Caregiver to Caregiver

It was difficult watching Rachel and Daddy board the Amtrak train for their return trip to North Carolina. So many special memories of the two weeks they had spent with us in Brooklyn were stored in my heart. I wondered if Daddy’s mind had recorded any memories to take home. 

Although he had showed occasional signs of forgetfulness and confusion, he still functioned well for an eighty-four year old man. It was comforting to know Rachel was taking good care of him, but she planned to return to Brooklyn in the spring. My three sisters who lived within one-half mile of Daddy would be able to take care of his basic needs, but he would be by himself during the day while they were at work.

Those were the BC days – before cellular – and long distance calls were still billed by the minute (I remember getting one statement from the phone company for fifty dollars for one rather lengthy conversation), so Rachel wrote every week to let us know how she and Daddy were doing.

In early spring, Daddy had driven into town by himself. He pulled into a service station, got out of the car, and had no idea where he was. A UPS driver who had made deliveries to the farm was filling his truck up with gas and recognized Daddy. He notified my brother-in-law Ron, who was a policeman. Ron got him safely home that day. 

Soon after that scary episode, it was time for Daddy to renew his driver’s license. My sister Rachel, who had power of attorney, thought it would be best for him to allow him to attempt to pass the test; but he could not. He admitted he was unable to read the road signs, but he also complained that the people at the DMV “tried to trick me.”

Loosing the privilege to drive was a crushing blow to Daddy, as it is to any elderly person who reaches that stage in life. He loved being able to drive to visit friends and those he called “shut-ins.” He would take his Bible and “read and pray.”

After Daddy lost his license, Rachel (my daughter) wrote: “Grandpa is upset at me today. He had been secretly trying to study for his driver’s license and no one but I knew. He was going to ask Kevin (a grandson) to take him to the DMV in Siler City; he thought because it’s a smaller town, he may have a better chance there. I thought Aunt Rachel needed to know, but when he found out that I had told her, he wasn’t too happy with me. He doesn’t seem to understand that no matter where he goes, he will not be able to get his license back.”

Because this is such a sensitive, yet vital subject – when your loved one’s dementia interferes with the ability to drive safely – I will dedicate the rest of this chapter to that issue. 

At least four early warning signs identified by the Alzheimer’s Association affect the ability to drive:

• Difficulty completing familiar tasks
• Confusion with time and place
• Trouble understanding visual images and spatial relationships
• Decreased or poor judgments.

In spite of these possible driving impairments, caregivers often avoid addressing this situation because of the emotional side of the issue. Yes, it is difficult for an elderly person – who is also becoming aware of other changes he is experiencing – to relinquish the keys to his car. 

A friend has frequently confided in me that her father’s driving scares her. She described several close calls when another alert driver saved the day. Yet, she cannot bring herself to take away his keys because, “He would be so upset.”

Opinions differ concerning driving and dementia. Some advisers state that in the early stages, short trips in familiar surroundings may be safe. As Daddy’s experience indicates, no one knows when “familiar” may suddenly become “unknown.” I thank God that He took care of Daddy that day, but that scenario could have had a tragic ending. I have read too many accounts of people with dementia being involved in accidents or becoming lost – even some that resulted in death.

I would choose to err on the side of caution.

Caregivers are usually the best judges of a loved one’s ability to drive safely. Consider these warning signs, which may indicate driving skills are deteriorating:

• Confusing the brake pedal with the gas pedal and vice versa
• Getting “lost” while driving to a familiar place
• Ignoring traffic signs
• Changing lanes improperly
• Running off the road or hitting the curb
• Driving extremely slow or stopping in the street for no reason
• Forgetting to signal
• Driving on the wrong side of the street
• Parking inaptly (such as stopping halfway into a parking space)
• Expressing inappropriate emotions while driving, such as extreme agitation
• Inability to foresee or react to a dangerous situation

When the time comes to limit or prohibit driving, it is imperative that alternative transportation be provided. This will ensure that your loved one’s usual activities will not be restricted and he will not feel a great loss of independence. Respond to relatives or friends who ask, “What can I do to help?” by suggesting they serve as chauffer for medical appointments, church services or pleasure outings.

Explaining your safety concerns to your loved one may or may not achieve compliance. If she balks at the idea that she should no longer drive, a conversation or written directive from a doctor, lawyer or car insurance agent may help. Refusal to cooperate may necessitate disabling or removing the vehicle.

While it is certainly not a pleasant task to tell your loved ones that it is no longer safe for them to drive, their safety and keeping others out of harm’s way should be the main concerns. It may be challenging to stand firm in your decision; but the consequences of giving in and allowing someone to drive who can no longer do so safely could result in a much more difficult situation.