Sue Hovey’s first question after her stroke last fall was how soon she could drive.
“That was the main thing, even before I got back to work,” the Wilmette resident said. “It’s terrible when you’ve been self-sufficient all these years and now you have to rely on someone to drag you around.”
Hovey, 56, was behind the wheel after a few weeks. Part of her therapy at Evanston Hospital was participation in the Driver Rehabilitation Program, which includes testing with a simulator and on the road.
Hovey “breezed through with flying colors,” occupational therapist Beth Egge said. “But we don’t necessarily get everyone back to driving.”
At some point many drivers must surrender their car keys because of accident, illness or decline in abilities. Some, like Hovey, are temporarily sidelined, while others will never drive again. The issue is almost always a difficult one.
“Giving up driving is a tremendous injury to a person’s self-esteem,” said Erica Karp, a social worker and principal of Northshore Eldercare Management in Evanston.
“It means, `I’m not as independent’ and `I’m more isolated.’ It is often seen as a failure.”
But safety is at stake as well.
According to the National Highway Traffic Safety Administration, drivers age 70 and older have higher rates of fatal crashes than all other age groups except for teenagers. They crash less frequently, but are less likely to survive a crash because of their greater fragility.
Furthermore, the number of older drivers is growing rapidly. In 2000, the last year for which figures are available, there were 18.9 million licensed drivers age 70 and older, a 36 percent increase from 1990, according to the safety administration. That number is expected to increase to 25.7 million by 2010, and to 30.7 million by 2020.
“Several factors are converging: more older people, more people who live longer and more people, particularly women, who grew up driving,” said Jean Shope, senior research scientist at the University of Michigan Transportation Research Institute in Ann Arbor.
The time to stop driving varies widely, and age is not the determining factor, said Linda Lewis, president and chief executive officer of the American Association of Motor Vehicle Administrators in Alexandria, Va.
“Just because you’re a senior doesn’t mean you’re an unsafe driver,” she said. “There are very healthy 90-year-olds on our highways, and there are 40-year-olds with medical conditions who probably should not be.”
Some states prohibit more frequent or more rigorous re-examination of drivers on the basis of age.
Illinois requirements, however, are among the most stringent.
Here, drivers age 81 through 86 must renew their licenses every two years rather than every four years for younger drivers, and those age 87 and older must renew every year. Drivers age 75 and older take a driving test each time they renew. Drivers of all ages take a vision test each time they renew their licenses.
Recognizing impairments
Driving a vehicle involves motor skills and cognitive ability.
Indications that either or both are impaired include increases in driving errors, damage to vehicles or property, agitation or irritation while driving, traffic violations or tickets, inability to remember the destination and getting lost.
Many who experience these symptoms voluntarily curtail their driving, perhaps by not driving at night or by limiting the distances they drive.
If a family member appears to have difficulty driving and does not self-regulate, intervention may be necessary.
Karp suggested starting a calm conversation, perhaps with other family members present, about your concerns and the reasons not to drive. Be aware that the response could be one of anger or denial.
A focus on physical reasons not to drive rather than cognitive ones is usually more palatable to the older driver, Karp said.
Jane Smith of Glencoe took over most of the household driving responsibilities when her husband, Neil, 76, was first diagnosed with dementia three years ago.
As his disease progressed, she explained the liability and financial issues if he were to cause an accident and that she believed he should stop driving.
“He gave up more easily than I thought, but I have found him sitting in his car and trying to start it,” she said. “I’ve taken the key off his ring.”
Neil Smith often asks why he can’t drive when people older than he are on the road, and she repeats the answer.
“I think it’s hardest for a man who is used to driving and doing social aspects of opening doors and taking someone appropriately where they go and in a fashion they feel a woman deserves,” Jane Smith said. “It’s very painful to watch.”
Have plan of action ready
“Have other alternatives lined up before saying, `We don’t think you should drive anymore,'” Karp said.
“You can’t just take something away from someone without replacing it with something else unless you want the person to be depressed, isolated and angry.”
In Illinois, family members do not have the authority to have someone’s driving privileges rescinded. Only physicians and law enforcement officers can do that.
Calling in a physician may or may not work, Karp said.
“I’ve heard some doctors say, `I agree, but I don’t want to be the one to tell them.’ It’s hard to be the bad guy.”
Experiment with different strategies until you find those that work, said Kathleen O’Brien, vice president of program services for the Alzheimer’s Association in Chicago.
Creativity may be required
If the family member insists on driving, you can remove the battery or distributor cap, or file the key so it no longer fits in the ignition.
Some people may forget about driving if the car is removed; others are comforted as long as the car, although undrivable, is still in sight.
“A car can be a symbol to people as much as something they use,” O’Brien said.
The Alzheimer’s Association offers an identification program, Safe Return, which links those with confusion or memory loss to emergency services and family contacts. (The number is 800-272-3900.)
Depending upon the individual and medical condition, a total end to driving isn’t always necessary.
Those in the early stages of dementia often can drive safely as long as their skills are continuously assessed. Some have correctable vision problems, while others are able to continue driving after outfitting their vehicles with adaptive equipment.
And some are happy to have their driving restricted as long as it isn’t taken away.
“Some people just want to be able to drive a 5-mile radius from home,” Egge said. “That’s all they want to do.”
How gracefully the Baby Boomers will give up their keys remains to be seen.
“I don’t think they will be any more willing to admit they can’t do this than any other generation,” Karp said.
She added, “Baby Boomers are into a more healthy lifestyle, so they may be more proactive about maintaining their skills and abilities as long as possible.”
People need to plan for the day they will no longer drive, just as they plan for retirement, Lewis said.
Pilot program set to begin
In the Washington area, the American Association of Motor Vehicles is broadcasting that message through a pilot media campaign called GrandDriver that kicks off April 1.
The campaign will address such topics as driving impairments, alternatives and tips on how to prolong driving abilities. For more information, beginning April 1, call 888-GRAND03(472-6303) or visit www.granddriverinfo.com.”We Baby Boomers need to think about where we live and how we will get around as we approach those years, to make sure we have access to the shopping centers and social events,” Lewis said. “Usually people don’t think about these things until they have a major catastrophe.”
Agencies offer transportation options
If you’re looking for alternatives to driving, call the town clerk, the township, senior center or local Suburban Area Agency on Aging to see what might be offered in your town. For example:
Lake Forest offers weekday transportation by appointment, scheduled shopping trips and a subsidized taxi program to senior residents of Lake Forest, Lake Bluff and Knollwood. For more information, call 847-615-4276.
The Skokie Senior Transit for Area Residents (STAR) provides weekday curb-to-curb service for qualified residents within the village for any reason and to certain medical locations outside the village. For more information, call 847-676-7827.
The Suburban Area on Aging in Oak Park refers callers to senior transportation programs in their area, whether or not they live in suburban Cook County. For more information, call 703-383-0258. Other Suburban Area on Aging offices are listed at www.state.il.us/aging/aaas.htm
Plus, Pace, the suburban bus division of the Regional Transit Authority, provides fixed routes, dial-a-ride services, vanpools and special-event buses throughout six suburban counties. For more information, call 847-364-7223.
–Pamela Dittmer McKuen
