How can I take Mom's driver's license away if she has cognitive impairment?

A fellow caregiver asked...

Mom, who is now 83, has had several fender benders, and is showing signs of forgetfulness that sounds not like normal aging but points to real cognitive issues. However, she insists that she's okay to drive. She still has her valid license, but we feel it's time for her to stop driving the car. How do we take her driver's license away, because she says that she can't live without her car?

Expert Answer

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

There is no short answer to this problem, or a one-size fits all solution. Nothing defines personal freedom and independence in America, particularly among the elderly, as does the ability to come and go at will in one's own car.

And nothing defines the challenges and conflicts of realities of aging that involves diminishing reflexes, changes in eyesight, cognitive and memory loss issues, and side effects of prescription medicines as does the first indication that mom is a real threat to herself and others while she is driving. This epiphany can come in many forms, and none of them includes an admission by mom (or dad) that she no longer feels that she is a safe driver.

What's usually involved when considering mom's safety as a driver is one of several possibilities: an accident, the awareness of a very near-miss of an accident, her becoming disoriented or lost while driving, or being on the receiving end of a ticket for a traffic violation. While a sigh of relief on your part may be the price of having witnessed or heard about any of those events, it's not enough, and borders on denial of the underlying problem of mom's failing skills as a licensed driver.

Typically, mom will tell you that's she's perfectly okay to drive, but once you or another family member has made the decision to deny mom access to her car and have her driver's license revoked, the family wars and challenges begin. Here are the usual key issues that crop up:

· You feel guilty about impacting mom's freedom and independence · Mom feels that you're trying to control her life · You have no plan in place as to how to get mom to where she needs to be or go · Mom feels that she will become isolated from friends and activities · Mom may become depressed and/or very angry at you

There are ways in which you can approach this very thorny problem. First, talk with your mother to see if she too agrees that it may be time to give up driving. It's possible that mom has been hoping that you would take the initiative and help her make this tough decision, while also helping her plan for her needs for transportation. This however, is not the typical scenario, but it's certainly worth the effort if she happens to agree.

Let her know that you're concerned that she might injure another person. Push the envelope and ask her how she would feel if she had an accident that injured or killed the grandchild of another woman your mother's age. This borders on "dirty pool" but it's a real concern and may cause her think about it. Of course she'll say it would never happen to her, and you have to calmly state that it is possible, and that's why it's called an "accident." It wasn't planned "“ it just happened. And you know that she could never forgive herself if she hurt someone else. If you want to really compound the pressure without being directly confrontational you can even add, ""¦and mom, if something happens there could be lawsuits that could financially ruin you and take all your money." Again, not fair, but it's true and the goal here is to get mom out from behind the wheel of her or any other car.

Don't try to bully or argue you way to a rational conclusion by telling mom that she's an unsafe driver. That's a lose-lose situation and places you into serious conflict as a daughter and caring loved one. There are ways to achieve the goal without you becoming the enemy.

First, be sure that you have full support of family members, since mom may try to set up an "us versus them" situation. Also, it will more than likely be the local friends and family members upon whom mom will have to rely when she can no longer driver her own car.

Having done that, call mom's primary physician, discuss your concerns, and enlist his/her aid. In some states, physicians can send a letter to the state voicing concerns and suggesting that the driver, mom, be tested for safety as a licensed driver. This means that the testing to be approved for a driver's license must be more than just an eye exam and a fee at the Bureau of Motor Vehicles office. Ask to have mom tested as a new driver with the written exam, eye test and driving skills test as part of the process. Remember, the goal is to try to have mom fail the test, thereby making the State the bad guy in this situation.

There may also be other medical testing approaches. For instance, in southern Florida, there are two places where a physician can send a driver to be tested for motor skills, reflexes and cognitive skills as part of a very comprehensive driving test that includes a road test in a car other than the owners. This makes the test very thorough, and for a driver that is even moderately compromised in any aspect of the skill sets needed to drive safely, difficult to pass. The results of the testing, if less than satisfactory, are forwarded to the State Bureau of Motor Vehicles with a recommendation to recall the privileges of the person tested, and deny driving privileges or a driver's license. In Florida, the State honors those recommendations.

This process usually costs the family about $200 out pocket and is not covered under medical or car insurances. But if the goal is to take mom off the road for the good and safety of everyone in the areas where she drives, it's a lot less money than a hospital bill or lawsuit for having injured or killed another party.

Be sure you have a plan in place so you can answer all of mom's concerns when she asks, "How will I get to the doctors"¦hair dresser, supermarket, Canasta game, church"¦?" You have to be able to assuage her fears of being confined to her home. Check with your local senior services agencies to find out about public transportation, connector buses, and other available means of transportation that can keep mom engaged in life without threatening the safety of her life or others on the streets and highways of your community. And good luck!