Wednesday, July 09, 2008

Family Conversation with Older Drivers

When the time comes for the elderly to stop driving they will do so only after "kicking and screaming all the way. If you find yourself in the position where you need to ask them to stop driving it will be one of the most difficult conversations you will ever face. Here are some tips on the following pages.

Preparing for a conversation

Successful family conversations begin with good preparation and caring communication. With sensitivity toward the feelings of older drivers, families can help the older driver make safe driving decisions and ensure peace of mind for the entire family.

Start Early

If you start early you might find that convincing the person is easier over time.

Ideally, the first conversations about safe driving should occur long before driving becomes a problem. Early, occasional and candid conversations establish a pattern of open dialogue and allow time for the older adult to consider his or her driving skills and make appropriate modifications.

Here are some conversation openers:

“Health and safety first.”
When driving is placed within the larger context of other safety concerns, it may take the personal edge off the conversation.

“Driving isn’t what it used to be.”
Family members of any age can find common ground by talking about stressful road conditions. Restricting driving in order to compensate for worsening driving conditions makes sense for all drivers.

“Did you hear about the car accident in the news today?”
Use news reports to inform – not scare – older persons. Headline news about accidents that involve older and younger drivers can provide an opportunity to explore your family member’s attitudes about unfit drivers and the question of who can help them decide when to relinquish the keys.

“How did Granddad stop driving?”
This opener may provide an opportunity to reveal personal feelings about driving and family intervention.

Anticipate Reactions

Older drivers may express strong emotions when someone talks to them about their driving.

Older adults may agree with the assessment of their driving ability but feel depressed at the thought of relinquishing driving privileges.According to our survey:

* Nearly 1/4 of older adults reported feeling sad or depressed as a result of the conversation.
* Less than 10% reported responding with anger.

Older adults in poor health are more likely to have negative reactions. They may agree with the assessment of their driving ability but feel depressed at the thought of relinquishing driving privileges.

Negative reactions are often more about the message than the messenger. Older adults understand the implications of driving cessation:

* Fewer trips outside the home.
* Increased and permanent dependency on others for transportation.
* Becoming a burden to others.
* Fewer social opportunities.

Persuade the Driver

If an older driver doesn’t realize that his or her driving is a serious problem, it is necessary to have follow-up conversations with the driver, family members, doctors or law enforcement officials.

Here are some more direct appeals to help persuade a high-risk driver not to drive:

"Even if you were not at fault in a collision, you could be seriously injured or die." Regardless of who is at fault, older adults are more likely to be injured or killed because they have less capacity to endure the physical trauma of an accident. Pre-existing medical conditions may complicate recovery or result in death.

"I know you would feel terrible if someone was hurt when you were driving." Concern for others is often a stronger motivation than concern for self. In addition to physical harm to others, an accident can pose enormous financial and legal risks. Families should tactfully mention this possibility, but not dramatize the point.

"I'm afraid to let the grandchildren ride with you." An older relative may realize the degree of concern when family members will not ride with them. Protecting lives is more important than protecting feelings.

"Let's talk with your doctor about this." Blame the poor health, not the driver. Preferably, find out the doctor's opinion before suggesting this step. The doctor might not agree with the family's assessment nor want to assume the role of determining who should drive.

Discuss Alternatives

Effective conversations encourage future planning and show respect for the older adult’s ability to make appropriate decisions. When you observe the older person modifying his or her driving habits, use these opportunities to explore transportation options together to give the older adult time to adjust to them.

Here are suggestions of what to say:

"If you don't want to drive at night, we can arrange for someone to pick you up."
Commend the older driver for being cautious and help arrange transportation.

"Let's take the bus so we don't have to deal with the parking downtown."
Practice public transportation together before it becomes a necessity. And remember, public transportation may be difficult or impossible to use for some older adults with physical or cognitive difficulties. In these cases, families are often the first and only alternative transportation.

"You could save hundreds of dollars if you sold your car."

Insurance, maintenance, depreciation, and gasoline costs make owning and operating a car expensive. Even taxi services can be more economical.

This one of the most diffult tasks you will ever undertake. Good Luck!

Additional sources MIT and the Hartford

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life