Is it time to give up driving?

A dear friend called me this morning to tell me her opthalmologist had conveyed to her recently that, given her declining eyesight, it was no longer safe for her to drive.

More than one physician has told me that telling a patient that they are no longer drive can sometimes feel more devastating than telling them that they have cancer. Cancer, after all, is treatable and possibly a temporary situation. Not driving is a permanent loss of independence.

Not long ago, I had to convey this hard news to a client with declining cognition. You can imagine why I was promptly fired. (I was later rehired.) The thing is that I can imagine having the same response myself.

If we step back from the psychological aspects of this weighty situation, what practical steps may an adult child, neighbor or close friend take if they have serious concerns about their loved one's ability to safely drive and resistance to giving up driving?

One tactic is to reach out to their loved one's primary care physician, opthalmologist or neurologist to express concern with at least three supporting incidents. Even if you do not have permission to discuss your loved one's medical care with their physician, you can provide the physician important relevant information (though the physician cannot respond to you without the permission of their patient). Keep in mind, physicians are incredibly busy. However, it would be appropriate for you to submit a short letter, listing three instances (for example, running a red light, two fender benders in one month, getting lost, going the wrong way on a one-way street, etc.) that exemplify your concerns.

A second tactic may be sending a similar letter to the NC Division of Motor Vehicles (Medical Review Branch, 3112 Mail Service Center, Raleigh, NC 27699-3112). The DMV will review the correspondence and then, if warranted, send a letter directly to the driver requesting that they have their physician(s) complete a short assessment and fax to the DMV. The DMV, upon reviewing physician assessments, may then determine that the driver must either take a driving test before they can continue to drive or they may determine that it is time to relinquish their driver's license.

While it is never easy to hear this news, it is easier to hear it from a physician than from a family member or friend, as a physician can provide objective, measurable criteria that informs their recommendation.

When I asked my friend how she was doing not driving, she said for a few days, every time she looked out at her car sitting in the driveway, she got really angry. However, when talking about it with her son, he said, "Let's reframe the situation. What if every time you looked at it, you instead said to yourself, 'That horse is dead?'"

This made her think of old John Wayne cowboy movies and after a few days of chuckling when she looked at the car in the driveway, she had a little ceremony in the kitchen in which she removed the car keys from her key ring.

When I asked how she was getting around now (after all, it is critical that families determine an alternate means of transportation), she said she was just getting in from early senior hours at the grocery store with her daughter-in-law. The previous day, when she reached out to a neighbor to ask for a ride to the post office and bank, the neighbor exclaimed, "You have made my day." They had a short and delightful outing together.

The bottom line is getting older presents challenges. But what life doesn't have challenges (especially during a global pandemic)? That said, we humans are creative and infinitely adaptable--even if it takes a little while to find the way into our new reality.