In This Issue

	Senior Citizen Driving: Warning Signs and Helping an Unsafe Driver to Stop Driving
	If you answer yes to any of these questions, Hurley Elder Care Law can help
	Life Care Planning Goals
	The Nuts and Bolts Guide to VA Benefits

Senior Citizen Driving: Warning Signs and Helping an Unsafe Driver to Stop Driving

	When is it time to give up driving? This is always a difficult question and there is no specific answer beyond: It just depends. I remember vividly when I was about fourteen years old and I had a dental appointment one afternoon. My mother could not take me, so my grandmother got the job. Relatively speaking, my grandmother was not that old at the time, only about seventy-five. But as we were leaving the dentist’s office, she pulled out onto a busy, five lane road. It was a left hand turn and she could not get into the lane where she wanted to be or even into the middle turn lane for that matter. I thought we were going to get hit from the back, then the front. My heart was racing and I am not sure she was even aware of the problems. Though she continued driving for several years thereafter, I did anything that I could not to have to ride with her. This was just the tip of the iceberg for my experiences with driving and the elderly. We know that this is a very difficult matter to address, so please use the information that follows as a guide for handling a sticky situation.
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If you answer yes to any of these questions, Hurley Elder Care Law can help.

		Has the elder been diagnosed with a mentally or physically debilitating disorder such as Alzheimer’s, Parkinson’s, ALS, stroke or a decline in functional capacity?
		Is the elder isolated due to the recent death of a spouse, or have family that either lives too far away or is too busy to provide adequate care?
		Is the elder soon to be discharged into a care facility or currently receiving in-home care?
		Does the elder have a variety of healthcare providers and need coordination and advocacy for quality care?
		Does the elder seem unusually concerned about costs of medication and services, indicating he or she may be having financial troubles?
		Does the elder have assets that fall between $50,000 and $400,000 – enough to finance a short stay in a care facility but not enough for an extended stay?
		Does the elder have a spouse whose financial needs must be considered in light of the elder’s medical condition?

Life Care Planning Goals

1. Meeting the elders’ immediate health care and long-term care needs.
2. Making sure the elder/family is making good health care and long-term care decisions.
3. Helping the elder/family sort through the maze of their long-term care options including residential options.
4. Identifying and accessing public benefits and resources to pay for care should the elder meet the qualifying criteria.
5. Help with asset management, including the burden of home ownership and personal property.
6. Providing the entire family the peace of mind that comes from knowing their loved one is monitored by a team that combines legal and financial expertise with specialized knowledge of the elder’s physical, mental and emotional health.
7. Ensuring the highest level of independence the elder can achieve, while ensuring safety.

Senior Citizen Driving: Warning Signs and Helping an Unsafe Driver to Stop Driving

The information for this article was taken from the following website http://helpguide.org/elder/senior_citizen_driving.htm Written by: Tina de Benedictis, Ph.D., Gina Kemp, M.A., Doug Russell, LCSW, and Monika White, Ph.D. Driver safety is an important issue for seniors. Everyone ages differently, so some people are perfectly capable of continuing to drive in their seventies, eighties, and even beyond. Many elders, however, are at higher risk for road accidents. The elderly are more likely to receive traffic citations for failing to yield, turning improperly, and running red lights and stop signs – an indication of decreased driving ability. A person 65 or older who is involved in a car accident is more likely to be seriously hurt, more likely to require hospitalization, and more likely to die than younger people involved in the same crash. In particular, fatal crash rates rise sharply after a driver has reached the age of 70. If you know an older driver who is experiencing trouble on the road, it is important to carefully monitor the situation. Because everyone ages differently, some drivers are safe behind the wheel well into their eighth or ninth decade, while others need to find other sources of transportation much earlier. Risk Factors of Aging That Can Affect Driving Ability Visual Decline – Vision declines with age, which means depth perception and judging the speed of oncoming traffic becomes more difficult. The eyes also lose the ability to process light, which makes night vision worse and causes more sensitivity to bright sunlight and glare. By age 60, you need three times the amount of light that you did at age 20 in order to drive safely after nightfall. Hearing Loss – Approximately one-third of adults over age 65 are hearing-impaired. Because hearing loss happens gradually, seniors may not realize they are missing important cues when driving, such as honking, emergency sirens, or a child’s bicycle bell. Limited mobility and increased reaction time – With age, flexibility may decrease as response time increases. A full range of motion is crucial on the road. In addition, chronic conditions can limit mobility (rheumatoid arthritis, Parkinson’s disease, sleep apnea, heart disease, or diabetes). Medications – People often take more medications as they age. Certain medications, as well as a combination of medications and alcohol, can increase driving risk. Be particularly careful about medication side effects and interactions between medications. Drowsiness – Aging can make sleeping more difficult, resulting in daytime tiredness and an increased tendency to doze off during the day (or while driving). In addition, certain prescription drugs cause drowsiness. Dementia or brain impairment – Mental impairment or dementia makes driving more dangerous and more frustrating. Brain impairment may cause delayed reactions to sudden or confusing situations on the road. Warning signs of unsafe driving If a senior who is close to you is finding driving more difficult than before, watch for signs of unsafe driving. If you notice any of the warning signs, it is time to reassess the senior’s road risk. Many small warning signs of unsafe driving can add up to the important decision to quit driving. Abrupt lane changes, braking, or acceleration More frequent “close calls” (i.e., almost crashing), or dents and scrapes on the car or on fences, mailboxes, garage doors, curbs, etc Failing to use the turn signal, or keeping the signal on without changing lanes Drifting into other lanes Driving on the wrong side of the road or on the shoulder Trouble reading signs or navigating directions to get somewhere Missing highway exits or backing up after missing an exit Range-of-motion issues (looking over the shoulder, moving hands or feet, etc.) Trouble moving the foot from the gas to the brake pedal, or confusing the two pedals Feeling more nervous or fearful while driving or feeling exhausted after driving More conflict on the road: other drivers honking; frustration or anger at other drivers Oblivious to the frustration of other drivers, not understanding why they are honking Reluctance from friends or relatives to be in the car with the senior driving Getting lost more often Trouble paying attention to signals, road signs, pavement markings, or pedestrians Slow reaction to changes in the driving environment Increased traffic tickets or “warnings” by traffic or law enforcement officers. Steps to take if you are concerned about the safety of a senior driver If you are concerned about an elderly driver, closely monitor his/her driving before deciding whether there is a need to brush up driving skills or give up the driver’s license altogether. Some steps include: Watch for changes in driving habits, general behavior, and health. Encourage a driving evaluation through your local Department of Motor Vehicles, along with refresher driving lessons and the AARP Driver Safety Course. Offer the senior some self-evaluation tools to assess driving risk, or work together on these quizzes. You can get these on-line. See resources below. Explore ways to reduce driving, such as making purchases on-line or through mail-order catalogs. If possible, arrange for home delivery of groceries, and home visits by clergy, medical and personal care providers, and government service providers. If necessary, get support from the older adult’s primary care physician and other family members. Research and propose alternative modes of transportation. Maybe the senior can continue to drive some of the time (such as in the daytime or off the freeway), and alternative transportation can fill the need for rides at other times. Talking to a senior driver who should stop driving If you feel that it is time to talk to a senior close to you about stopping driving, approach the issue with sensitivity. A driver’s license signifies more than the ability to drive a car; it is a symbol of freedom, independence and independent living self-sufficiency, fun and spontaneity and involvement in social and religious activities. Understandably, driving is not a privilege that anyone wants to relinquish willingly. As important as it is to treat the senior driver with respect and not jump to unjust conclusions, it is also important to help the elderly driver retire from the road. Start slowly and try to persuade the senior to give up the keys. Some approaches that may work: Be understanding about resistance. The senior may dismiss you and refuse to listen to you. Emotion may get in the way of a rational decision. Ask questions, rather than make demands. For example, “Would you consider not driving at night?” Talk about safety considerations. Many senior drivers who shouldn’t be driving have already had an accident or some close calls. Remind the impaired driver of the danger of serious injuries and that the safety of others is also at risk. Explain transportation options. Help the senior driver see that living without a car won’t make him/her permanently homebound. Acknowledge the lifestyle change, but also show how to continue favorite activities and to remain mobile. Emphasize monetary savings. The cost savings associated with giving up a car may be a selling point for some older drivers. Costs include insurance, gasoline, maintenance and repairs, and license and registration fees. Offer rides and visits. Volunteer to come by once a week or to provide rides on a regular basis for things like grocery shopping, library visits, or doctors’ appointments. Seek confirmation of the situation. Some elderly drivers may be aware of their faltering ability, but be reluctant to give up driving completely. Another person’s concerns may force the senior driver to act and may even feel relieved to have someone else help make the decision to stop driving. When a senior driver refuses to give up the keys If the senior driver refuses to give up the keys, you may need to take stronger steps. Ideas for further action include: Take away the car keys. Disable the car or remove it from the senior driver’s residence. Ask the elderly driver’s doctor to write a prescription stating “no driving.” Enlist the help of a local police officer to explain the importance of safe driving and the legal implications of unsafe driving. Some seniors may forget that they aren’t supposed to drive. If that is the case, it is even more important to remove the car or the keys to make it impossible to drive. Resources Following are several Websites that may be especially valuable regarding driving safety for older adults. Thehartford.com – The Hartford/MIT At the Crossroads: A Guide to Alzheimer’s, Dementia & Driving AARP.org/55alive Nhtsa.dot.gov – National Highway Traffic Safety Administration Nsc.org – National Safety Council TheDefensiveDrivingSchool.com Driver-ed.org – Certified Driver Rehabilitation Specialists Eldercare.gov HighwaySafety.org – Insurance Institute for Highway Safety American Medical Association Guidelines for Older Drivers Aota.org – American Occupational Therapy Association AAA.com – AAA Foundation for Traffic Safety AgeNet.com SeniorDrivers.org Recommended Book: The Driving Dilemma by Elizabeth Dugan, PH.D Listed below are places in Metro Atlanta that will perform driving assessment on elderly persons who are still driving. Most of them require a doctor’s order. 1. Emory Center for Rehabilitative Medicine Driving Rehabilitation Program 1441 Clifton Road, NE Atlanta, GA 30322 Phone: 404-712-5527 Fax: 404-712-5974 www.emoryhealthcare.org 2.   Dekalb Medical Center Outpatient 2701 North Decatur Road Decatur, GA 30033 Phone: 404-501-5140 www.dekalbmedicalcenter.org 3.   Shepherd Center Driving Evaluations Adapted Driving Services 2020 Peachtree Road, NW Atlanta, GA 30309 Phone: 404-350-7760 www.shepherd.org 4.   Freedom and Mobility Center Marietta, GA 30066 Phone: 770-514-9957 Fax: 770-874-1703