Posted on: Thursday, May 13, 2010
Taking the keys away
By Paula Rath
Advertiser Staff Writer
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It's often tricky to deal with an elderly relative who's become a risk on the road.
Advertiser photo illustration
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HELP AT HAND
• AARP offers a CarFit program to help set up a senior's car optimally for rearview mirror, seat and steering wheel settings.Older drivers are invited for a free, 20-minute CarFit check-up, 8 a.m. to noon Saturday at Kapi'olani Community College, Parking Lot D. Pre-registration is required: information, 843-1906. • Rehabilitation Hospital of the Pacific will introduce Senior Drive Smart, an advocacy program to evaluate drivers and offer them information on how to adapt their vehicles to accommodate risk factors and ensure safety, in June. Information: 544-3310. • AARP offers a volunteer-run Driver Safety Program, held frequently at various locations around the Islands. Information: 843-1906.
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HAVING THE TALK
Talking to a family member or friend about driving requires careful thought and planning. Don't procrastinate. Putting it off could lead to a more difficult conversation later, or perhaps even to an accident. Include parents as an active part of all discussions and decisions about their driving. They should feel they are still in control and that you respect their ability to direct their own lives. It's important to identify the best person to talk with the older driver. The messenger should be someone the driver believes has his or her best interests in mind. Some tips to help the messenger meet with success: • Accentuate the positive. While you may find instances in which your parent is not driving safely, focus on what he or she can do well. If simple trips during the day are still feasible, avoiding driving in some situations may be easier than stopping completely. • Be sensitive. No one at any age likes to be told he or she is a dangerous driver. Help them assess their current driving skills and address problems. • Encourage habits that make driving safer: ó Avoid night driving, rush hour or being on the road in bad weather. ó Limit trips in the car to short distances. Plan and know the route in advance. ó Have the driver incorporate more space between his or her car and the one in front. ó Obtain regular medical check-ups, including for vision and hearing. Make sure medications don't interfere with alertness. • Help drivers find other transportation. Help sort out bus routes and schedules. Understand that a $10 cab fee may seem astronomical at first and arrange to pay the cab fares at first if possible. ó AARP Driver Safety Program ALTERNATIVE TRANSPORTATION TheBus: www.thebus.org TheHandi-Van: 456-5555, www.honolulu.gov/dts /ridersguiderevision2009 Cash-free taxis: There are companies that will set up credit accounts. Among them are Charley's (531-2333) and The Cab (422-2222). TOP 10 SIGNS It'S TIME TO HAND OVER THE KEYS 1. Frequent close calls (near accidents). 2. Dents, scrapes on the car or on fences, mailboxes, garage doors, curbs, etc. 3. Trouble judging gaps in traffic at intersections and on highway entrance/exit ramps. 4. Other drivers honking at you. 5. Getting lost. 6. Difficulty seeing the sides of the road when looking straight ahead. 7. Slower response time, trouble moving foot from gas to brake pedal or confusing the two pedals. 8. Getting distracted easily or having trouble concentrating. 9. Difficulty turning your head to check over the shoulder while backing up or changing lanes. 10. Traffic tickets or warnings by traffic or law enforcement officers in the last year or two. Source: Elinor Ginzler, AARP director of livable communities
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HAVING THE TALK
Talking to a family member or friend about driving requires careful thought and planning. Don't procrastinate. Putting it off could lead to a more difficult conversation later, or perhaps even to an accident.Include parents as an active part of all discussions and decisions about their driving. They should feel they are still in control and that you respect their ability to direct their own lives. It's important to identify the best person to talk with the older driver. The messenger should be someone the driver believes has his or her best interests in mind. Some tips to help the messenger meet with success: • Accentuate the positive. While you may find instances in which your parent is not driving safely, focus on what he or she can do well. If simple trips during the day are still feasible, avoiding driving in some situations may be easier than stopping completely. • Be sensitive. No one at any age likes to be told he or she is a dangerous driver. Help them assess their current driving skills and address problems. • Encourage habits that make driving safer: — Avoid night driving, rush hour or being on the road in bad weather. — Limit trips in the car to short distances. Plan and know the route in advance. — Have the driver incorporate more space between his or her car and the one in front. — Obtain regular medical check-ups, including for vision and hearing. Make sure medications don't interfere with alertness. • Help drivers find other transportation. Help sort out bus routes and schedules. Understand that a $10 cab fee may seem astronomical at first and arrange to pay the cab fares at first if possible. — AARP Driver Safety Program ALTERNATIVE TRANSPORTATIONTheBus: www.thebus.org TheHandi-Van: 456-5555, www.honolulu.gov/dts/ridersguiderevision2009 Cash-free taxis: There are companies that will set up credit accounts. Among them are Charley's (531-2333) and The Cab (422-2222). TOP 10 SIGNS It'S TIME TO HAND OVER THE KEYS1. Frequent close calls (near accidents). 2. Dents, scrapes on the car or on fences, mailboxes, garage doors, curbs, etc. 3. Trouble judging gaps in traffic at intersections and on highway entrance/exit ramps. 4. Other drivers honking at you. 5. Getting lost. 6. Difficulty seeing the sides of the road when looking straight ahead. 7. Slower response time, trouble moving foot from gas to brake pedal or confusing the two pedals. 8. Getting distracted easily or having trouble concentrating. 9. Difficulty turning your head to check over the shoulder while backing up or changing lanes. 10. Traffic tickets or warnings by traffic or law enforcement officers in the last year or two. Source: Elinor Ginzler, AARP director of livable communities
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Linda Hoogs, 69, of Kailua, knew her 98-year-old father should not be driving. The neighbors in his retirement home were alarmed and called her about it.
During one of her monthly visits (he lives in Washington state) she noticed a big dent on the passenger side of his car. He tried to deny that there had been an incident.
"I was desperate to get the car away from him because he kept thinking he could drive, and he just couldn't," she said with exasperation. "His right leg was so weak that he could barely put on the brakes."
Over his strenuous objections, Hoogs took away his car keys and brought them home to Hawai'i thinking the problem was solved.
"Within a couple of days he called me and said in a taunting little-kid way, 'Ha ha, I have another set of keys,' " Hoogs said, sighing.
Realizing she needed help, Hoogs wrote to the Washington State Department of Motor Vehicles, explaining the situation. They sent her father a letter asking him to come in for a driving test. Realizing he could not pass the test, he relented. During her next trip she had his car shipped to Hawai'i. Now his granddaughter is driving it, which made him feel better.
Note: In Hawai'i, only a physician can report that a person may be unsafe to drive.
In retrospect, Hoogs said, there are some things she would have done differently. She would have had "the talk" much earlier — and she would have presented Dad with alternative modes of transportation.
"It's hard because he sees it as taking away his independence and he sees me as being mean, but I don't want him to hurt someone else or to hurt himself," Hoogs explained.
WRENCHING TO LIFE
Having the keys taken away can have serious psychological consequences. Many seniors believe that not driving will make them dependent on others for necessities, as well as limiting their social and leisure activities.
Convincing seniors to give up their keys can also be particularly challenging with a parent, because of the role reversal.
"It's really difficult. You want them to stay independent and mobile, but there comes a time when they shouldn't be behind the wheel," said Bruce Bottorff, associate state director of communications for the AARP.
The issue of when an elder should stop driving is seldom black and white, said Dr. John Houk, an internist and medical director at the Arcadia Retirement Residence.
"It's a subjective determination and it's really difficult," Houk said. "Quality of life in America depends a lot on the car."
Houk emphasizes the importance of being sure that taking the keys away is absolutely necessary. The family of one of his patients recently talked his eye doctor into telling him he couldn't drive. However, the doctor did not have all the facts. "Grampa had never had a ticket and was perfectly capable of driving. It was their subjective opinion, but his life would close in on him because he lived alone where there were no buses and he would have been miserable if the keys were taken away.
"Setting an age limit doesn't work because many people are fine to drive well into their 90s," Houk said.
SAFE TO DRIVE
It's helpful to think about, plan and have several talks leading up to the dreaded "big talk" about putting an end to driving.
In fact, it's ideal if the talks begin before there is any threat to the older driver. It's important to acknowledge the meaning of driving to the quality of life and to offer alternatives right away.
Houk advises families to collect the evidence from spouses, doctors, neighbors and friends — and then get in the passenger seat and see first-hand how the elder driver does.
Don't make it a "test," Houk suggests, just find an excuse to get in the car. It's best to go on a familiar trip (to the supermarket, for example) as well as to somewhere less frequented.
If it's clear the keys should be taken away, make a separate appointment with a doctor to discuss the issue; do not discuss it at a regular doctor's visit.
Most drivers monitor themselves and voluntarily limit or curtail their driving if they feel unsafe. However, if a physical problem such as eyesight or arthritis is the issue it's much simpler to determine driving ability than with, say, dementia or Alzheimer's. Since judgment is so critical to good driving, and judgment is impaired with dementia, it's important to identify if it is a problem.
Perhaps the most important thing, however, is to understand all the implications and life changes involved with taking away those keys.
