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Taking Away The Keys

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Taking Away The Keys

  1. 1. Taking Away the Car Keys: When Our Loved Ones Can No Longer Drive Safely LTC Expert Publications Community Education Series Raleigh Geriatric Care Management
  2. 2. Taking Away the Car Keys <ul><li>When to talk to your parents about their driving </li></ul><ul><li>skills </li></ul><ul><li>What to say to them </li></ul><ul><li>How to keep them off the road when it becomes </li></ul><ul><li>absolutely necessary to do so. </li></ul>
  3. 3. Why Talk About Driving Safety <ul><li>Age related declines in cognitive and sensory functions (hearing and vision) and physical impairments due to medical conditions may affect some older people’s driving ability. </li></ul><ul><li>Motor-vehicle related death rates per 100,000 for people seventy years old or older are higher than for people in any other group except those younger than twenty-five. </li></ul><ul><li>Per mile driven, drivers 75 years old or older have higher rates of motor vehicle crashes that result in someone’s death than do drivers in all other age groups except teenagers. </li></ul><ul><li>Older people who are injured in motor vehicle crashes are more likely to die of their injuries than are people in other age groups. </li></ul><ul><li>(Insurance Institute for Highway Safety) </li></ul>
  4. 4. <ul><li>Start early when your parents are still independent drivers. </li></ul><ul><li>2. Begin by talking about news articles you read about accidents involving elderly drivers or proposed legislation to test elderly drivers. (This invites your parents to talk about their feelings regarding driving and the elderly from an objective viewpoint and allows for non-threatening discussion about driving and the elderly without sounding accusatory .) </li></ul>When to talk about Driving Safety
  5. 5. Red Flags to Watch For: <ul><li>Close calls, violations, collisions (even if they are minor) </li></ul><ul><li>Difficulty in noticing pedestrians, signs, objects, or other vehicles </li></ul><ul><li>Being surprised by passing cars </li></ul><ul><li>Breaking harder than normal for hazards, stop signs, or stopped traffic </li></ul><ul><li>Backing into or over objects </li></ul><ul><li>Running over curbs </li></ul><ul><li>Going through red lights or stop signs </li></ul><ul><li>Turning too fast or too slow </li></ul>
  6. 6. <ul><li>Decline in Physical Abilities : </li></ul><ul><li>Difficulty in coordinating hand and foot movements </li></ul><ul><li>Worsening discomfort from glare of oncoming headlights </li></ul><ul><li>Difficulty in turning head, neck or shoulders </li></ul><ul><li>Slowed or erratic reactions </li></ul><ul><li>Difficulty in keeping the care centered in a lane </li></ul>Red Flags to Watch For:
  7. 7. Red Flags to Watch For: <ul><li>Observable Change In Emotions </li></ul><ul><li>Undue nervousness behind the wheel </li></ul><ul><li>Increased anger or frustration while driving </li></ul><ul><li>Times of intense grief </li></ul><ul><li>Rapid onset of fatigue from driving </li></ul>
  8. 8. <ul><li>Decline in Mental Abilities </li></ul><ul><li>No longer using turn signals or mirrors </li></ul><ul><li>Driving more slowly </li></ul><ul><li>Becoming confused in simple driving situations </li></ul><ul><li>Getting lost </li></ul><ul><li>Making poor or slow decisions in traffic </li></ul><ul><li>Hitting the accelerator instead of the break (or vice versa) </li></ul>Red Flags To Watch For:
  9. 9. Red Flags To Watch For: <ul><li>Increasing number of confrontations with other drivers who honk their horns, tailgate, or pass aggressively </li></ul><ul><li>Medical conditions that may impair driving: multiple sclerosis, Parkinson’s Disease. ALS, Alzheimer’s disease, seizure disorders, sleep disorders, uncontrolled diabetes. </li></ul>
  10. 10. Avoid all or nothing actions, such as rushing to hide the keys at the first sign of a driving problem. Driving gives us all a degree of independence, older people need to hold on to that ability for as long as possible. (page 26 in green) Intentions are good but he is overreacting. Independence
  11. 11. Adjustments <ul><li>Many times there are certain adjustments that can be made to increase the safety factor without taking elderly people off the road: </li></ul><ul><li>talk about restricting driving to day time hours </li></ul><ul><li>run errands close to home </li></ul><ul><li>stay off the highway </li></ul><ul><li>avoid rush hour traffic </li></ul><ul><li>drive only to familiar places </li></ul><ul><li>avoid driving alone </li></ul>
  12. 12. Open The Door To The Subject <ul><li>Focus on awareness of his driving skills and finding ways to maintain driving independence: </li></ul><ul><li>“ My friend Bob wants to get his dad to stop driving at night because he has cataracts and can’t see very well in the dark, but he doesn’t want to get his dad upset. I guess that can be a really hard conversations to have.” </li></ul><ul><li>or </li></ul><ul><li>“ Dad, I see a few small dents and scratches on your car. What’s been happening?” </li></ul>
  13. 13. Make an Observation and Then Make a Suggestion About How to Handle the Situation: <ul><li>Suggest a medical check up to evaluate physical skills necessary for safe driving: </li></ul><ul><li>“ Mom, I’ve noticed that you’re having trouble seeing traffic signs. Maybe it’s time to see your eye doctor and check on your Rx, and I think it might help to sit on a pillow so you can see the road better.” </li></ul>
  14. 14. 1. Offer specific ways to improve driving skills: <ul><li>When you see that your parent is losing the skills needed to drive safely, you’ll need to address specific issues: </li></ul><ul><li>page 29 </li></ul><ul><li>(AARP, occupational department of local hospital for a driving evaluation center) </li></ul><ul><li>“ I heard that AARP offers driver’s education courses for senior citizens. A lot of older people who take these classes find they can safely stay on the road much longer than those who don’t. How about I get a schedule of those classes and sign you up? I’ll even go with you if you like.” </li></ul>
  15. 15. 2. Encourage Action by Drawing on Your Personal Relationship <ul><li>(page 29) </li></ul><ul><li>Discussing driving skill with your parent requires great diplomacy. She is less apt to listen if you use words that are accusing, criticizing, threatening, or embarrassing. Talk with love and concern. </li></ul><ul><li>“ The number of near misses you’ve had on the road lately is a real concern to me. I’m worried that you’re going to be in an accident and hurt yourself or somebody else. For me, could you please go for a driving evaluation?” </li></ul>
  16. 16. 3. Take Action <ul><li>When you’re sure your parent is risking his safety when he’s behind the wheel, it’s time to do something about it: </li></ul><ul><li>“ I absolutely am not comfortable with you driving down to your winter vacation home this year, so I’ve bought you a plane ticket and made arrangements for your car to be driven down for you.” </li></ul>
  17. 17. 4. Explore Alternative Transportation Options <ul><li>Before taking away the keys, help your parent get used to other kinds of travel. </li></ul><ul><li>“ I was thinking that someday it might happen that you can’t use your car to get to your doctor appointment—maybe there will be snow on the road, maybe you won’t be feeling so good, maybe your vision will be weak. So I think it would be a good idea to find out how you can get there without your car. When you go to the doctor’s next Tuesday, I’ll come with you an we’ll go on the bus. It’s good to know how to use public transportation once in a while.” </li></ul><ul><li>(Or suggest a taxi.) </li></ul>
  18. 18. 5. Take The Keys <ul><li>If a medical professional has said that your parent can no longer drive at all under any circumstance, your conversation will need to be short and direct and your actions much more specific. </li></ul><ul><li>“ The doctor has said that you can no longer drive. I’m sorry, but for your safety and the safety of others, we’ll need to find other ways to get you to all the places you want to go.” </li></ul><ul><li>Understand that your parent will not go without a fight. They will need to go through the steps of denial, resistance, and, anger. Expect an emotional reaction and some resistance!!! </li></ul>
  19. 19. <ul><li>If your parent refuses to give up the car keys: </li></ul><ul><li>Install a car alarm. </li></ul><ul><li>Install a difficult to open security lock, </li></ul><ul><li>Disable the car </li></ul><ul><li>Sell the car </li></ul><ul><li>Report him/her to authorities – (This is an unpopular and extreme course of action. ) </li></ul><ul><li>You may feel compelled to notify your state DMV that your elder is an unsafe driver and they will order a driver reexamination, medical evaluation, or both </li></ul><ul><li>Be prepared to handle your parents’ extreme anger and allow them to express all the emotional pain that comes with losing driving independence. </li></ul>Taking Away the Car Keys- Reporting
  20. 20. Resources <ul><li>The Association for Driver Rehabilitation </li></ul><ul><li>608-884-8833 (to find a local location for a driver evaluation and rehabilitation center nearest you. </li></ul><ul><li>Request a free copy the booklet published by AARP: “The Older Driver Skill Assessment and Resource Guide: Creating Mobility Choices .” 888-227-7669 </li></ul><ul><li>The American Automobile Association (AAA) publishes , “Driver’s 5 Plus: Test Your own Performance. Send 2.00: AAA Foundation for Traffic Safety, P.O. box 8257 Fredericksburg, BA 22404 </li></ul><ul><li>AAA, Safe Driving for Mature Operators. Call a local AA branch. </li></ul>
  21. 21. The Next Step: <ul><li>Raleigh Geriatric Care Management exists to help adult children and their aging parents providing assessments, care plans, and monitoring of services in the </li></ul><ul><li>Raleigh-Durham area. </li></ul>- Lauren Watral, MSW, Owner
  22. 22. For more information call us! <ul><li>Raleigh Geriatric Care Management </li></ul><ul><li>919-803-8025 </li></ul><ul><li>www.rgcmgmt.com </li></ul><ul><li>Don’t wait until it’s an emergency…. </li></ul>
  23. 23. Source Cited: <ul><li>How to Talk to Your Senior Parents About Really Important Things, Specific Questions and Answers and Useful Things to Say , by Theresa Foy Digeronimo </li></ul>