How to Talk to Elderly Adults About Giving up the Keys
If you have concerns about an older adult's ability to drive, addressing them promptly could be a matter of life and death. It may be tempting to procrastinate -- to talk to him next week or before the first snowfall, for example -- but think how you'd feel if the delay led to an automobile accident that resulted in a serious injury or death.
Considering the possible consequences should help you overcome your hesitation -- but that doesn't mean it will be easy. It's awkward and painful to have to inform older adults that they aren't capable of doing something as basic and essential as driving the car. For them, it's another humiliating reminder of their growing inability to take care of themselves and manage the tasks of daily life.
As difficult as it is, if you have reason to believe that the person in your care could be dangerous behind the wheel, it's important to deal with the issue sooner rather than later -- because later could be too late.
It's a good idea to plan how you're going to approach the subject before bringing it up. Take time to consider how the situation looks from the driver's point of view and what driving means to him.
In his book How to Say It to Seniors, geriatric expert David Solie points out that because elderly people face so many losses at this stage of life, they tend to rigidly control the few things they can. This struggle for control will almost certainly come into play where driving is concerned, because giving up the car keys could affect where they live, who they see, and what interests and activities they can pursue. To you, this decision is a simple matter of good sense and safety; for them, it represents the end of life as they've always known it.
Make sure your expectations are realistic. If you assume that one discussion will neatly resolve the matter, you're bound to be disappointed. Given how charged the driving issue is, you need to think of this as a process that will take some adjustment and fine-tuning. Consider this a preliminary discussion only; a way to get the issue out on the table so it can be dealt with openly.
Consider your own role. Remember that it's not up to you to convince the person your caring for to immediately cease driving, even if you think this is the best course of action. Unless the driver has dementia or is otherwise incapacitated (see below), it's best to respect his right to make decisions about his life -- with your input and support.
Consider temporarily giving up the car yourself. Elizabeth Dugan, a geriatric researcher who wrote the book The Driving Dilemma, reports that a colleague stopped using his car for two weeks before talking to his elderly father about driving safety. His carless weeks gave him firsthand experience of the inconvenience and lack of mobility that his father was going to have to endure. You may not want to give up your car before you talk with an older adult, but you should give some thought to the emotional and practical issues he'll face when he gives up driving.
Plan your discussion for a quiet time of day. Find a time when you and the driver you're concerned about are both relaxed and rested and no one has any deadlines or commitments pending.
How to Bring It Up
When you introduce the subject, try to avoid coming on too strong, or you'll set the discussion off on the wrong foot. You may feel a keen sense of urgency, but if you jump right in with, "You have to stop driving! You're going to kill someone!" he'll probably either get angry or tune you out.
Remember that if you've noticed that his driving has grown erratic and sloppy, he's probably aware of it, too. You can be most helpful by helping him express and work through his own concerns. A good way to do this is to initiate the discussion with a question. For instance, if you know that he has received a traffic ticket, ask him about it, and then follow up with another question like, "How are you doing with your driving? Are you finding it a little difficult to manage?"
Handle Objections With Reflective Listening
Your loved one may respond by pointing out all the practical reasons he can't stop driving ("What about my weekly golf game?" or "My wife's physical therapy appointments are clear across town!"). Without directly answering your question about his driving ability, he's already making the case for why he can't stop. This is valuable information because it provides a glimpse of his own internal struggle: He knows that he's having trouble driving safely but can't fathom how he'll manage without a car.
Encourage him to discuss his concerns without immediately jumping in with solutions (don't rush in with "I'm sure Jack or Stan will be happy to drive you to the golf course" or "The bus goes right by the physical therapy office"). It's also usually counterproductive to offer reassurances ("Don't worry, it will all work out fine"). Such responses may offer temporary comfort, but they won't help you or him explore the larger issues involved.
Instead, you can help him express his fears by using "reflective listening," a technique Elizabeth Dugan recommends when talking about driving and other difficult issues with an elderly parent or other older adult. Reflective listening -- which essentially means rephrasing what the person has said -- conveys support and encouragement and helps the speaker gain insight about his experience.
To use reflective listening in the example above, you could say something like, "Look, I know you're probably worried that giving up driving would mean you have to give up some of your usual activities." This type of response will encourage him to keep talking about his worries and reflect upon them, which is an important step in working through major problems and transitions.
Allow Space for a Long Conversation
When reflecting about driving and its role in the driver's life, don't be surprised if he begins to talk about the past. He may reminisce about his honeymoon road trip to the Grand Canyon or recall how he saved up money for his first car or taught all the kids how to drive.
Resist the temptation to interrupt and get him back on track. Instead, try to encourage the reminiscences by asking questions or even requesting to see photos. Sifting through memories will help him come to terms with this life transition as he reflects on the role driving has played in his life and gradually accept the fact that he'll soon have to give it up.
As the discussion progresses, ask him directly what he thinks he should do about driving. You may want to help him jot down some of the pros and cons of the alternatives he faces. This approach can help someone realize that there are actually some benefits to not driving (tremendous savings on auto insurance, car maintenance, and gasoline, for example). It also may help focus him on the stark consequences -- such as a fatal accident -- that could result from maintaining the status quo.
Depending on how everyone is feeling, this might be a good point to put the discussion on temporary hold. Agree to meet again in a couple of days, after you've all had a chance to reflect on the various options. (You might want to set a specific time to meet to ensure that it happens.)
Of course, there's no telling how the discussion will unfold, since that will have a lot to do with factors unique to the situation. But the discussion is much more likely to be productive and positive if you approach it with a genuine desire to learn more about his experiences, ideas, and concerns.
Find Out if Other Issues Are Affecting Driving
Find out if medical problems are causing driving issues. If the person you're caring for acknowledges that he's having difficulty driving, find out the specific problems. Make appointments with his physician and eye doctor, and be sure to ask about medication, side effects, and drug interactions. It's possible that the problem can be remedied with a change in medication or a stronger pair of glasses. Make sure his car is suited to his needs and physical abilities, and ask his doctor if assistive devices might help address driving difficulties.
Discuss interim measures, if possible. Once you determine the source of the problem, you can decide what to do next. His physician might suggest that he limit driving to daylight hours or essential errands. If he's going to continue to drive at all, it's a good idea for him to brush up on his driving skills and the traffic laws by taking a senior driving refresher course. AARP, AAA, and commercial driving schools all offer such courses. Agree to revisit the decision every few months to see how it's going.
Help explore other transportation options. Whether or not he has to give up the car keys immediately, it's a good idea to help your loved one become familiar with other transportation options. Take the bus with him if he's apprehensive and help him find out more about local senior transportation services. Encourage him to carpool with friends.
Take a break if he refuses to address the issue of driving safety. He may become angry when you try to talk about driving or refuse to discuss it, so it's a good idea to temporarily drop the issue. There's no point in engaging in a battle -- it will only make him more resistant. Give the matter some time, and then bring it up again in a week or so. You may find that he's become more receptive to discussing the matter over time, as he grows used to the idea and realize that the risks of continuing to drive outweigh the benefits.