How to have the conversation about "taking the car keys away" from an aging parent

One of the biggest rites of passage into adulthood is getting your driver's license!

Do you remember the stress and anxiety you felt when your teenagers began to drive? Were they ready? Could they handle all the steps for changing lanes? Were they likely to be distracted by peers and mobile devices?

We gave them curfews, we told them what roads they were and were not allowed to drive on, we told them how loud they could play their music, and even limited the number of friends they could take in the car. By golly, some of us even had tracking devices on their phones to make sure they did not take detours!

Remember as a teenager thinking you were invincible? You wanted to be trusted but probably secretly wanted some limitations, too.

Fast forward, now you are faced with aging parents.

It's a major role reversal that is truly part of caregiving for loved ones. Almost every caregiver is faced with having the driving "talk." This conversation absolutely terrifies us for so many reasons. What if we don't do something and someone gets hurt? How will my loved one respond to the discussion? How will this conversation impact our lives from a time perspective?

We all secretly wish our parents would just realize they should not be driving anymore but most people feel like they're still able, often rationalizing by saying, "I only drive to church," or "I'm just going around the corner to the post office." If you decide to have a driving assessment completed by your loved one, you may learn short distances are actually fine, or maybe even daytime driving only is acceptable.

In 2015, there were more than 40 million licensed drivers ages 65 and older in the United States. Driving helps older adults stay mobile and independent. But the risk of being injured or killed in a motor vehicle crash increases as you age. In 2015, more than 6,800 older adults were killed and more than 260,000 were treated in emergency departments for motor vehicle crash injuries.

This amounts to 19 older adults killed and 712 injured in crashes on average every day. There were more than 40 million licensed older drivers in 2015, which is a 50 percent increase from 1999.

So how do you know if you should have a conversation? Think about these four areas that can impact your loved one's ability to drive.

1. Health status. Is their mobility restricted because of arthritis or chronic pain?

2. Cognitive diagnosis. Do they have a dementia diagnosis that is starting to impact their ability to make decisions?

3. Medications. Have they recently started a new medication that seems to make them sleepier than normal or even more anxious?

4. Recent history behind the wheel. Have you noticed dents and dings in the car or have you been in the car when there have been near misses?

If you are starting to feel distressed about the ability of a family member to safely drive you should trust your instincts above all else. When it's time to have the conversation, consider the following four points:

1. Have a firm plan. If you approach a family member with "you can't drive anymore" but don't have a solution for how they will be transported, you are setting yourself up for a very difficult conversation. Taking time to think about what their objections may be will allow you to plan for solutions and thus a better outcome.

2. Lyft/Uber are two options that were not even possible several years ago and have made it possible for transportation to occur with ease for seniors. You can even track them when they are on their routes! The main pitfall of these services is they are "door-to-door" not "through the door". So if your loved one needs any assistance at all getting in and out of a building, this is not the best option.

3. Mass public transportation is another option, but many people do not live on a traditional bus route and many seniors find the bus routes confusing.

4. Specialized public transportation for seniors and those who are disabled. Many counties in our area offer medical transportation for seniors, door-to-door. Below you will find public medical transportation for Wake, Durham, and Orange Counties:

• Wake County: GoWake Access
• Durham County: Durham County Access
• Orange County: Senior Non-Emergency Medical Transportation Program

Private transportation is another option for family caregivers. Some of these companies will be door-to-door while others will take the person through the door. Some caregivers find it useful to hire a private duty homecare agency or companion care agency to provide transportation in conjunction with other services their family member receives.

Pick a time for the conversation. As with any topic of importance that carries some emotional weight, timing is extremely important. Pick a time when you and your loved one are feeling at ease so they will hear your concerns in the way you wish them to be delivered. To learn more about how to have a difficult conversation, see the article recently written for Caregivers Corner here.

Seek outside help if necessary. There are third parties that can help your loved one see where their deficits are without having the battle of wills you worry about. The types of third parties to involve include the family doctor, an occupational therapist that specializes in driving assessments, and even the DMV. AAA has a great online tool for drivers to check their performance. It is a self-rating tool with facts and suggestions for safe driving. You can find this tool here.

Duke University offers driving assessments by occupational therapists. According to their website, the assessment looks at the following skill sets and provides recommendations following the session: visual acuity and depth, night vision, memory/cognitive skills, safety/judgment skills, understanding of road rules and regulations, physical strength, coordination and sensation, eye-foot and eye-hand reaction time speed. For more information about the assessment at Duke click here.

Creativity may be key especially if you are caring for a loved one with a cognitive impairment. There is a common belief that you cannot reason with a person who has dementia and even if you can get them to agree to give up the car keys, they may forget you have had the conversation minutes, hours, or days later. In those cases, you may have to be creative.

Some caregivers report success by disabling the vehicle (perhaps by taking out the battery), hiding the car keys, moving the car to a different home, and even selling the car.

If you find yourself needing to have this type of conversation with a loved one, join our online community of caregivers to continue this conversation. We have more than 200 family caregivers supporting each other and sharing resources.