Eight signs that aging loved ones need to put the brakes on driving

The ability to drive provides independence, but as we age, driving can become especially dangerous. The rate of fatal car crashes is known to rise sharply among drivers over the age of 70, and so, it is important to observe your parents and grandparents for signs of a diminishing capacity to drive safely. From my experience, as a geriatrician, here are some simple ways to determine that the time may have come for your loved ones to turn over the car keys. 

1. Close calls. The number one indication is when the person begins to have close calls. You may notice dents and marks on his or her vehicle, or the garage door. When you ask he or she may be unwilling—or even entirely unable—to tell you how it happened.
2. Small accidents/tickets. I always ask my patients about any driving accidents or citations they have had within the past six months. Use this to determine if your loved one has begun to lose control over his or her confident driving history. 
3. Memory issues. Another warning sign is loss of memory. For example, your grandma might call and tell you that the other day she was driving to the grocery store but unexpectedly took a wrong turn, and lost her way. Getting lost on familiar roads and neighborhoods is very worrisome. 
4. Eye sight concerns. As we age, our eye sight diminishes. Make sure to ask your loved ones if they have trouble reading road signs or driving in bad weather or at night. If they are having trouble with their vision at home, they are likely experiencing similar problems while driving.  
5. Reduced reflexes. Our reflexes also degrade with age. When you are in the car with your loved one, observe whether he or she is having trouble at stop signs and intersections, hesitate to change lanes or merge into traffic, forget to use turn signals, or start to drive too close to or too far from other cars.
6. Limited neck-motion mobility. Frequent and flexible neck motion is critical to driving, and people in their 20s have a much wider range than those in their 70s. A quick test I do in the clinic is to ask my patients to demonstrate their neck motion to evaluate its range.  
7. Chronic health issues. Many older adults have chronic medical conditions, such as diabetes, arthritis, or progressive illnesses such as Parkinson's, which can cause weakness in the limbs or cause pain when using them. This can put them at a greater risk for accidents.
8. Medications. Many medicines cause side effects that can lead to accidents. It is critical to review all of your parents' medications with their physician, to ensure that none will impact their ability to drive safely. 

Talking to your loved one about this is often difficult. Instead of becoming "the bad guy," it is best to bring him or her to his or her provider for such a discussion, or a medical evaluation. If the provider determines that he or she should not drive anymore, or should limit driving in specific ways, it is easier for the provider to deliver this news. Such a visit also provides your loved one with an opportunity to ask questions, or express concerns and disagreements in a non-confrontational setting. Additionally, occupational therapists can conduct a behind-the wheel (BTW) driving evaluation.

No one wants to be individually responsible for making the decision to take away a driver's license, and a BTW evaluation is often the best approach. However, BTW evaluations are typically not covered by medical insurance. Check with your insurance provider before making an appointment.