Managing Caregiving Details: The Basics
Session 1: Driving and Transportation Issues
Course Sessions
- Seminar Introduction
- Driving and Transportation
- Communicating with Health Professionals
- Public Programs to Investigate
- Checking Legal Issues
- Knowledge Test
Transportation can be a major challenge to an older person's ability to live independently. Some people remain good drivers into their nineties. Others face physical problems that can make driving unsafe. While some cities often have good public transportation, these systems may not meet the needs of older people. Public transportation routes and schedules are often designed to take people to work rather than to stores, medical appointments, and friends' homes. Taxis are a good option for older adults who no longer drive, can afford them and reside in a major city. However, many older adults live in rural or suburban communities and rely on family and friends for rides.
Transportation concerns can also be worrisome for adult children. Is Dad still driving safely? Are the fears that stopped Mom from driving justified? Can they live on their own if they don't drive?
Cars give us mobility and freedom, as well as a sense of safety, privacy, convenience and comfort. In many communities, a car is essential because there are few, if any, alternative forms of transportation. However, some changes associated with aging can affect a person's ability to drive safely. For these reasons, safe driving is the major transportation issue most older Americans face.
Older parents and adult children often view driving issues differently. From the older person's point of view, driving is likely to be more than a practical issue. It is often linked to feelings of competence, independence and inclusion in society. Adult children often wonder whether and when their parents should stop driving. However, many parents resent having their driving ability questioned and don't believe there is a problem with continued driving. In fact, a common perception among older people is that younger drivers are a greater danger.
On the other hand, some older drivers worry excessively and without sufficient cause that they are no longer safe behind the wheel. By giving up or limiting their driving too soon, they can restrict their daily lives and become isolated unnecessarily.
Where does the truth lie? Arguments support both sides. Older drivers have a low frequency of accidents and fatalities overall, but a higher rate of accidents and fatalities per mile driven (second only to that of drivers age 16 to 24). Transportation experts believe that the low frequency of problems comes in part from a recognition by older drivers of their declining skills. Older people avoid driving in high-risk situations, such as at night, during rush hour, in bad weather or on high-speed roads. The slower driving that provokes many complaints from younger people may simply be a reflection of people driving within their limits. Sometimes slow driving is legitimately dangerous. But, it is when drivers don't acknowledge difficulties with driving that they present the greater problem to themselves and to others.
Age alone cannot predict fitness behind the wheel. Just as among younger people, driving skills among older people vary enormously by individual. In general, these skills begin to decline at about age 55, but no scientific data support the need to reassess driving ability on the basis of age alone. However, it is also true that the poor eyesight, hearing loss, slower reaction times and reduced muscle strength and flexibility that many older people experience can all affect driving ability.
When older people do decide to give up driving, other issues may arise. Some may have no one to ask for rides, with family far away and friends no longer driving either. Others may be reluctant to ask for help, not wanting to impose on others. Instead they stay home at a time when being involved with the community is more important than ever.
Staying mobile safely
You can help your parents continue to drive safely, assess abilities realistically and find alternative sources of transportation if necessary. Here are some steps you may want to take.
Review and adjust your own attitudes about older drivers. Points to consider: Does your own driving style make you see slower drivers who stick to the speed limit as unfit? Do stereotypes about aging affect your feelings about older people as drivers? Do you view older people as individuals with different strengths or do you lump them together as a group? Will your feelings about older drivers change when you grow older?
Try to get an objective idea of your parent's driving abilities. Recent accidents or traffic tickets could signal a problem. Try to drive with him or her, or ask someone else to observe. This will give you information so you can be specific when you discuss the situation. Some community groups assess an older person's ability to drive by riding with that individual. Signs to watch for: Changing lanes without signaling. Going through stop signs or red lights. Slow reaction time. Problems seeing road signs or traffic signals. Straying into other lanes. Going too fast or too slow for safety. Problems making turns at intersections, especially left turns. Jerky stops or starts.
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. Simple trips around a small town during the day, for example, may pose no hazards. Avoiding driving in some situations may be easier to face than stopping completely.
Be sensitive in how you approach driving issues with your parents. No one at any age likes to be labeled as a dangerous driver, and studies show that most older people consider themselves relatively safe behind the wheel. Examples: Avoid taking a nasty tone, criticizing them or making them feel attacked. Express positive and supportive feelings for them. Bring up the topic indirectly, such as, "I hear Mr. Jones gave up driving. Do you think your driving ability has changed?"
Talk about ideas you have for keeping them on the road rather than suggesting that they give up driving. Provide reinforcement to correct shortcomings and overcome fears. Try to be understanding if your parent resists change. Just talking about the issue can help you gradually work toward better answers. Think about how you'd like your own children to address your driving some day.
Check your parent's car. Points to look for: Can your father still see over the dashboard easily? Do your mother's feet reach the pedals easily? Are the steering wheel, mirrors and seats properly adjusted? Are windows and mirrors free of clutter? Is the car in safe operating condition?
Help parents assess their current driving skills if they are agreeable. You also can check with local colleges or universities, occupational therapists, doctors or the American Automobile Association to see if they can help assess your parents driving skills.
Address problems the assessment uncovers. For example, if reaction time is slowing, a driver can allow more space between his or her car and the one in front. He or she can also avoid driving during peak traffic times or in crowded areas. Driver refresher courses or even behind-the-wheel driver education courses such as the AARP Driver Safety Program are other options.
Encourage habits that make for safer driving. Examples: Avoid night driving, rush hour driving and being on the road in bad weather. Limit trips in the car to shorter distances. Plan and know the route in advance. Have regular medical checkups, including hearing and vision. Exercise regularly to maintain strength and flexibility. Make sure medications taken don't interfere with alertness or ability to drive. Avoid potential vision problems, such as tinted windshields and windows.
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. The motivation for change must come from them, both for their own safety and for your relationship.
Involve others if driving is dangerous and your parents refuse to make changes or stop driving. A doctor, a member of the clergy or family friend may be able to help. As a last resort, you can contact the local Department of Motor Vehicles and report unsafe driving. Most states will contact older adults and have them take a driving test, revoking their license if necessary.
Help parents find other means of transportation so they can learn how to get around without a car. Work with your parents to identify what public, private and community transportation services are available. A good place to start looking is your local Area Agency on Aging, which can refer you to local transportation services for senior citizens. These may include public buses, subways, taxis, private drivers for hire, senior transportation services and volunteer driver services. Approaches to consider: Brainstorm together how your parents might get rides, and pitch in yourself when possible. Check out what's available in their community. Talk about what they might do for someone else in exchange for transportation. Find out about any discount or reduced rate programs for older adults.
