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Safe Carroll: When to talk to older adults about driving abilities

How do you know when it's time to talk with your loved one about their driving? What do you say to convince them that their driving is unsafe? How do you prevent them from hurting themselves and others? Who should talk with the person about not driving?

Driving abilities and restrictions for older adults is a sensitive topic. Driving represents independence, being competent and still having control. As we age, our functional and cognitive abilities decline, and the tasks necessary for driving safely may be compromised. Driving is a highly complex activity composed of the ability to:

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•hear, see and feel;

•interpret visual cues such as symbols, shapes and colors;

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•make judgments and decisions;

•adhere to traffic laws;

•maneuver oneself and the vehicle.

For example, the activity of operating a motor vehicle to drive backward requires that the driver put the vehicle in the correct gear, demonstrate the upper body strength and range of motion to turn the steering wheel in the correct direction, turn their neck to look behind the vehicle, use the rearview and side view mirrors to be aware of their surroundings for judging distances and spatial relationships, and use the brake and gas pedal correctly. All these tasks must be done simultaneously.

Driving for the older adult is a balance between maintaining independence and safety. So, proceed cautiously. First, look for warning signs of unsafe driving. These include:

•getting lost or returning from a routine drive later than usual;

•failing to observe traffic signals;

•making slow or poor decisions;

•driving at inappropriate speeds;

•confusing the brake and the gas pedals;

•becoming angry or confused while driving;

•hitting curbs;

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•exercising poor lane control;

•making errors at intersections.

Next, discuss your concerns and make attempts to limit the person's driving:

•Talk to the person about their driving by focusing on behaviors. State what you see and how it is unsafe.

•Suggest they limit their driving and offer to drive them where they want to go.

•Recommend they take a driver's safety course to evaluate their driving abilities. These are offered

at the local senior centers and hospital.

•Arrange for home delivery of medications and meals. Utilize errand services.

•Provide information about public transportation in the area, and ride with them until they get comfortable.

Finally, get support.

•Attend a caregiver's support group.

•Express your concerns to other family members. Talk to the person as a group.

•Inform their physician about your concerns, and ask that they talk to the person.

•Ask that the physician write a "do not drive" prescription or order.

•The physician should also notify the Maryland Motor Vehicle Administration about concerns in writing and by telephone.

•The MVA's Medical Advisory Board may request a medical report from the physician.

•Screening tests, including a driving test, may be conducted at the MVA.

Although driving represents self-sufficiency and independence, it is important to remember that the main goal is to keep the person and others safe. Older adults experience much loss, and it is no wonder that losing the ability to drive (voluntarily or involuntarily) may contribute to isolation and possibly depression. However, the integrity of the older adult can be retained by assisting them in identifying other ways to feel connected, valued and independent. For more information, visit http://www.aarp.org or call 410-876-4997.

Anne Messina works for the Carroll County Health Department Nursing Bureau's Adult Evaluation and Review Services.

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