Living in a county with a large aging population, I frequently see news reports about accidents and tragedies involving elderly drivers. In recent cases, older drivers have crashed into plate glass storefronts, hit pedestrians, driven into a body of water and even disappeared altogether when night driving. Maybe family had told them or asked them to stop without success.
The struggle to get an aging parent to give up driving can be very difficult for family members, particularly when the aging person thinks he or she is perfectly fine. Loss of independence is a very threatening thing for most people. An aging parent who is determined to keep driving, despite warning signs that it's time to give up the keys might not be willing to listen to family members. But, the elder might be persuaded to get a driving evaluation by an objective person just to "prove I'm fine".
The Burke Institute http://www.burke.org/outpatient/services/occupational-therapy in White Plains, N.Y. offers what looks to me like a model program for drivers who may be marginal. It's their Driver Evaluation Program, conducted by licensed occupational therapists.
The program is described on their website as evaluating "vision, perception, attention, reaction time, memory, judgment, safety awareness and cognition. Each is thoroughly assessed to determine if the patient can continue to drive safely for themselves and those around them. The in-vehicle evaluation, performed by participating certified driving instructors, allows a third party professional to assess how all areas come together during the actual task of driving. This comprehensive testing enables professionals to make a reliable recommendation based on medical knowledge."
I have long been an advocate of using licensed occupational therapists to do the job of assessing the multiple skills involved in aging parents' driving, rather than relying only on family's opinions when there is a conflict with the elder. This is the first program I've seen that is conducted in a rehabilitation facility by a group of professional occupational therapists. It lends an air of credibility to the concept of assessment and could make it easier to get the elder there for evaluation. A doctor's prescription is required. That also takes the onus off the doctor, who may be reluctant to say that an aging patient should stop driving when the doctor and patient have had a long relationship and the doctor has never witnessed the elder's driving. There may be signs of early dementia in the elder, but everyone, including the doctor, is hesitant to say that the elder should stop driving now.
As a retired personal injury attorney who represented victims of auto accidents, some caused by these aging drivers who should have given up the keys before they hurt my clients, I can only applaud the Burke Institute for its program. I would like to see programs like it all over the country, using their method as a model. Getting this kind of testing is one sure way to tell if your aging parent should give up the car keys for good.
The cost of the program is $268, including a one-hour evaluation (ability testing), with recommendations and a report that is sent to the driver or physician requesting the evaluation. With a report describing driving impairments in hand, it would be easier for any physician to tell an aging client it's time to stop driving. If the elder gave permission to the family to receive the information, all involved could plan for alternative transportation arrangements to maintain the elder's activities. And the cost of this testing is far lower than the price a dangerous driver hurting someone or even damaging a car.
From what I've observed with aging individuals, however, the biggest challenge for families may not be finding an occupational therapist to do such an evaluation of driving ability. It will be getting the elder to go for evaluation. Perhaps those who need it most will protest the loudest and refuse to be tested. It may be up to responsible family members to use other means of persuasion.
Until next time,
Carolyn Rosenblatt
AgingParents.com
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