Tag: driving

Driving, Dementia, and the Right to Drive

dementiasherpaAs the adult child who watched the dings accumulate on my parent’s car, and then as they continued to drive after their licenses were revoked, this topic still makes my tummy and heart ache.

However, as a Daily Money Manager, I’m now having these discussions with my clients who have hired me to help with the daily finances and bill pay usually because of health issues, and also hearing them lament over their children’s suggestion they give up the car keys.

This week, a client diagnosed with Parkinson’s and that by self-admission is having issues finding words and managing bills is very angry at her children who are suggesting she stop driving. When I asked her what her neurologist said when she asked about driving and safety, she said the rules tell him he has to write a note to rescind her license only if she is passing out. God Bless America. We have made driving a right you receive, not a right you earn and must continually qualify for.

I shared with my client that her adult children are worried for her safety, while she is fighting for her independence. I gave her some examples about how driving can be challenging because she will have to make split second decisions when she’s behind the wheel of her car.

As we discussed the topic a little deeper, she said she was going to voluntarily give up the car keys, but is now so mad that her kids are demanding she give them up, she is fighting to keep driving. My bent toward logic made me talk that through with her a little, but right now, she’s wants understanding and is devastated at the losses she is facing.

I left hoping I could wave a wand and make this easier for everyone. I can now clearly see how this topic is so difficult for every family.

I recently was introduced to Christy Turner, The Dementia Sherpa. She offers a host of great suggestions on how to better  communicate with your loved ones diagnosed with dementia, including some tips on how and when to navigate the issue with driving. Dementia just stinks. Recommended. 

Do your loved ones have an Umbrella Insurance policy?

pexels-photo-100671.jpegThanks to Barbara who asked about concerns she had with wording in a renewed insurance policy. I suggest that all families who are helping or caring for someone with mild cognitive impairment or dementia consider the addition of an “Umbrella” policy.

In a Kiplinger article titled Why You Need an Umbrella Policy, they share that “adding extra liability coverage to your auto- and homeowners-insurance policies can protect your finances from expensive lawsuits.”  Umbrella policies are designed “to help protect you from major claims and lawsuits and as a result it helps protect your assets and your future. It does this in two ways: Provides additional liability coverage above the limits of your homeowners, auto, and boat insurance policies.”

One of my super-powers that I used to my advantage during my parents journey into dementia, was a sense of possible future landmines. My parent’s had auto- and homeowners insurance, but I had a major concern that the might do something that would jeopardize their retirement savings because of their cognitive status. Thankfully, I suggested to my dad that he add an Umbrella policy to their insurance and he agreed that it would be a smart protection given how litigious the world had become.

There was a period of about 3 months when my dad was driving without a valid license. Their doctor had submitted the paperwork to have both of their driving licenses revoked. However, they let me read, then ripped up the notice from the Division of Motor Vehicle that notified them of the license revocation and acted like it never existed. For some reason, they thought only my dad had his licenses revoked, even though they both received the letter (just a week apart). My mom would tell me that if the police pulled them over she would tell them “I was driving but got a cramp in my foot, so my husband took over so he could get me home to take my medication.” Yeah, my parents got really crafty in trying to maintain their status quo.

I was pretty sure the auto-insurance wouldn’t cover them since their licenses were revoked, so I prayed that nothing would happen. If it did, I hoped the umbrella insurance would help protect their assets to pay for the years of care they would be needing.

Later, at a happy hour at my parent’s retirement community, my dad fell over onto a woman and sent her to the ER. Thankfully, she knew my dad and she nor her family pursued a lawsuit. However, I could only imagine how quickly all of their assets could disappear in legal fees and an award.

Two things to do to protect your loved one and their assets:

  1. Contact your insurance agent and have an open discussion about your concerns to find the type of policy that could best protect you and your loved ones.
  2. Contact your estate lawyer. A Trust might be a solution to help protect your assets …. but I’m NOT a lawyer …. so please find a local elder care attorney who can help you navigate the coming years.

Dementia is a cruel beast and it steals so much from the individuals it preys upon, and the loved ones caring for them. I hope the suggestion on how to deal with practical issues to protect your loved ones will help you and your family. Experienced. 

Is Driving a Battle Worth Having? YES!

The choices you are faced with when you are stepping in to help are many and varied. One adult child was telling me how she just got her dad to move into an independent living community and dad was still driving. She shared that he was diagnosed with Alzheimer’s so they wanted to get him somewhere and he seemed to be doing pretty well. I understand the hope to at least get them into a place that is more attuned to help, and that offers other levels of care when needed.

She also mentioned that she worried about him continuing to drive. However, most of us might just accept the move as a win and move on. I know, I was in that situation. For this daughter, just getting him into the community was a victory. The next issue was going to be the driving.

You would hope that the doctor that diagnosed “Alzheimer’s” would help, but in many cases, they don’t discuss how it might impact things like driving and managing the finances.

The daughter was happy that he agreed to move out of his home and into the Life Care Community. When should she bring up the issue of driving?

According to a the National Highway Traffic Safety Administration, the youngest and oldest drivers have much higher rates of highway crashes and deaths than any other age group, according to 2008 government mileage data, the latest available. Drivers ages 16 and 17 are involved in more crashes, and fatality rates rise steeply for those older than 65, with drivers older than 80 being the most vulnerable.

Consumer Reports Dangerous Drivers 10-12

I am not sure if I’m more worried about the issue of causing a fatality, or the risk of losing all of your life savings should an older adult be sued or charged with a crime. In our litigious society, I don’t think it will be long before someone will prove that an individual diagnosed with “Alzheimer’s” or even “cognitive impairment” was reckless by making the choice to drive after a medical diagnosis.

Do you wait for the accident to happen?
As I have reiterated on this blog, when their is cognitive impairment, you often find that you have to wait for a failure. It actually has a medical term. Anosognosia is when someone is unaware of their own mental health condition or that they can’t perceive their condition accurately.  Anosognosia affects up to 81% of people with Alzheimer’s and some studies show up to 77% of patients suffer anosognosia after a stroke. So can your loved one accurately assess their driving ability? How many of us without a diagnosis over-rate some of our abilities?

Some rehab centers offer assessments, but it’s not so easy to find and in reality, who wants to go pay for a test to learn they might not be safe on the road anymore?

As the adult child, my siblings and I discussed it with our parent’s before the doctor submitted the paperwork to revoke their licenses. We were seeing a lot of dents and dings on the car that were multiplying at an alarming rate before this happened. In the end, we had to hide the cars when they continued to drive after their driving privileges were suspended by the state. I had also retrieved them a few times when they got lost driving to familiar locations. To read more about how we managed through this stage, you can read my posts from back in 2012 called Operation Safety Net.

The car keys represent freedom and independence. Most people don’t want to let that go. However, it’s a battle that is worth fighting for everyone’s safety. Believed. 

Options:

  1. Check out your local community to see if you have a Village that can provide a ride.
  2. Contact your county Agency for Aging that can refer you to discounted coupon packages or other discounted local ride services.
  3. Contact a home care agency to set up permanent rides to the grocery, mall, or drugstore.
  4. Check with neighbors or church members who might be interested and available to help out.

Is it Time to Stop Driving?

CAR KEYSI shared the story of how my family dealt with driving. It was difficult and horrible because my parents didn’t know they had lost their licenses and kept driving. Our biggest fear was that they would have an accident and without a valid license … had no auto insurance. If they were in an accident, I could see them being sued for everything they owned. If you want to revisit that series of post, you can find it here.

What has been interesting to witness is the variety of my clients who have freely (but not happily) given up their car keys. There were little issues, like getting lost or having a minor fender-bender, that usually preceded the choice.

For my clients that have given up keys, the ease at which we have been able to get them to the events they want to attend made all the difference in the world. We could shown them that not driving was not going to slow them down.

Friends have mostly filled in to help get them to church, to their member groups, and even to their volunteer obligations. It is actually making their interactions with others richer. In my community, we have a local non-profit that sets up volunteer rides. You may have a similar group in your community. In the McLean area, we have a Shepherd’s Center of McLean/Arlington/Falls Church. In Reston, they have RC Rides through the Reston Community Center, and several of the villages in our area provide rides to their members. To see if you have one in your area, you may want to reach out to the Agency for Aging in your county.

For one client , we incorporated personal care assistants (through an agency that we pay) that can offer on-demand rides when needed. For a few dollars more than a cab ride, he has someone who can comes once a week to help get the grocery list together, get the shopping done and put-away. The other client purchased discounted taxi vouchers so she can get to the grocery store.

I am happy that we can make the loss of the keys not limit my clients ability to continue doing the things that they love. When you face this issue, are there ways to make the loss of the keys not feel like a loss of freedom, but maybe even a move to promote socialization with friends they enjoy and community activities they love? Recommended.

 

 

 

 

Is it Still Safe for Mom to be Driving?

open-roadI remember how excited I was when I got my license and could drive to 7-11 just because I wanted a slurpee.  It wasn’t really about the slurpee but about just being able to go where ever I wanted to go, when I wanted. I didn’t have to plead with a parent to take me somewhere.

Nearly 40 years later, I am still in love with the freedom a car brings. My husband and I always talk about how nice it would be to be within walking distance to the shopping area of our town, but for now, if we want something from a store, it’s a car ride away.

Driving is a precious right most of us take for granted. For those of us who have had to suggest to a spouse or tell a parent we think it’s unsafe for them to drive, we know how devastating and contentious this discussion becomes.

My parents used to help pick up my kids from pre/school and it was wonderful to know we had a safety net. However, I realized when I was riding with my dad how unsafe his driving had become and we quickly managed to make other arrangements. We didn’t actually tell them why, we attributed it to another parent or team practice.  We initiated pizza night so we could spend time together, but not have our kids as passengers in our parent’s car.

We did subtly ask about the growing number of scraps on the car, but we knew my parents would never willingly give up their car keys. Years later we realized they had cognitive issues and if you want to know how bad it got, you can read these stories.

However, I have heard from several adult children who know something is cognitively wrong with  a parent, and they haven’t considered how unsafe driving can be. Our worries grew when my dad, the engineer, and a navigational savant, was getting lost every now and then on the drive drive from their house to my home. It was a drive he made for more than a decade and hundreds of times.

If you are concerned, I hope you will discuss it with your loved ones. We were rebuked and chided when it was mentioned. A doctor submitted the papers to revoke both of their driving licenses’ after they showed up in the ER and weren’t sure why they were there or for whom they came. Every state has a process to report your concerns. Several people have often shared they would call the police on their own parent which resulted in getting a license revoked. It’s not easy and it’s not a light-hearted topic at all.

The real issue becomes processing speed and the ability to make decisions when you are driving. If someone is having trouble recalling information, they will have the same trouble behind the wheel of a car, but the consequences are much bigger and the outcome could be devastating for your family … and someone else’s if you ignore that a loved one might no longer be safe on the road. Recommended. 

You should have similiar options in your state. Here are examples of what Virginia offers:

Reporating an Impaired Driver

What a Doctor Can Submit to Notify the DMV Driving is Unsafe 

 

Tougher Rules for Elderly Drivers

conesOn January 1st, Virginia implemented tougher rules for elderly drivers. They include requiring the individuals to renew in person, renewing their license every 5 years (instead of 8), and passing the Virginia Department of Motor Vehicles’ vision requirements or presenting a vision statement no older than 90 days from an optometrist or ophthalmologist.

When we started to see dings on my dad’s car multiplying, we stopped asking him to pick up the kids from school. When they would get lost driving to my house, I was very concerned about having them behind the wheel and the safety of the other drivers on the road. They had driven to my home hundreds of times and my dad began to get repeatedly lost on his way over. When he finally did arrive, he would be relieved, but had no recall of any previous instances. My dad was finally diagnosed for Alzheimer’s.

My parents felt that driving was a right, not a privilege. I recognized and appreciate the need to be able to get around, but they were unsafe drivers long before the doctor finally submitted the papers to the DMV to rescind their licenses. They bought into a Continuing Care Retirement Community (CCRC), but would repeatedly tell us they weren’t old enough to move in full-time.

For detailed information on how we dealt with and managed this, you can read a summary of the steps we took that I posted as we were facing this very issue.

I’m glad the state is taking some action, but know that my parents would have passed the test well into the first few years of dementia. I believe that driving is a privilege we should have to earn probably more frequently than the initial milestones when we are in our teens and now these minor checks at 75. My parents managed to renew their license early and I shared my concern back in 2012 that the DMV was not doing enough. I consider this often as I imagine where my husband and I should live next and how we might manage our driving. Pondered.

Please share what your state has done about this issue, if anything. 

 

 

 

 

Making the transition to Assisted Living when your parents refuse – Part II

lessonslearnedAfter my parent’s driving licenses were revoked by a doctor, they continued to drive. Their brains filled in the details with their own manufactured information. At first, my mom admitted they were revoked and showed me the letters, and then later, they would pull out their licenses as proof that they were still valid drivers.  The letter from the state requires that you turn in your license, my parent’s refused.

We had to take their car keys. My brothers came to town and my parent’s initially handed over the car keys. At first they just took the keys and moved the car’s out of my parent’s garage. One was sitting a block away from their home. After my brothers left town, my parent’s found it and hired someone to rekey the car. I’m sure they would have driven more if the electrical system wasn’t toasted in the process.

Eventually, we hid both cars by putting them in storage.

I’m one of their four children, with two older brothers and a sister. We worked well together and thankfully, my brothers came to town to manage the dirty work. When they left, I could still be the go-to for my parents and could tell them I had no idea where the car’s were. My brothers had taken care of the details.

My brothers accomplished this by following what they believed to be the moral choice. What if my parent’s had another accident (they never shared the first one with us)? In the event that my parent’s would reported the “theft” – one brother visited the local police department (we live in a major metropolitan area) to share that our parent’s continued to drive without a license, their diagnosis (and inability to remember) and tell them we had stored their cars.

At first I struggled with having to lie to my parents, however, as things got more bizarre, I came to realize that giving them a modified version of information helped manage us through several transitions and was the best course of action.

After about two weeks, my parents had created their own version of the car’s disappearance and I just feigned ignorance and helped out where I could by giving them rides to the grocery store.

The first two of the three steps that helped us support our parent’s transition were:

  1. Address driving if you think it’s an unsafe activity for your parents and their doctor agrees.
  2. If they continue to drive disable or hide the cars.

If you have been reading my blog, you know this was not an easy process, however, I hope that my experience can help others more easily make this transition with their parents. Learned.

Making the transition to Assisted Living when your parents refuse – Part I

no drivingI have been writing about my family’s struggle in helping my two parents with moderate dementia for more than a year. While my parents had an apartment in a retirement community, they kept their town house and divided their time between the two homes. They were unwilling or unable to make the move and as a result, they were always about two steps behind being in the place they should have been for their own happiness, health and safety.

While I know my parent’s relished the independence, they really struggled to keep up with two homes. They were starting to become targets of elder-care abuse, and we had several instances where we had to intervene on their behalf.

In looking back, there were three keys to our success in finally getting my parents into the level of care they needed. Today I will address the first item: Driving.

For more than two years, I would not allow my parents to drive my children. Their cars continued to get a little more battered and scratched. They kept telling us they would be moving full-time into the retirement community … but each new milestone came and went and they failed to move. We realized the movement between homes became my parents’ only real activity.

For the past two years, my siblings and I had face-to-face conversations with our parents requesting they consider moving full-time and give up the driving. They rebuffed our suggestions.

Finally, almost 9 months ago, they showed up in two different hospital emergency rooms in two days that was staffed by the same doctor. She was so alarmed at my parent’s confusion she championed the cause to have their licenses revoked and wrote to the DMV.  We had previously asked their doctor (who diagnosed the dementia) if this was possible, and he was not aware he had this capability.

If you are in this situation, call your state DMV office to request the forms and under what circumstances will a license be revoked. Our parent’s licenses were revoked in less than two weeks of the doctor’s form submission. Surprised.

Related Blog Posts:

Dementia and Driving Issues

Driving is a Right, and I think that is Wrong

When are you too old to drive?

When are you too old to drive?

I don’t think this is a fair question, but it is the one that most often comes up. It’s really not about age, but about ability and competence.

The Washington Post ran a story Should older drivers quit? Families key in wrenching decision, need docs, better tests to help.  The story includes a few simple tests the American Medical Association recommends that doctors administer when advising older drivers. Among them:

—Walk 10 feet down the hallway, turn around and come back. Taking longer than 9 seconds is linked to driving problems.

—On a page with the letters A to L and the numbers 1 to 13 randomly arranged, see how quickly and accurately you draw a line from 1 to A, then to 2, then to B and so on. This so-called trail-making test measures memory, spatial processing and other brain skills, and doing poorly has been linked to at-fault crashes.

—Check if people can turn their necks far enough to change lanes, and have the strength to slam on brakes.

We live in Virginia and it took us three different doctors before one knew that the state has a provision to revoke a license. She swiftly completed both forms for my parents.

However, we knew it was time when we would no longer ask “nana” and “pop-pop” to pick our kids up from school. That was more than two years ago.

I don’t think those tests account for someone with dementia. You need to make quick decisions.  I’ve been with my parents when they got lost in the midst of driving a route that used to be routine. My dad would drive faster when he was lost — like he was almost in hurry to find a place he recognized.

I’m glad they no longer have their licenses. Now, if they would only remember! Contemplated.

Was there a defining moment when you knew your loved one should stop driving? What was it?

Make laminated contact cards for their cars.

While I’m not so keen on my parents driving and we are working toward a resolution for this, I was shocked when the social worker told me my parents couldn’t come up with complete names and phone numbers. They both have carried contact phone numbers in their wallets for years.

Apparently, my mom didn’t have her purse with her and I’m not sure if my dad looked in his wallet.

The social worker recommended that I make laminated contact cards and put them in the glove box and back seat of their cars. If they are pulled over or lost and assistance is given, the glove box is one of the first places most police or emergency support will look. Activated.