Anita Kamiel, RN, MPS
Summers often mean “Road Trip”, but getting seniors to give up the keys to their car is no small task and, frankly, I am quite sympathetic to the seniors. After a lifetime of independence, it is yet another degradation they must endure as they age and their faculties wane. Only with this one, it can feel like a prison sentence, being confined to four walls.
While there are many seniors on the road that should not be, [National Highway Traffic Safety Administration (NHTSA) driving statistics for those post 75 years old attest to this], sometimes children of senior citizens are overly cautious in their ‘drive’ to strip parents of their car keys. There are professionals out there who can help assess whether or not it is time for that step.
Driving Rehabilitation Specialists are a subspecialty of Occupational Therapists (OT-DRS), but they could have a background in physical therapy, kinesiotherapy, driver education or psychology as well. Their clinical assessments include a review of personal medical history and cognitive ability and a functional/on-road assessment that keeps an eye on visual, cognitive, physical and behavioral impairments while driving on which they make recommendations for intervention in terms of vehicle modifications or specialized training. These assessments range from $200-$400 depending on your area and could include $100 per hour for any necessary subsequent service. The American Occupational Therapy Society can help you locate someone in your zip code.
Driving Skills Evaluators (DSE) are also trained, licensed and certified by the state and perform evaluations based on an in-car evaluation of driving skills and may recommend further testing with an OT-DRS or additional training by the DSE. Those evaluations run $100-$200 with additional hourly charges ranging from $75-$150. The Association for Driver Rehabilitation Specialists should help you understand the different levels of certification as well as how to find one in your area.
Family members must watch for indications of problems that might lead to possible harm to the older adult or others. If the senior has trouble seeing street signs at night, their reflexes have slowed, an increase in near miss accidents or fender benders, a history of falling or been diagnosed with a medical condition that could impact their driving due to diminishing vision, seizures, dementia, stroke or sleep disorders, it is a good time to visit the idea of an evaluation. An informal self-assessment can be found through AAA Roadwise Review or the Fitness-To-Drive Screening Measure Online through the AARP.
It is understandable that as children see more physical signs for concern, they feel awkward about broaching the subject with their aging parents. There are many, many resources out there for information about how to enter this new phase of life readily yielded by a simple google search. Seniors and their families should be aware that there are many options to take before giving up the keys and solutions to lessen the negative effects of a total relinquishing.
When seniors don’t drive, most of the burden falls to the caregiver. However, for those who don’t have a ‘resident driver’ or who can’t rely on their caregivers 100% of the time, there are alternatives.
The following are different categories of services available.
- Curb to curb or taxi services that pick you up and drop you off curbside and don’t help at all with mobility aids such as walkers or wheelchairs.
- Door to door car services that pick you up and drop you off, but don’t get out of the car to assist you with entering and exiting the car. Again, they may not want to help you with any walking aids or wheelchairs.
- Door through door services that provide a full service of helping you in and out of the car or van and help you with whatever you need including groceries and packages.
As more and more Baby Boomers relinquish their licenses, they will need more services to fill this needs gap. Certain companies like the for-profit SilverRide and the not-for-profit Independent Transportation Network of America (ITN America) are available only in specific states.
Seniors in New York rely on a mix of private car services, government subsidized programs and community and religious organizations to supplement transportation needs. The New York City Department for the Aging can provide transportation services through listed senior centers. Information regarding Access-A-Ride, a subsidized door-to-door transportation service available 24/7 to those eligible can also be obtained there. Manhattan residents can take advantage of the Community Arranged Resident Transportation (CART) Project funded by that department which provides free transportation service to the frail elderly five days a week.
It’s all about keeping everyone safe. According to the AAA, the highest fatal car accidents occur in two distinct age groups – teenagers and those 75 and older. The difference is that seniors are far less likely to survive these car crashes, not to mention the harm that can be inflicted upon others. They are more fragile and don’t bounce back from injuries well at all.
On the other hand, until the age of 65, the accident rates of older adults mirror those who are middle aged. In order to ensure that seniors continue driving safely for as long as possible, we need to educate them about the warning signs and plan for the various options for maintaining their independence.