Boomers and Beyond: A difficult decision

It could very well be one of the hardest conversations to have with a loved one. How do you broach the frightening realization that driving skills are diminishing with age, physical limitations or dementia?

There is no doubt this is a delicate subject for many families, yet the consequences of not having a frank and open conversation about an unsafe driver in the family can be deadly. "Confronting a loved one about their driving is one of the hardest conversations family members can have," says Sue Piazza, a certified social worker and assistant director of the Oneida County Department on Aging. "Think about when you got your license, that sense of freedom. Now think about asking someone to give that up. It's very hard."

Piazza deals frequently with family members who come to her seeking advice about discussing diminishing driving skills with a loved one. She has found that one of the most common perceptions among people who need to have this conversation is that they feel alone and are at a real loss as to how to go about even starting this discussion. Piazza assures people there are alternatives. "There is help out there," she says. "People don't have to go through this by themselves. We have many options for those who can't drive anymore."

Statistics bear out that the older drivers get, the higher the risk of accidents. According to The Hartford, a car insurance company, car accident numbers decrease as age increases, but experts attribute this to self-imposed limitations many seniors put on themselves. For instance, they may curtail driving at night or on busy freeways. However, after people turn 75 or older, the accident rate and rate of risk is nearly equal to that of drivers in the 16 to 24 age group; and the rate of fatalities increases tremendously after age 75. This higher rate is due to the decreasing ability to withstand the physical decline that often occurs with age.

While statistics bear out the fact that older drivers can pose a risk on the road, confronting a loved one about their driving is a very personal matter. One of the first steps to take is to make sure the driver in question is really a risk on the road. Are there more dents and dings in the vehicle? Have there been more "close calls?" Are other people commenting on the person's driving habits? "Before you start a conversation with a loved one about driving, make sure there really is a problem," says Piazza. "Everyone can have a close call or put a dent in their car, but if the instances are not isolated and are happening more frequently, then you need to address that."

Choosing how to have this conversation is also very important. "The time to sit down and talk with a loved one about their driving is not immediately after they have had a close call or an accident," Piazza says. "In fact, the best way to approach it is to have several conversations about it over a period of time."

Angrily confronting a loved one is also very unproductive. "You can't come at the person with a bunch of ultimatums like, 'We're taking your car keys away' or 'We're getting rid of the car," she explains. "That just builds resentment."

If discussions about a loved one's diminished driving abilities take place calmly, lovingly and over a period of time, these drivers are more apt to listen. According to the Hartford survey, of the older adults who reported that someone had talked to them about their driving, more than half said they followed the suggestions of their loved ones. Women generally complied more than men.

But what if a loved one just won't take suggestions or insists on driving when they may be suffering from dementia or other age-related maladies that make them a risk on the road?

According to the Department of Transportation (DOT) website, Wisconsin does not have a mandatory reporting law, but physicians may report concerns about a patient's driving ability to the DOT without informed consent of the patient. This applies to anyone whose physical or mental condition may affect his or her ability to safely operate a motor vehicle, based on a physician's judgment. Decisions about impaired drivers are based on individual signs, symptoms, behaviors and the observations of others, rather than the type of condition or diagnosis.

There is a form (MV3141) that must be filled out through the DOT if a person thinks someone poses a risk on the road because of his or her age or medical condition. Depending on the nature of the driver's limitations and the contents of the driver condition report, the DOT may require the person to undertake a road test; a knowledge test; supply a medical report; or pass a vision test or screening. If results of these tests show a diminished ability to operate a motor vehicle, the person's license may be cancelled; however, only a behavior report signed by a doctor of medicine, advanced practice nurse prescriber or doctor of osteopath can result in immediate cancellation of a license.

Regardless of the method used to convince someone his or her diminished driving ability is unsafe, to make the transition easier, loved ones should explore alternatives that do not require the person to drive. For instance, family members can take turns driving a loved one to the grocery store, barber or hair dresser, church services or on other errands. In addition, at least in Oneida County, there are a couple of very helpful alternatives for seniors who don't drive anymore. A bus is available to take clients to doctor appointments, shopping and on other errands. Also, there are kind-hearted volunteers willing to take non-drivers wherever they need to go. "We have drivers who will pick people up in Three Lakes, Rhinelander, Minocqua and drive them to doctor appointments in Marshfield or Wausau," says Piazza. "These people are godsends for this program."

She also advises adult children or caregivers to accompany their non-driving loved one when they do use these alternatives. "That way, if you can't be there, then they will feel more comfortable when they need to get somewhere and they are alone."

All in all, talking to a loved one about his or her driving ability is a delicate subject that requires tact, sensitivity and kindness. "If this conversation is done in a loving and compassionate way, most people will see the reason and comply," Piazza says. "People don't need to feel alone when they are confronted with a situation like this. We are more than willing to help. All they need to do is call."

For more information, contact the Oneida County Department on Aging at (715) 369-6170.

Mary Ann Doyle is the associate editor of the Star Journal.

This article first appeared in the Feb. 1, 2012 edition of Northwoods 'boomers and Beyond.