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Driving: When to Give Up the Keys?

Driving: When to Give Up the Keys?
by Anna Lisa Curtis and Denise Sparks, PhD
Director of the Louis and Anne Green Memory and Wellness Center
at Florida Atlantic University

When we were young, most of us could hardly wait to drive. Once we were behind the wheel with our foot on the gas, we quickly became aware of the freedom this new skill afforded. Because driving is something we can easily take for granted, we may never completely understand how difficult it is to give it up until we are faced with this decision ourselves. If you are helping someone make this decision, begin by trying to imagine their position. If you put yourself in their shoes, it will help this difficult process.

Driving helps defines us as functional human beings. Giving it up threatens our independence. These two facts along with any denial, or lack of awareness of declining skills, make it even more difficult for a person to surrender their keys. Even when someone is fully aware that their driving is no longer safe, deciding not to drive is a decision that generally doesn’t come easily. It is important to know that ability, not age, should be the deciding factor in the decision to give up driving. Many older adults are good drivers according to Michelle Owens, research assistant and driving test administrator at Florida Atlantic University’s Memory and Wellness Center. “Roughly 60 to 65 percent of the individuals who come in for driving evaluations pass our driving assessment,” Owens said. Most driving test participants arrive at the urgings of friends, family, physician referral, and sometimes court order. Rarely does an individual undergo testing based on his or her own decision. So when a majority of older drivers (whose skills have been questioned) pass a comprehensive driving evaluation, this supports the fact that most older drivers are safe enough to drive. Therefore ability, not age, should always be the deciding factor. A thorough driving evaluation measures physical and mental skills through a series of clinical exams along with a driving test on the open road. “The following conditions impair senior driving skills,” Owens said, “vision problems, diminished strength, flexibility and endurance, as well as cognitive impairment.” While vision and cognitive issues are the most obvious, strength and physical functioning are also important to driving and can impair one’s ability to drive safely. We rarely think about how leg, hand and arm strength along with body rotation enables driving. For example, a condition such as arthritis can prevent safe handling of the steering wheel. Poor flexibility and body rotation impairs a driver’s ability to see what is behind or to the side of their vehicle. And leg strength is necessary for proper use of the gas and brake pedal and the ability to quickly change between the two.


Vision is the last sense to develop and first one to decline as we age, according to cognitive and developmental psychologist Alan Kersten, Ph. D. of FAU. Many things can go wrong with vision, so it is essential to check eyesight annually as we get older. To safely drive we must be able to see the internal instruments to control our cars as well as external street signs, lane markers, medians, pedestrians, cyclists, and vehicles. Vision problems may only occur at night. If this is the only issue, operating a vehicle only during daytime hours might be the one change an older driver needs to make to continue driving safely.


Driving also requires divided attention, good judgment and quick reaction time. These are all dependent on cognitive skills. Therefore, cognition is an important factor to consider when deciding whether or not to drive. Difficulties with cognition from dementia, illness or medication can affect attention, judgment, perception, and reflexes necessary to operate a vehicle and navigate the road. And anyone who experiences confusion, dizziness, seizures, or loss of consciousness should not be behind the wheel.
In helping someone assess his or her ability to drive, remember that one day someone may be helping you make that same assessment. With dignity and respect, help your patient, client, parent or friend take inventory of their flexibility, strength, vision, and cognition. You may have to recall recent driving events that might indicate that there is a problem. If so, try to do this by stating the details as factually as possible without scolding or shaming.


Also keep in mind that when memory becomes an issue, a person with significant memory loss may not be aware of a problem because they are not recalling recent difficulties behind the wheel. When this occurs or a person simply refuse to give up driving, someone other than you, such as a physician, family member, or driving evaluator, may be able to convince them to surrender the keys. It is also possible to make a confidential report of an unsafe driver to the Medical Advisory Board of the State of Florida Department of Highway Safety and Motor Vehicles. The reporting form is available on line at: http://www.flhsmv.gov/ddl/helpful.html. If all else fails or if there is immediate danger, alter the keys, disable the car, or sell it, donate it or give it to a family member.


On a final note, it is also important to help someone who needs to give up driving find other forms of transportation. “We always make it a priority to engage in mobility counseling with persons who fail our driving test,” Owens said. “This means connecting them with resources, such a special transportation for the disabled, private drivers, friends and family. Otherwise, they become vulnerable to depression and increased loss of function.”


Don’t forget, if we live long enough this will likely be something we will have to face. According to Socrates, those who are older are simply further up a road we must travel. So, it is a good idea for all of us to make a plan for the day we can no longer drive, because available research suggests that most people outlive their ability to drive by 8 to 10 years.

M. Denise Sparks, Ph. D. First North America Serial Rights Director of Louis and Anne Green 2008 Anna Lisa Curtis Memory and Wellness Center 2008 Mary Denise Sparks Boca Raton, FL 33431 word count: 996 561-297-0502 msparks@fau.edu acurtis5@fau.edu

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View South Florida Today tv segment on this subject.