Sherrie Waugh has been yelled at, insulted and wept upon in the course of her job administering driving tests. Typically these extreme reactions happen when she is forced to render an upsetting verdict: It’s time to hang up the car keys.
Ms. Waugh, a certified driving rehabilitation specialist with The Brain Center, a private neuropsychology practice in Indiana, often works with older drivers, putting them through an assessment that measures things like visual skills, reaction time and processing speed.
“I had one gentleman, who had early onset dementia, who was just sitting here crying,” Ms. Waugh said. “His wife was out in the car and she was crying. And we all came back, and we were all crying. Because it’s so hard.”
Decisions about when an older person (or someone whose physical or mental circumstances make operating a vehicle dangerous) should stop driving are often agonizing. They can rock the driver’s sense of independence and identity, and add to the responsibilities that many family caregivers shoulder.
“It’s a major, major loss for older people,” said Lauren Massimo, an assistant professor at Penn Nursing. “It’s been described to me as dehumanizing.”
But it is important to raise concerns as soon as you have them, experts said, and there are ways to make the car key conversation less painful for older drivers and their loved ones.
Get a good look at the problem.
Before you ask a partner or parent to give up driving, do your research, experts say. Ms. Waugh, for instance, is surprised by the number of caregivers she sees who raise concerns about older drivers they haven’t actually driven with recently.
“If they need to pick up something at the grocery store, hop in the car,” she said. Take note: Are they missing traffic lights or safety signs? Are they struggling to maintain the speed limit or stay in their lane? Are they becoming confused about directions, particularly on familiar routes? Those are all signs that their driving skills may be waning.
And beware of ageism, especially when figuring out how to approach the conversation.
“It’s really not about their age,” said Marvell Adams Jr., the chief executive officer of the nonprofit Caregiver Action Network. “It’s about changes in their ability, which can happen to anyone.”
Mr. Adams suggested this opening gambit for a talk: “‘Hey, you know, I noticed it looks like your tires are getting beat up. Are you hitting the curb more often?’” His own mother made the decision to stop driving herself, he said, after she hit the gas pedal instead of the brake.
Pin the decision on someone else.
The driving conversation is one of the hardest parts of Dr. Massimo’s job as a health care provider who works with patients with neurodegenerative disease, she said. But she is happy to relieve caregivers of that burden.
“Make the provider the bad guy,” she said.
Many of Ms. Waugh’s clients come to her through referrals from primary care doctors, neurologists or eye doctors, though family members also reach out directly. She charges $175 for a 90-minute clinical assessment, and $200 for a road evaluation — fees that she acknowledged might be prohibitive for some families. (She has not succeeded in getting insurance to reimburse her clients.) But, experts say, professional driving evaluations can offer objectivity and clarity.
Ms. Waugh recently saw an older client who used to teach driver’s education and was miffed that his wife and doctor had been urging him to stop driving. During the evaluation, he struggled to finish short-term memory tests, including a simple maze and a counting exercise. When Ms. Waugh showed him his results, he finally understood that he posed a safety risk to himself and others on the road.
Have solutions ready.
Although giving up driving is rarely easy, services such as grocery delivery and ride-sharing apps can lessen the inconvenience and offer continued autonomy and independence, Mr. Adams said.
Make a plan for how you will help a retired driver get around. In addition to ride-sharing apps, the experts also mentioned public transportation and car pools, as well as friends and family members who might be able to give rides.
Consider risk-reduction strategies, too, Mr. Adams said. Maybe your partner or parent is safe to drive during the day, but not at night and not on the highway.
Even though older drivers and their family members may be loath to do it, look ahead.
“Make this a part of the conversation early,” said Cheryl Greenberg, who coaches seniors and their families on life transitions and planning in North Carolina. “You know, ‘You’re 60 years old and you’re driving just fine, but Mom, what would you do if the time came and you were less comfortable and less able?’”
All of the experts said that it was important to make space for big emotions around these conversations.
“Be empathic,” Dr. Greenberg said. “Don’t just go in and say, ‘Well, now you’re done driving.’ Listen. Ask questions that might help them be centered in the process.”
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