Imagine if, at this moment, you no longer had access to a vehicle or the ability to use a ride-share service. What would you feel, anger, fear, panic? It can be challenging to empathize when our fear is based on the potential dangers each time our family member gets behind the wheel. Our impression of their abilities is entirely at odds with their impression. When Dad no longer had a valid driver’s license, he insisted on continuing to drive and hid his car key. He was not unique in his pursuits, and his motivations made perfect sense considering his circumstances, the losses he had already experienced, and his vested interest in remaining independent. After months of intense conflict, the dust settled, but there were wounds and battle scars. My ego was the only winner in the end, which meant there were no real winners.
Loss
The decisions surrounding driving can result in some of the most emotionally charged conversations during the caregiving experience. While there are accounts of older adults voluntarily handing over the keys and declaring that they no longer feel safe driving, that is often not how the scenario unfolds. It is crucial to understand what is at stake for your family member and you as a caregiver when driving is no longer an option. Your family member is losing the freedom and independence to manage their own life.
“Loss is like a wind, it either carries you to a new destination or it traps you in an ocean of stagnation. You must quickly learn how to navigate the sail, for stagnation is death.” – Val Uchendu
Losing the freedom that driving offers is likely one of several successive losses and can result in a grip on the wheel that can look like a grip holding onto life itself. To navigate this transition in a way that sustains your relationships and emotional well-being, it is crucial to understand the loss from your family member’s perspective so that you engage from a place of compassion and empathy. It is vital to begin with the end in mind and focus on common objectives to avoid the wounds of a potentially epic battle.
Awareness
Planning, preparing, and practicing awareness are the steps you can take now so that when the time is right for a transition, you will be able to support your family member through the actions that will help them maintain a sense of continued control and independence. Learn the signs that will alert you to a needed change. With awareness, you can determine when to move forward. Planning will help your parent remain connected to the people and interests that fashion their identity and add quality to their lives. Preparing for both the conversations and the new methods of mobility will minimize stress.
My awareness was blurred by denial. The tipping point was when a man followed Dad home and angrily insisted that he be more careful. Dad had run through a slew of Ibises. Ibises are gentle white birds that feed in the grass and leisurely cross the road throughout the neighborhood. Dad claimed they ran out in front of his car, and he couldn’t avoid them. Truthfully, he never saw them and likely wasn’t aware of the incident until the horrified witness brought him to task. My brother shared another concerning account. It was nighttime, and Dad was in the lane to turn right at a red light. A pedestrian started into the street, and Dad proceeded forward. The pedestrian stopped. Pat alerted Dad, who also stopped. The pedestrian started. Dad started. Pat yelled. It was a loop. Dad never saw the pedestrian.
Navigating the Transition
Assess
There had been other signs, scratches, and dents. Dad and I were both in denial. We were both at risk of losing our freedom, so I avoided the conversation until it was painfully evident that we needed to make a change. I was not prepared for this level of conflict. Nor had I planned the next steps that would have made the transition less traumatic.
To ease the transition, take a ride with your family member to evaluate reaction time, how increased traffic is handled, lane-changing challenges, vision difficulty, or missed turns. Is driving speed significantly slower than the speed limit, or do you notice sudden or unnecessary braking? This ride is your baseline. Plan a regularly scheduled ride and note any changes. Check out the vehicle and look for scratches and dents. You may take photos or keep a log. Your parent may share a story about a concerning incident or a close call, but the details may be fuzzy. These clues indicate that a change is on the horizon and preparations are in order.
Identify Concerns
After a few ride-alongs, identify the specific concerns about your family member’s driving abilities. You may be primarily focused on vision, hearing, reaction time, cognitive issues, or have concerns about a medical condition. For example, if eyesight is the challenge, understand the DMV guidelines to qualify for a license and plan to attend your family member’s next eye exam. Before the visit, discuss your concern with the tech or doctor. If the reaction time is the concern, a driving test designed for older adult drivers may be warranted for peace of mind. Check with the local DMV, AARP, or AAA Club locations for information and resources. You may also locate an older adult driver’s safety course.
Is memory a concern? Has your parent gotten lost on a familiar route? You might research a neurologist specializing in age-related cognitive issues and begin testing for dementia. An early diagnosis increases options. If a medical condition or prescribed medication is a concern, discuss the worry with the doctor. When you have a worry, make a plan. The plan will help you from obsessing over the worry. It will also help you take action when the time is right rather than getting caught up in stressful research.
Be prepared with choices so that you may collaborate to create a plan. Self-driving cars may be the solution of the future. Until then, identify the senior and disability transportation options in the community. Start with the local Area Agency on Aging. Research the public transportation services to identify the systems in place for senior transit. Learn about eligibility requirements. Request forms and information. Is there a waiting list? What is the cost per ride, and how is payment handled? What mobility challenges will need to be considered? How complicated is it to schedule a ride? Does the schedule look adequate to accommodate needs, and are there distance or other limitations, such as the number of eligible passengers per vehicle?
Research
Does a house of worship or a faith-based organization provide transportation in the area? Is transportation included with home care services provided by an agency? Is there a senior center nearby that offers outings? What family and friends can help? Ridesharing services such as Uber and Lyft recognize the opportunity to provide a different level of service for the older population and the challenge that technology presents. While scheduling a ride for someone else remotely is possible, that option can be complicated to coordinate. Lyft Concierge is designed to be used without a smartphone. Identify local private rideshare services that cater to clients who do not have a smartphone. Medicaid will cover non-emergency transportation to doctor’s appointments. Some private insurance companies may cover transportation costs as well. Some doctor’s offices will assist by requesting a return ride for a patient.
Plan & Prepare
Once you understand the options and have more information about what may lead to a transition from driving, you can prepare by focusing on the details. List the places that your family member goes to and begin to consider and match each outing’s transportation options. Consider how scheduled appointments versus hobbies or interests may be managed. Research services that may reduce trips, such as prescription delivery, grocery delivery, meal service plans, Amazon Pantry or Amazon Prime. If shopping is also an opportunity for exercise and entertainment, how can that continue to be a part of the activities? Where will you or your family and friends fill in the gaps?
You may choose to take responsibility for the doctor’s appointments to stay abreast of health conditions changes. Or you may use social outings to help you and your family member maintain some of the fun aspects of your relationship. This is the time to consider your boundaries. Clearly communicated boundaries are required, so your family member’s loss of freedom does not significantly impact your freedom. It may be uncomfortable to see your parent in pain, refusing all options but your services. Still, tough love is required for the transition and a sustainable continuation of the journey.
Have the Conversations
Discussions around driving were the most challenging series of conversations we faced while on this journey. The conflict highlighted an overarching theme of the entire experience until I understood the dynamic. In the beginning, it was a battle for control. Who was in charge? Growing up, Dad was the gentle enforcer, and I was mostly obedient. I was not prepared nor interested in swapping these roles, and Dad wasn’t either. I was not parenting a child, but what was this strange new relationship, and what were these strong, uncomfortable emotions? We were both resisting our new roles and responsibilities.
Kathy Blair from KRB Move Management stated the reality well, “Children who hire us to help move their parents often have two personas: one when dealing with us and another when their parents are present and part of the conversation. When dealing with us, they are decisive, self-assured, and competent. In the presence of their parents, they are compliant, apologetic, emotional, and sometimes fearful. Often, there is a cry for help, sometimes spoken and frequently implied, ‘Please take this burden from me.’ We have been told, ‘You don’t know what he can be like. I don’t want to see his wrath.’ We totally understand this.”
After recovering from a stroke at 94, Dad came home from rehab. He demanded his car keys. I said, ‘No way.’ He turned all shades of red, then purple, and demanded that I give him the keys, and made threats. For the first time, I understood the term “spitting mad.” I lost all resolve. I feared he would have a heart attack or another stroke, and I needed him to calm down, so I gave him the key. I was shaking, angry, furious, lost, and afraid.
Strategies
When I let go of outcomes, I could release the anger and fear. My responsibilities were fulfilled when I communicated concern, enlisted the support of professionals, and set up alternative transportation options. I set boundaries around my emotions. I acknowledged that I owned the worry and the obsession with anticipatory guilt; therefore, these anchors were mine to set free. When I became aware of my thoughts drifting to driving, I took a few deep breaths to focus on the present. Through journaling, I further explored my frustration and identified a feeling of anticipatory guilt. I realized that the reason I felt alone was because no one else, particularly Dad, seemed to be as concerned as I was about what might happen, who could be injured, and what consequences might be incurred. I was a lone paddler working against the current, which was wearing me out.
In addition to setting limits around my emotional investment, I set boundaries around my actions. I would not call the police and report that Dad was driving without a license. I did put a club on his vehicle and set a key aside for the aides. With the club on the steering wheel, Dad still tried to drive the car, but with more curiosity than determination. He eventually accepted that he would no longer be able to drive, and the club was no longer necessary.
The strategies I employed to navigate the transition did not directly lead to the solution, but they helped me survive the turbulent emotional rapids that made me feel like I was drowning. By accepting that I could not control Dad’s behaviors nor the resulting outcome, and by placing boundaries around my emotional involvement, I created a more sustainable experience. I protected my well-being so that I could continue to look after Dad’s well-being. It was the best that I could do, and it was enough.
For more about navigating the challenging transitions, check out Navigating the Caregiver River: A Journey to Sustainable Caregiving, available on Amazon. Episode 13 of the Self-Caregiving Strategies Podcast explores planning and preparing for caregiving transitions.
Schedule Theresa Wilbanks to speak on caregiving and empower the caregivers in your workplace or community with the 12 Sustainable Caregiving Strategies.
Advice offered is for general information only; please contact your healthcare team, legal or financial advisors to guide your particular situation.