Driving Issues

Driving Issues

by Debbie Ricker, OTR/L, DRS

True or False? Most older drivers cease or restrict their own driving when they experience changes in their ability to drive. 

  If you answered “True”, you are correct!  Most older adults do give up driving when they are no longer safe to drive.  The population that does not give up driving, typically, are the individuals who have dementia.  The complication of dementia is that it often robs the individual of the ability to know when they are no longer safe to drive.

    It is normal that our minds and bodies start to change as we age.  It becomes more difficult to switch our vision from near to far, so in the car it becomes more difficult to look at the gauges in your car, then look ahead to scan the traffic.  Our peripheral vision starts to lessen, and we don’t see objects in the periphery like we used to when we were younger.  Also our pupil reaction time slows down, so when we drive between sunny and shady areas, or drive at night, the pupils react more slowly.  Most of us have arthritis as we age, which can lead to difficulty with steering, shifting gears, starting the car, and stepping quickly from the gas pedal to the brake.  

    Some of us lose our high frequency hearing, so it might be more difficult to hear the siren of emergency vehicles.  Our multi-tasking skills dramatically slow down.  Research says that we as humans were not meant to multi-task, but driving requires good multi-tasking skills.  Have you ever ridden in the car with a driver who was distracted by their own conversation with you?  It is scary to watch how many mistakes a driver makes when they are distracted.  Our brains start to process information more slowly, so it takes longer for us to respond to emergency situations or construction zones.

    Our minds can also have greater difficulty with concentration, which means it is even more important to not have any distractions while driving.  Sometimes an older adult may have momentary confusion, especially in a busy intersection, or an intersection with a new signal light.  And each state has their own version of traffic signs, so these signs can differ from state to state.

    Medical conditions may hinder a person’s ability to drive.  For example, a broken ankle may cause a person to give up driving temporarily, but having a stroke or Parkinson’s may cause so much impairment that the individual has to stop driving permanently.

  Growing older does not automatically mean that you must stop driving.  But whether we are 50 or 75 or 99, we are all responsible for demonstrating our ability to drive safely.  If you are concerned about your driving, or a loved one’s driving, we have a program to provide driving assessments to older adults, and driving lessons.  And we come to your home.  

Debbie Ricker, OTR/L can be reached for a driving evaluation at (562) 760-1400.

Driving and Dementia: A Difficult Conversation

by Debbie Ricker, OTR/L, DRS, professional driving evaluator and authority on driving and dementia

Family members report that discussing this issue with their loved one can be fraught with hurt feelings and dead-end conversations. The Alzheimer’s Association recently released helpful new tools for families who are struggling with this decision.

Driving demands quick reaction time and fast problem solving. Due to the progressive nature of Alzheimer’s disease, people with the disease will eventually be unable to drive. The Alzheimer’s Association recommends that families discuss driving before there is a crisis, ideally while the person with Alzheimer’s is still able to participate in the conversation and decision-making process.

“Driving is often associated with autonomy, so relinquishing car keys can be a very emotional and stressful process,” said Linda Mitchell, president and CEO of the Alzheimer’s Association of Colorado. “Educating yourself on approaches and options prior to having this difficult conversation can help ease the transition for everyone involved.”

To assist with these conversations, the Alzheimer’s Association has created four short videos depicting different scenarios for discussing driving and dementia. Watching the videos may give families an idea of how to start the conversation or how to respond to a particular objection. In one video, a woman in the early stages of Alzheimer’s drafts a contract saying that when she reaches a point when she can no longer drive, she gives her children permission to step in. Another technique shown in the new videos is to secure a doctor’s “prescription” advising the person with Alzheimer’s to no longer drive. Following each of the videos is a list of tips and techniques families can use when having the conversation about driving.

What Are the Signs That Driving Is No Longer Safe?

“Talking to loved ones who have Alzheimer’s disease about handing over their car keys can be difficult—especially if the individual is unable or unwilling to recognize symptoms they may be experiencing,” said Mitchell. She says that some people are able to continue driving in the early stages of Alzheimer’s disease, but it requires ongoing evaluation to ensure safety.

The Alzheimer’s Association offers a list of red flags that suggest it is time to stop driving:

  • Forgetting how to locate familiar places
  • Failing to observe traffic signs
  • Making slow or poor decisions in traffic
  • Driving at an inappropriate speed 
  • Becoming angry or confused while driving 
  • Hitting curbs
  • Using poor lane control
  • Making errors at intersections
  • Confusing the brake and gas pedals
  • Forgetting the destination during the trip

The Alzheimer’s Association also provides sample “driving contracts” and a list of local evaluation specialists. For more information on dementia and driving, visit the Dementia and Driving Resource Center, which contains helpful information about recognizing when driving is unsafe, finding alternate transportation, and getting a driving evaluation. The project was supported by a grant from the Department of Transportation’s National Highway Traffic Safety Administration.

Source: The Alzheimer’s Association – Colorado Chapter. The Alzheimer’s Association advocates for those living with Alzheimer’s and their families on related legislative issues, and with healthcare and long-term care providers.

Learn More The National Highway Traffic Safety Administration offers information about driving and Alzheimer’s disease, including a training manual for professionals that includes information of interest to family caregivers.

In the next issue of Caring Right at Home: Giving up the car, physical limitations, and brain changes that make it harder to navigate public spaces cause many older adults to spend most of their time alone. Read “Loneliness Is a Health Risk for Seniors” in the July 2012 issue to find suggestions for helping older loved ones remain socially engaged.

Debbie Ricker, OTR/L can be reached for consultation and a formal driving evaluation by calling her at: (562) 760-1400.

10 Signs That it’s Time to Limit or Stop Driving

(Learn what to look for in yourself and others)

Most people want to continue driving for as long as they can do so safely. However, for many people, a time will come when they must limit or stop driving, either temporarily or permanently.

The following are some warning signs that indicate a person should begin to limit or stop driving.

  1. Almost crashing, with frequent “close calls”
  2. Finding dents and scrapes on the car, on fences, mailboxes, garage doors, curbs, etc.
  3. Getting lost, especially in familiar locations
  4. Having trouble seeing or following traffic signals, road signs, and pavement markings
  5. Responding more slowly to unexpected situations, or having trouble moving their foot from the gas to the brake pedal; confusing the two pedals
  6. Misjudging gaps in traffic at intersections and on highway entrance and exit ramps
  7. Experiencing road rage or causing other drivers to honk or complain
  8. Easily becoming distracted or having difficulty concentrating while driving
  9. Having a hard time turning around to check the rear view while backing up or changing lanes
  10.   Receiving multiple traffic tickets or “warnings” from law enforcement officers

If you notice one or more of these cautionary signs in yourself, or in a loved one who is driving, you might want to register yourself, or that person, for a driver-improvement course, such as the classroom or online courses offered by AARP Driver Safety.