Tuesday, September 29, 2009

Driving (or Not) Part 3

Most of us think driving is necessary for our quality of life. No wonder we dread having the not-driving talk with our parents! If we can have this talk before driving is an issue we’re a step ahead. If we’re in crisis mode, it’s so much harder.

What follows are strategies and some information that I knew, wish I’d known or tried successfully with my parents.

I put older drivers in three groups: Those in the first group know themselves, are honest with themselves and quit driving when they should. They have pride and don't appreciate being told what to do. Denial characterizes the second group’s members, who don’t realize they’re bad drivers. Drivers in the third group are the most difficult. They’re not only bad drivers, but you can’t discuss anything with them. Today we focus on groups 1 and 2.

If your parent is in the first group like my father was, you’re lucky. Dad took the “Driving Miss Daisy” movie to heart; we had the driving discussion early. As a far-away-living adult child who believes in empowering, I found excuses to visit him every 4-6 weeks after Mother died. Once Dad turned 90 friends constantly pressured me to make him quit driving. (Age, you know.) I couldn’t see making my father do anything if there was no threat to life and limb. I did check his car for scratches, dents, or newly painted areas during each visit.(I would have done that regularly, even if I lived in the same town.) If we were going some place together, I always asked him whether he wanted to drive. He volunteered at least once each visit.

He stuck to the speed limit. Not over, not under. His depth perception was better than mine. He no longer had the radio on. “A distraction,” he said. Writing about it now I wonder if he surmised he was taking a driver’s exam with me. He was in control.

The second group is in denial. Denial exists without our even realizing it. It’s a psychological mechanism that keeps us from facing a reality we’re not yet ready to deal with. How do we speed up parents’ readiness to face reality? We can only try. An often successful start begins by saying “I need your help,” which pulls them in as a partner to the solution. We could explain that older drivers should know about resources that extend people’s ability to drive and offer information from the last post’s websites, or possibly an objective observation we’ve made of their driving or something connected to their driving; then see if anything resonates.

For example, my mother had a stroke. She recovered well, but her balance was shaky. She worried about falling. She still planned to drive. My kneejerk reaction was to tell her all of my reservations. Instead I said objectively that she could drive (true), and she could have lessons to boost her confidence or go with me to a large empty parking lot if she wanted to try that first. I also explained that she would have to be able to get in and out of the car by herself and maneuver her walker alone (reality). At first she said she wanted to try, but then decided there was too much effort involved. Perhaps because Dad was still alive to drive her, she never drove again.

“Driving (or Not)” concludes--honest!-- with the next post.

Saturday, September 26, 2009

Driving (or Not) Part 2

We know from the last post that older drivers have much better safe-driving statistics than teenagers. We also realize that the consequences of unsafe driving are usually far more life-changing for older people than for teens.

When adult children take the time to think things through, as in Kim’s mother's case, the sobering reality of “taking away the keys” (along with the unhappiness, loss of independence etc. that accompany it), is averted. We can’t say “avoided” because dangerous drivers can not be on the road and there’s always the possibility—for anyone actually— that in future years safe drivers could become unsafe drivers.

While my parents were alive, I was clueless about information and programs to help older people continue drive. Luckily my father had seen the movie “Driving Miss Daisy” while he was in his 70’s. He said he would never drive too long and I should let him know if/when I thought he should limit or stop driving. (He stopped himself some 20 years later; mother was a different story—more about that later.) Here's a sample of information that I wish I'd known about.

AARP has an excellent site http://www.aarp.org/families/driver_safety with valuable information, that includes taking the “55 Alive” Driver Safety Course, (added bonus--it may save on auto insurance), a Driving IQ test and warning signs for when to limit or stop driving. A friend of mine—when he turned 55—told his mother that he would take the course with her every year and as long as she passed, she could continue to drive if there were no accidents. (She stopped driving at 98; they both took the course many times.)

Then there is CarFit, a program that enables you to check how well your car fits you (or in this case how well your parent’s car fits her or him). Individual appointments are scheduled for a “quick comprehensive check.” Recommendations for car adjustments and adaptations, as well as a list of resources, are then given. The easy-to-use website (http://www.car-fit.org/) provides all the information you need.

Finally there are booklets. Check out The Effects of Aging on Driving Skills, an excellent, free, small booklet offered by the USAA Educational Foundation. It’s downloadable from the website. http://www.usaaedfoundation.org/ (phone 800-531-8159). I also like The Older and Wiser Driver, http://www.aaafoundation.org/ (202-638-5944). Just write: "older and wiser and driver" (without quote symbols) in the search space and the brochure comes up.

I find the above helpful for keeping older parents, who are capable of driving, safe and “in the driver’s seat.” And that expression is actually appropriate. When older people can continue to drive safely, as you well know, a huge aspect of their independence and feeling of control stays in tact. They feel good and we don’t have the additional responsibility of getting them from place to place. So we feel good.

Next post: the “(or Not)” conclusion to my driving posts.

Sunday, September 20, 2009

Driving (or Not) Part 1

“Perhaps the scariest road hazard is the one they don’t make a sign for.” The large bold type on the back cover of the August 10&17, 2009 New Yorker catches my eye: The silhouette of a girl, leaning forward, hands on the steering wheel, pony tail flying fills a drawing--a yellow and black, road-hazard-shaped sign, with a smaller sign just below saying TEENS. I save the back cover. I know I want to use it in my blog.

When we think about scary drivers, don’t we usually think “old drivers?” Mary’s Florida father (last post) won’t be driving for a while. That may be a relief. Admittedly many of us shudder when we think about older Florida/Arizona/California drivers. And some of us may wonder if drivers in their 80’s should be on the road, period. If teenagers are “perhaps the scariest road hazard,” what about older drivers?

Research shows that drivers age 55 and older are 25% of the driving population but have only 1% of the accidents. AARP tells us that older drivers usually drive fewer miles each year than younger drivers, so we must consider that. Also the number of accidents per mile rises sharply at age 75, which may be why some think older drivers are scary.

The New Yorker back cover informs us that “teens make up only 7% of America’s drivers but account for 12% of all accidents,” elaborating “IN 2007 TEENS KILLED MORE THAN 3,000 PEOPLE IN OTHER VEHICLES.” With the goal of supporting our parents’ self-esteem and not taking away independence prematurely, how do children use the preceding facts and information when assessing and discussing older parents’ driving?

If we have aging parents and teenagers and we see signs of dangerous driving, how do we respond to each age group? Yes, I know, have sufficient insurance. But of course more is involved. Aren’t we more likely to ground a teenager (whose whole life is ahead) but take the keys away permanently and change the life of an older person? Should one size fit all older drivers?

“Make Haste Slowly” is good advice, unless there’s a threat to life and limb. Taking time to get the information needed for informed decisions instead of knee-jerk reactions, is especially important when potentially life-changing consequences are at stake. As we gather information and review options, solutions for seemingly large problems are often clarified.

Example: Kim’s 76-year-old mother spends winters in the South with her adult son. Her mind is good and she’s a good driver; but she gave her children a scare. She took a wrong turn going home from a party, got in a lane that put her onto a freeway, and ended up in a neighboring state. Ultimately she got home three hours later. While her son immediately wanted to take away the keys, her far-away-living daughter suggested their mother have thorough physical, neurological, and vision examinations-- taking away the keys only until the results were back. The results? She was fine. Then what? Creative thinking. Her adult children gifted her with a GPS programmed only for “home.” Three years later, a happy, confident, independent 79-year-old continues to drive without incident.

Thursday, September 17, 2009

Release from the Hospital

One night in August I came home to find a voice mail message from a woman who said an aunt had told her to contact me. She needed advice about home health aides. Her father was coming home from the hospital.

When I phoned the Florida number I learned that Mary lives and works in New Jersey. Her healthy, Florida-living father (age 83) had his annual physical, was sent to a cardiologist, and thought it was no big deal. Although he told Mary, an only child, not to bother coming to Florida, she took a week off work and went. Father ended up with successful bypass surgery, but an infection followed, and he was now in an intermediate care/rehab facility about to be released.She needed reliable temporary help for her dad when he went home.

I suggested the hospital social worker whom, it turns out, she had met with. She said she had “around a hundred” names of agencies etc. and didn’t know where to begin. While medicine’s not my competency, when there’s a chance to empower a parent I grab it.

After being told her father was very independent and mentally capable, I asked if her father preferred a male or female aide (hadn’t entered Mary’s mind, she said). I explained some men prefer men for obvious reasons or because they don’t appreciate the nurturing nature (“Honey,” “Sweetie”-- they want “Boss”). Having this kind of conversation with him is affirming and empowering. He would begin to feel some control, providing the potential for a better result.

I also asked if there were family or close friends living near her dad. None. He and his girlfriend ended their relationship some months before and since she was in her early 90’s, Mary didn’t think she could be much help anyway.

We discussed the importance of contacting an agency where the workers were bonded to ensure—as much as possible—that nothing would be stolen (a major problem and concern). Her response that her father had nothing of value in his condo made me think how violated and insecure we would feel if someone we depended on came into our home and took anything without asking and I mentioned this. I then added older people, like my dad, often balked at paying additional monies to an agency. Mary quipped “Are your dad and my dad brothers?” She had a plan.

"Empower" is usually not one of the first words we think of when it comes to older people. More often we hear that we should "preserve" older people's independence, "preserve" their dignity. There is nothing wrong with that. Yet it's a static concept. "Preserve"--hold onto. Think about children. We try to empower, move them forward-- not "preserve." Can we apply this to older people?

Mary's father had no major issues until now. While we never know when our parents’ first “aging event” will occur, we do know that when we can find ways to empower, regardless of the situation, parents feel respect, feel some control, and everyone benefits.