The Car Conversation: When and How to Broach the Topic With Your Elderly Parent

Car keys in a man’s hand

In the United States, cars and driving are an integral part of our culture of personal independence. So, what happens when your elderly parent shows signs that they might not be safe behind the wheel? The “car conversation” is often a difficult one which stirs up feelings of defensiveness, frustration, and anxiety for all involved.

When to Broach the Topic of Driving with Your Family Member?

In many cases, “the conversation” arises after a senior has exhibited unsafe driving behaviors or been involved in an accident. The National Institutes of Health has identified several driving-related warning signs for caregivers, such as:

  • Car crashes, new dents, or “near misses” on the road

  • Higher auto insurance premiums, due to driving infractions

  • Two or more traffic tickets or warnings in the last two years

  • Feedback from physicians or friends suggesting that driving may no longer be a good idea

However, some experts recommend being proactive about the car conversation and starting a dialogue early with aging family members about driving. AAA has developed the “Driver Planning Agreement” which helps families discuss what they will do if/when a senior’s driving abilities change.

When Your Parent Has Cognitive Issues…

The driving discussion can become more complex if your family member suffers from dementia or Alzheimer’s disease. In the early stages of these conditions, it’s often still possible for your parent to drive. However, it’s important to keep a close eye on the progression of the disease.

When my Dad developed dementia following heart surgery and a resultant stroke, he also had a condition called “anosognosia.” He was unable to recognize or acknowledge his own impairments and he became angry because he was completely convinced that he could still drive. I asked his primary care doctor to speak with him, but I still ended up hiding the car keys.

Four Tips for Addressing the Driving Dilemma

  1. Prepare yourself for the conversation. AARP, the Hartford, and the MIT Age Lab have developed a free, online seminar called “We Need to Talk” which provides helpful information to caregivers who are concerned about a senior’s ability to drive. The seminar has three modules and takes around 1.25 hours to complete. When you engage with your family member, avoid being confrontational and focus on being as supportive as possible. Having a one-on-one conversation is often more productive than bringing in the entire family for an “intervention.”

  2. See if your family member would be willing to have a clinical driving assessment. These assessments are conducted by occupational therapists who are trained to help people with medical conditions that affect driving. This can be helpful for seniors with conditions like dementia, strokes, or impaired vision who insist that they can still drive. I considered scheduling this type of assessment for my Dad with the full knowledge that he would fail, so he would have another data point about his abilities from an outside expert. Bear in mind, these assessments are rarely covered by insurance or Medicare and cost between $200 to $400, plus additional fees for rehabilitation services. The Veterans Administration may cover the cost of this type of assessment for some eligible veterans. To find a driving program or specialist near you, check out the American Occupational Therapy Association’s online database.

  3. Attend a CarFit clinic. As people age, it can be more difficult to turn one’s neck while driving and in general, reflexes become slower. Although you can’t turn back time with regard to these physical limitations, it makes sense to ensure that your parent’s car is adjusted to fit them. Modifications like steering wheel tilt, line of sight above the steering wheel, mirror adjustments, and seat position relative to the gas and brake pedals can help seniors feel more comfortable and confident in their vehicles. AAA offers CarFit clinics periodically around the country. You can search online to find an event near you.

  4. Think about your parent’s transportation needs and what resources are available. Simply telling your family member that they can no longer drive isn’t productive. Before engaging in a conversation, take time on your own to think about your parent’s transportation needs and how those could be met without a car. You may want to research whether options exist in your community like an “aging in place village,” Council on Aging buses or rides, public transportation options, or ridesharing services.

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