Older Drivers: The Car Key Decision
As the number of older drivers increases as the population ages, the question arises more often: When should the car keys be taken away to ensure the safety of older drivers -- and others on the road?
When It's Time to Quit
If an older driver's declining skills are beyond help, the best
solution is helping family and friends convince the drivers to hang up their
keys for safety's sake. While some older drivers relinquish their driving
privileges on their own, most need to be persuaded to stop driving by a
relative or doctor.
To get a driver off the road, police officers, doctors, social
workers, and family members can file a hazardous driver report (in some states,
anonymously) with the state Department of Motor Vehicles. The DMV is then, in
effect, the "bad guy." When they revoke a license, most people will
comply, if bitterly, according to Nancy Wexler, MA, MFCC, a founding member of
the National Association of Professional Geriatric Care Managers, which helps
families arrange for long-term care and other services.
Doctors, for their part, would prefer to limit their
involvement to patient counseling. Despite a proposal of its Council on Ethical
and Judicial Affairs stating that the reporting of impaired drivers is an
"ethical obligation" of a physician, representatives to the American
Medical Association twice rejected that position at the urging of many medical
societies, including the American Academy of Ophthalmology.
"We were concerned that patients with potentially blinding
diseases would not seek the medical care they might need to halt progression of
vision loss once they learned their physician was obligated to turn them in to
the DMV," says Craig H. Kliger, MD, a representative of the ophthalmology
academy to the AMA. The AMA eventually adopted language that made it
"ethically acceptable and desirable" to report an impaired driver, but
not mandatory -- except where required by law.
But if the DMV is not involved, or the driver's doctor is
unsuccessful in convincing the patient, more creative solutions are needed.
Wexler recalls a man in his 80s suffering from dementia who refused to stop
driving. Finally, the family asked a distant relative who was a police officer
to come to the house and tell the man that his insurance had lapsed and his car
was going to be removed. The man agreed to stop driving and instead of being
angry with his family, called his son to complain about what the police had
done. "If the person respects authority, this can work," says
Mr C is finally off the road, too. His son came to visit and
told his father he couldn't drive any longer. Oddly, Mr. C seemed relieved,
says Gauthier, the retirement community's assistant manager. "He says,
'Well, my doctor kind of said I shouldn't be driving. ... ' " And he had
been thinking about giving his car to his grandson, anyway.