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When a Privilege Yields to Age

When the elderly can no longer drive, family members must deal with the transition too. Offering alternatives may calm fears of being cut off.


Of all the insults of growing older, losing one's driving privileges can be one of the most difficult to bear. A new driver's license is a symbolic rite of passage from youth into adulthood, but giving up the car keys as physical and mental faculties diminish is a passage of another sort.

"Driving is the ultimate symbol of independence and self-reliance," said Gloria E. Gesas, a clinical social worker with Jewish Family Service of Los Angeles. Older adults often feel that their life is essentially over without a car, she said. And they may stubbornly resist relying on their children or others for transportation. For families of an elderly driver, the issue is emotionally charged, one that can drive a wedge between husband and wife, parent and child. Family members, often the first to observe an older adult's diminished driving abilities, don't want to feel responsible for curtailing a loved one's independence--the ability to drive to the grocery store, to religious services or to pick up a grandchild after school. The need for mobility is especially acute in regions such as Southern California, where urban sprawl, inadequate mass transit and access to commerce, culture and social activities make automobile transportation a near-necessity.

Though there is little debate about when people are ready to start driving--age 16 in most states--there is no consensus or standard age for relinquishing the privilege.

"One thing that just keeps coming through loud and clear is how different seniors are from each other," said Arline Dillman, traffic safety manager for the Automobile Club of Southern California. "I know some people in their 90s who are still marvelous drivers, and some in their 50s and 60s--or for that matter in their 30s and 40s--who ought not to be driving."

One thing's certain: More older drivers will be on the road as the nation's population ages. In 1990, older drivers accounted for 6.7% of all travel on U.S. roads, but that figure will increase nearly threefold by 2030, when they'll account for about 19%, according to federal estimates. The responsibility for the safety of older drivers is shared by many people, including family, doctors and the government.

Often, changes in someone's physical or mental health condition will prompt discussion about whether an older driver is still fit to be behind the wheel.

Glaucoma, cataracts, diabetic changes in the eye or macular degeneration may impair the ability to read signs or gauge distances. Arthritis, for example, may make it impossible to turn the head to drive in reverse, or maneuver the foot from brake to accelerator. Certain prescription drugs, such as high blood pressure medications, can create drowsiness and slow reaction time. Although dementia alone doesn't preclude driving, those people with moderate to severe dementia lack insight into their behavior and may make poor judgments.

Although relatives are in a position to make valuable observations about an older driver, they often resist confronting the issue of a loved one's deteriorating skills because they fear the consequences. They may worry that a spouse or parent will stop talking to them or become deeply depressed if they broach the subject. Another factor is the guilt and resentment of realizing they may have to become the primary driver, said Gesas, who counsels families on how to handle situations involving an older person's loss of driving privileges. She guides them to transportation services, in-home help and mental health support.

Sometimes an accident--or series of accidents--or other troubling event, such as a driver getting lost, will force a family into action.

Esty LaHive's first inkling that her husband, Joseph, was losing his driving abilities came in August 1997, when he took the car and disappeared for hours, missing their anniversary celebration, and then couldn't account for his time. Then another incident: After leaving the couple's Studio City home one morning and failing to show up for a golf game, he called hours later from a shopping mall in Calabasas. He couldn't find his car, he told his wife. A Sheriff's Department helicopter eventually located the badly damaged car in a ditch several miles away.

After that incident, Joseph LaHive, now 80 and living in a nursing home with dementia, still wanted to drive and his wife sometimes allowed him to borrow her car. She eventually removed the car key from his key ring.

In 1999, a neurologist diagnosed Joseph with dementia and filed a report with the DMV. Months later, the agency informed him he'd have to take a written test. After he had trouble concentrating on the study guide at home, Esty decided against having him take the written test, hoping to spare him the indignity of failing.

"It was very traumatic for him,'' Esty said. "He didn't want to give up driving."

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