The time will come when you will feel concern or even fear that an aging loved one should no longer drive an automobile. This is likely one of the most important and contentious topics you will face as a family caregiver.

Age should never be the sole reason for taking away a person’s driving privileges. There are people in their eighties and nineties who drive safely every day, while there are people in their fifties and sixties who are dangers to themselves and others when they’re on the road. Physical and mental health conditions, medications and age-related changes can all impact a loved one’s ability to drive safely.

Regularly assessing a senior’s driving is crucial for ensuring their safety and that of their community. If an aging loved one has a new diagnosis or is confused, inattentive, excessively nervous or reckless behind the wheel, then it is time to take action and make some changes. Explore the following challenges that can make driving difficult or downright dangerous for older individuals and how family caregivers can help them cope.

Senior Health Issues that Impact Driving

Age-Related Vision Changes and Eye Diseases

Eye conditions such as cataracts, macular degeneration, glaucoma and diabetic retinopathy can affect a senior’s vision and greatly alter their driving ability. Regular appointments with an optometrist or ophthalmologist can ensure early detection and treatment of vision problems, ideally preventing permanent and worsening eye damage.

It is possible that some visual impairments can be accommodated by not driving at dusk or night. Some conditions, such as cataracts and glaucoma, can be corrected with minimally invasive surgical procedures. If your loved one wears glasses or contacts, annual eye exams are crucial for detecting changes in visual acuity and ensuring they’re wearing the correct prescription.

Hearing Loss

Hearing is another sense that weakens with age. While it may not seem like a factor that can affect safe driving, hearing loss can make it harder for seniors to notice horns, sirens and noises from their own vehicles. They may not be aware of approaching emergency vehicles, other drivers’ warnings or mechanical issues while driving, which can be very dangerous.

It’s important for seniors to have their hearing checked regularly. The American Speech-Language-Hearing Association recommends doing this at least every three years after age 50. If hearing loss is significant, seeing a audiologist and purchasing hearing aids may help. Seniors who wear hearing aids should always remember to put them in before getting in the car. Keeping the inside of the vehicle as quiet as possible can help reduce ambient noise and increase the likelihood that a senior driver with hearing loss will be able to detect sounds and alerts around them.

Limited Mobility, Reduced Strength and Longer Reaction Times

Most people don’t consider driving to be a physically demanding activity. However, maneuvering an automobile takes dexterity, coordination and strength in the hands, arms, legs and feet. Even minor physical limitations may affect a senior’s ability to control the steering wheel, gear selector/shifter and pedals. Rigidity and/or pain in the back, neck and other major joints can also prevent seniors from looking behind their vehicle and checking blind spots while driving.

Consider, too, the loss of height as a person ages. Thanks to gravity, osteoporosis and the deterioration of cartilage, people tend to shrink approximately one-quarter to one-half inch each decade after middle age. No senior wants to acknowledge that they are becoming shorter, but simply moving the driver’s seat forward and upward can make driving more comfortable and provide a better vantage point for improved awareness and control while behind the wheel.

In addition to improving a person’s strength and dexterity, physical activity is crucial for maintaining healthy response times. Unfortunately, many older adults lead a sedentary lifestyle and do not engage in regular exercise. Seniors aren’t just responsible for safely driving their own vehicles—they must also pay close attention to other vehicles around them, traffic signals, signage, pedestrians and much more. If an aging loved one is exhibiting physical difficulties and delayed reaction times, it may be time to begin an exercise regimen or take the keys away.

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Medical Conditions That Impact Driving

There are several medical conditions that can make driving extremely risky. Depending on their severity and symptoms, health issues like epilepsy, fainting, sleep disorders, and a recent stroke or heart attack can prevent a person from driving for a certain period of time or altogether.

Difficult diagnoses like Alzheimer’s disease, other forms of dementia and Parkinson’s disease can make it challenging to determine if an elder is capable of driving. Dementia and driving can be a dangerous mix. This is especially true in the early stages of these diseases, when patients are prone to “showtiming” and their impairment may be only noticeable in certain areas. This is even more reason for dementia caregivers to be vigilant about monitoring changes in a loved one’s functioning.

If an aging loved one has a new or worsening medical condition that you feel is interfering with their ability to operate a car safely, it is crucial to address these concerns with their physician. The doctor should be willing and able to broach the subject with your loved one, discuss options for treatment and symptom management, and advise them on the risks of continuing to drive.

Medications Can Have Dangerous Side Effects

Prescription drugs are designed and prescribed to treat conditions and produce specific outcomes within the body. However, along with the benefits comes a host of potential side effects. While these drugs have been studied extensively, medications don’t affect every person the same way. Seniors in particular are more susceptible to adverse reactions. Common side effects of prescription medications that can affect driving abilities include drowsiness, dizziness, slowed reaction time and movement, fainting, blurred vision, excitability, and inability to focus. Antidepressants, cold and allergy medications, anti-anxiety drugs, narcotic pain medications, tranquilizers, and sleeping pills are most commonly associated with these disruptive side effects.

It’s important to understand that one medication may not affect a senior adversely, but when they are taking many different prescription and over-the-counter (OTC) drugs, they can interact and have serious effects on judgement and alertness. Your loved one’s physician(s) and pharmacist can explain all potential side effects and interactions of the medications they’re taking. If a senior is experiencing any problematic symptoms, it’s important to notify the prescribing physician to see if an alternative medication may be effective.

Seek a Professional Opinion

It can be challenging to determine if a senior is still a capable driver, especially if several of the above issues might be affecting their daily functioning. The best way to head off any problems is to encourage an aging loved one to maintain an open dialogue with their various physicians about this matter. While it may not be beneficial in every case, a mature driver course or senior driving improvement course may help those who simply need a refresher on proper driving techniques and rules of the road.

If you feel that a senior is unable to accurately self-assess their driving abilities and it is time for them to hand over the keys, recognize that you will likely run into resistance. This is understandable. However, if that is the case, there are several different approaches that can help you prevent your loved one from getting behind the wheel. You just have to find a tactful, loving way to approach this difficult topic.