Taking Away the Car Keys

November 29, 2010

Studies show that a frightening number of accidents in the elderly are caused by people who should not be on the road in the first place, because they have dementia.  Since this is such a touchy subject with patients and caregivers alike, those with dementia often continue to drive until they are forced by circumstances to stop.  Sometimes, those circumstances are tragic for the patient, her passengers, innocent bystanders or people in other vehicles.  If tragedies are to be prevented, the family must take responsibility for their loved one.

There are lots of excuses for not addressing the driving issue.  “She only drives in her little town,” or “I don’t really think he’s that bad, do you?” or “He doesn’t drive often and NEVER in rush hour!”  Excuses aside, the two most common actual reasons are first, the fear of the dementia patient’s reaction.  The family fears they will be blamed, and their loved one will be angry, hurt, insulted, upset, or depressed.  Secondly, the family worries about the added caregiving responsibility if the dementia patient can’t drive herself to doctor’s appointments, the grocery store, religious services, etc.  For these two reasons, dementia patients often drive LONG beyond the point when it is safe.

As the family member(s) responsible for the dementia patient, you must be proactive about driving.  A Pennsylvania woman with Alzheimer’s disease, who lived alone and still had possession of her vehicle, was reported missing by a family member and multiple law enforcement agencies were notified.  She had no GPS bracelet, which would have allowed police to find her soon after she was reported missing.  More than 24 hours later, she was found dead in her car.  Apparently, she had crossed into New Jersey, come to a near stop on the New Jersey Turnpike, was struck from behind by an SUV, and struck again by a tractor trailer truck, the force of which pushed her car into a concrete median.  This is just one of the many PREVENTABLE horrific stories that occur when families don’t take the initiative to stop a loved one with dementia from driving.

The cost in human life and well-being is certainly the primary concern, but additionally, the family could be held liable if they knew their loved one had dementia, but did not stop the person from driving.

Nothing is worth risking precious lives and your family’s financial well-being.  It isn’t pleasant to take away the keys, but here are some ways to make it easier:

  1. Take the patient for an eye examination.  Given the prevalence of cataracts, macular degeneration and other eye conditions in the elderly, your loved one may be forced to give up driving because of poor eyesight.
  2. Get your loved one a driving evaluation.  First, check your state’s requirements, as many states have begun requiring driving evaluations beyond a certain age.  If your state does not require it, ask his physician to order a driving evaluation by an occupational therapist.  This will give you objective information about whether or not is it safe for your loved one to drive.  My father-in-law had this evaluation one year and recognized 17 of 18 road signs.  One year later, he recognized 1 of 18 road signs.  We were flabbergasted.  His physician took the keys away from my father-in-law in the office when my father-in-law received the test results.  If you can find a doctor who will do this, it is an incredible blessing, as it keeps the family from being the “bad guys.”
  3. If the cost of a driving evaluation is a concern, there are other options.  If your loved one has ever gotten lost in familiar territory or has trouble performing daily living activities, she should not be driving and the physician should not have a problem taking away the keys, even without a driving evaluation.  The American Medical Association offers a kit called, “The Physician’s Guide to Assessing and Counseling Older Drivers” which gives guideline and assessment tools.  It’s available at http://www.ama-assn.org/ama/pub/physician-resources/public-health/promoting-healthy-lifestyles/geriatric-health/older-driver-safety/assessing-counseling-older-drivers.shtml.  You can print this and take it to your loved one’s physician.
  4. If your loved one has a fixation on a certain car, detach the battery.
  5. Sell the patient’s car.
  6. Give the car to a younger member of the family and appeal to the dementia patient’s sense of “helping the younger generation.”
  7. If all else fails, see if you can get the driver’s license bureau employees involved in keeping your loved one off the roads.
  8. Once you have taken the keys away, hide them.  I have known men especially who have taken the keys back.

Usually (not always), the patient will grow accustomed to the idea within a reasonable amount of time and cease to ask about driving.  My father-in-law was adamant about being able to drive, but within a couple of weeks, he didn’t ask about it anymore.  My grandmother gave her car to me, as I had just turned 16, when she got to the point she should not drive.

Physician involvement is key if you believe the patient will have serious problems giving up driving.  It makes it so much easier for the family to be able to say, “Remember?  Here is the paper from Dr. Jones saying that you shouldn’t drive anymore.”  Statements by the caregiver like, “I’ll drive today.  I need the practice!” are good to keep patients from arguing with you.  Eventually, the person usually stops talking about it.

We welcome the benefit of YOUR experience as a caregiver!  Please comment on our blogs!

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2 Responses to “Taking Away the Car Keys”

  1. I often encounter this issue with many of my Generational Coaching clients, and this posting is right on point! Thanks for addressing this problem and offering some concrete solutions to help caregivers of elderly loved ones.

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