When is the Right Time to Pull the Car Keys?
Mom refused to give up her car keys even as her memory continued to be erased. Our family really struggled to determine how we were going to get her to stop driving. One problem was that she lived out in West Texas with my father and their relationship was increasingly under duress due to Mom’s mental lapses. I did increasingly notice when I visited that Mom would let me or my brother take the wheel if we were going someplace with her. But no family lived nearby to pick up the slack when we weren't in town.
I finally figured out how to get Mom’s attention about driving when she was living with me. I asked her favorite doctor to agree to write a letter to her explaining that she needed to quit driving. Thanks to her short-term memory loss, Mom would soon forget about his recommendation and begin to talk about running an errand somewhere. Then I’d pull that letter out of the safe spot where I had stashed it and make sure she read it. Although she was not happy with his decree, she agreed to abide by it.
My experience echoed the findings from a Canadian study that was just published in the New England Journal of Medicine. Researchers followed 100,075 patients who had received a medical warning that they needed to stop driving from 6,098 doctors. The researchers compared the total number of car crashes by these patients during the three-year period prior to the warning to the number of crashes that happened the year following the warning. The researchers defined a road crash as “any time the patient had an emergency room visit due to a road crash in which they were the driver.”
During the period prior to the doctor’s warning, the patients were involved in 4.8 crashes per 1,000 individuals. That number dropped to 2.7 road crashes per 1,000 in the one year after the doctor had given the warning. However, that number was still higher than the average number of crashes for the overall population (1.98 crashes per 1,000 drivers). The authors noted that the decrease in crashes among the patients did seem to indicate that the physician’s warning made a difference either by causing them to turn over the car keys to someone else, encouraging them to be a safer driver, or providing additional incentive for family members to ask the elder not to drive. The researchers also found that an increase in the number of emergency room visits due to depression by these patients after they had received the doctor’s warnings.
So how can you gauge whether your loved one who has mild cognitive impairment or dementia is nearing the point where he or she needs to stop driving? The American Medical Association identified warning signs that you should look for in the loved one’s driving while you’re riding as a passenger. These signs include:
- Forgetting to buckle the seatbelt.
- Not obeying stop signs or traffic lights.
- Failing to yield the right of way.
- Driving too slowly or too quickly.
- Often getting lost, even if the route should be familiar.
- Stopping at a green light or at a wrong time.
- Not noticing that there are other cars, walkers or cyclists on the road.
- Not remaining in his or her lane.
- Is honked at or is passed often.
- Reacting slowly to driving situations.
- Making poor decisions while driving.
The AMA also notes that there are four additional signs of unsafe driving, which are:
- Recent near misses or fender benders.
- Recent tickets for moving violations.
- Comments made by passengers about close calls, near misses, or the driver not noticing other vehicles.
- A recent increase in the premium for auto insurance.
If your loved one is experiencing these types of issues, talk to his or her doctor who can administer tests to see if the loved one physically and mentally is able to continue driving safely. If the decision is made to tell the loved one to stop driving, you’ll have a valuable ally who is trusted by your loved one and who can help deliver a really difficult but important message.
Primary Sources for This Sharepost:
American Medical Association. (nd). How to help the older driver.
Wolfson, R. (2012). Physicians’ warnings for unfit drivers. The New England Journal of Medicine.