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When to Take the Keys Away

Jonathan Burns, MDJonathan Burns, MD
Board certified in Family Medicine and Geriatric Medicine
Elder Service Plan of Cambridge Health Alliance

If you are worried about an older family member driving – you are not alone. As a physician who serves older adults, people often ask me about driving safety. Because independence is vital to an older adult’s health and well being, it’s hard to know when to draw the line when it comes to yourself, a family member, or a patient/client.

Here are some quick Q&A’s about older adult driving safety to help you start thinking about this issue.

Q: What are some signs that it is not safe for an older adult to drive? Q: What are some factors that could impair driving? Q: Do you have tips on how to talk to older adults about their unsafe driving habits? What about caregivers? Q: What else should I do?

Q: What are some signs that it is not safe for an older adult to drive?

A: There could be many signs like:

  • Multiple car accidents, traffic violations, close calls, or getting lost while driving
  • Multiple falls in the past 1 or two years
  • Cognitive impairment or memory problems
  • Recent loss of vision
  • Recent impairment (including stroke) might require reevaluation of driving
  • Seizures

Click here to take a quiz that may help you identify an unsafe driver.

What are some factors that could impair driving?

A: Many older adults are on several medications, and unfortunately, some of these may make driving less safe.

You may be aware of the “Beers Criteria” of potentially inappropriate medications administered to older adults (from the American Geriatrics Society). This list categorizes medications that could impact an older adult’s health. For example, benzodiazepines and certain antidepressants are common medications that are known cause sedation and could impair driving. To get the full list from the AGS click here.

Q: Do you have tips on how to talk to older adults about their unsafe driving habits? What about caregivers?

A: Gauging an older adult’s dependence on driving and their desire to continue driving is important while discussing safety. Sometimes it helps to emphasize the consequences of impaired driving by asking, “Have you ever known anyone who has been seriously hurt in a car accident?”

As for caregivers, I like to start by reviewing the clinical reasons for concern regarding driving. This can be a challenging discussion. But if we agree that driving is unsafe, I ask for a commitment from the patient directly to stop driving. This may mean turning over keys to a family member.

For additional tips, click here for an excellent article on how to approach the conversation.

Q: What else should I do?

A: Here are a few ideas:

  • If an older adult is seeing a specialist regularly (for example a neurologist for Parkinson’s Disease), ask the doctor if any symptoms or medications could affect their driving.
  • See an occupational therapist. They may be able to provide a clinical driving evaluation.
  • Find a comprehensive driving school. Some schools offer a detailed, objective safety evaluation. Please note that there might be out-of-pocket costs. Also, click here for information from AAA and Car Fit.

Here’s to continuing to drive safety in the years ahead.

This article provides general information for educational purposes only. The information provided in this article, or through linkages to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call consultation or the advice of your physician or other healthcare provider. Thank you.