Do you have residents who are driving and probably should not be driving?
While most individuals who live in senior living communities have quit driving, not all have. The question a senior living community has to face from time to time is how to evaluate the quality of a residents ability to drive and when management should intervene. This is an area that generates much controversy about whether to allow older adults to drive. However, there are complications with forcing an older adult to stop driving. One problem is that there are parts of the country, especially here in Southern California, that do not have adequate transportation options. Another problem is figuring out how to know when someone is no longer able to drive safely.
How old is too old to drive?
Quiz question (answer True or False): Most older adults give up driving when they are no longer safe to drive. This is a trick question. Most older adults do give up driving when they are no longer safe to drive. The population that does not typically give up driving when they should are the adults with dementia. The disease process robs them of the ability to make good decisions about their abilities to drive safely. Some cities in Orange County, California have transportation options for seniors- either an access bus system, taxi vouchers, friends, family, or volunteers. But these can be very inconvenient options. People have told us that they have to wait up to four hours for the Access bus to arrive. And many seniors don’t like taking a taxi. For the individual with dementia, there are additional issues with using public transportation. They may not remember how to take the subway or bus, or maybe never learned how. And to start a complicated task like using public transportation, when under the challenge of dementia, would be very difficult for the individual. Who would train that individual to learn the system? Who would ensure the safety of the individual to travel?
Driving Assessments
What we have discovered in the many years of providing driving assessments, is that the only way to determine whether an individual is safe to drive is by doing a driving assessment by an occupational therapist who also specializes in driving rehabilitation. Oh, sure, you can use one of the computerized tests, but that is not the same as driving in a real car. Driving assessments in 3D do have their risks- we put our lives in the hands of the driver, and stay vigilant to ensure we will prevent accidents before they happen. This is a frequent occurrence! People are referred to the driving assessment center for a reason- they already have a medical issue that the doctor feels concerned enough to refer for an assessment. In the coming weeks we will address specific disease processes, and how they affect the individual’s ability to drive safely. This will help you as a senior living operator better identify residents who are at risk.
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Debbie makes a great point that the best way to determine whether an elder is still safe to drive is to get an occupational therapy assessment. The larger problem is that family often have difficulty approaching the elder about giving up the keys. In my booklet, How To Handle A Dangerous Older Driver, I recommend a 5 step approach to the conversation and what to do if it fails. I also suggest using a checklist (Texas Aging Network’s in in the booklet) to help, as well as getting an OT assessment. The booklet is available under Products at AgingParents.com. If you know an elder is dangerous behind the wheel, please don’t “wait until there is an accident”. Someone could die as a result. As a former RN and personal injury attorney, I write about this subject often!
Thank you for the information Carolyn! You brought up some good points about the family. I’ve found that sometimes the family resists the cessation of their loved one’s driving, because they don’t want to be responsible for all the trips to the doctor and the pharmacy. This would probably not be an issue if the driver lived in an assisted living facility, for example, because the facility would be able to provide the transportation to needed destinations.
The second part of my reply refers to the difficulty the family has in approaching their loved one about giving up the keys. I find that often a family member will call me and ask me to be the “bad guy” to say the older adult is no longer safe to drive. That way the family can stay in the good graces of their loved one.
Giving up the keys is difficult on the driver AND the family!
In California you can anonymously report an “unsafe” driver to the DMV. They will notify the reported driver by mail to come in and take at least the vision test. In in the case of someone close to me that I reported to the DMV who had impaired vision, they did not make that family member do a driving test, and he somehow passed the vision exam, how I’ll never know. Fortunately this family member gave up driving shortly thereafter without incident, thankfully, but families need to be proactive about doing that before someone gets hurt or killed. My theory is denial and guilt likely play a part in family members taking charge of a potentially dangerous driving situation.
Jeff- you CAN report people anonymously to the DMV. However, I’ve heard of numerous times that there is a sympathetic DMV worker to has revealed the name of the reporter to the individual they reported. Also, there are sympathetic DMV workers who will help a senior pass the vision test- I’ve heard from family members who observed this happening.
That is why I started this discussion. Since the DMV is not consistent in removing unsafe drivers from the road, those of us who are working in the senior industry need to be vigilant in assessing older adults who have a medical condition that may interfere with their ability to drive safely.
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