aerobic ability, this should be a concern.

Diagnoses that Impact Driving

Patients with Alzheimer's disease can become disoriented almost anywhere, and a severe diabetic may fall into a coma. The parent's physician can advise of such possible problems and risks. But, don't assume that your parent has Alzheimer's if he or she forgets momentarily the location of a wallet, purse or newspaper.

Medication Reactions Affect Ability to Drive

Prescription drugs are chemicals designed to produce specific and desired changes or functions within the body. But, as in the law of physics, for every action there is a reaction. That reaction may be drowsiness and/or a slowing of the person's reaction time. In the field of medicine these are identified as side effects and may effect, even seriously, a person's ability to drive.

A patient taking several different prescription drugs, particularly if they are prescribed by different doctors who don't have updated knowledge of other drugs being taken, may have even more serious side effects as each of the drugs creates its own side effects plus conflict with other drugs to cause even worse reactions. The latter is known as polypharmacy.

Your parent's physician(s) can advise of the side effects of each drug plus the added conflicts through polypharmacy. You may also take all the prescription containers to a friendly pharmacist who can quickly do a computer-based analysis.

Doctor's Orders to Hang Up the Keys

The American Medical Association has published a detailed report and recommendation to all of its physician members that they assist caregivers, answer their questions, and present their recommendations regarding the elder's physical and medical conditions. The report also recommends that the physician be actively involved in counseling the patient to hang up the car keys.

Here are some hints for determining your mom or dad's ability to drive:

  1. Ride along: Take a ride or three with your parent and observe his or her physical ability in controlling the vehicle, staying within the lane, how turns are handled, the driving speed, ability to scan from left to right, any visual susceptibility to glare, and for any possible confusion in traffic. Do your observations simply, without nagging or distraction. Make notes upon return, for you may need to share them with an expert.
  2. Check the vehicle: Periodically and without fanfare, check the outside of the car for any possible dents or scrapes.
  3. Accompany your parent at least once to every medical specialist and service or treatment center and have him or her sign a HIPAA release of confidentiality form naming you as a relative with whom they can share any and all medical information without violating federal confidentiality laws. If your relative is on Medicare, you can check the Explanation of Benefits (EOB) statements he or she receives after each medical visit or payment. This will ensure that you are aware of changes in health status. These steps will guarantee that you can ask questions and express concerns with healthcare professionals as well as invoke professional assistance if needed.

Senior Driving Safety and Alternatives

Research other available transportation for if and when mom or dad must quit driving. A call to the local Area Agency on Aging can learn about Dial-A-Ride, public transit, specialized transit (door-to-door service typically by minibuses) and even volunteers who provide chauffeur service. And talk to your siblings, children and other relatives to be volunteer drivers when in need.

If you determine that mom or dad is still capable of driving, suggest they enroll in a Mature Driving course. Such enrollment may even qualify your parent for a discount on auto insurance.

Taking the car keys removes the parent's independence, the ability to drive to the market or to meet friends for coffee, to church and the senior center, the library or to visit friends. The experience can be traumatic, so consider the decision carefully.

As the caregiver, you may also have to deal with other relatives who may be too quickly judgmental and even emphatic that the keys must be taken. Let your parents know of everyone's concerns. Involve mom or dad in the consideration and decision. You may find a positive reaction when talking candidly with them, and they may understand your concern for their safety.

If you feel that your parents are unable to accurately self assess and it is time for them to hand over the keys, recognize that you may run into resistance. This is understandable. However, if that is the case, there are several ways to legally revoke your loved one's license. You just have to find a tactful, loving way to approach this difficult topic.