When should an aging loved one stop driving—and how can families handle that difficult conversation without stripping away their independence? Jenny Nordine, OTR/L, CDRS, founder of Driving to Independence and a Certified Driver Rehabilitation Specialist, shares the warning signs that may signal unsafe driving, including getting lost on familiar routes, unexplained vehicle damage, increased anxiety and difficulty navigating traffic.
Transcript:
Jeffrey Snyder, Broadcast Retirement Network
Well, Jenny, it’s so great to see you. Thanks for joining us on the program this morning.
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Absolutely, thanks for having me.
Jeffrey Snyder, Broadcast Retirement Network
I really appreciate it. You know, this is a difficult decision for so many family members, and I get the sense from your career as an occupational therapist, but also as someone that is found in an organization, this is kind of what you do. How do I, it can be probably very difficult for family members to say, hey, mom, dad, loving family member, you can’t drive anymore.
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Yeah, it is really a difficult conversation to have. And you know, my suggestion is always that you start that conversation early, not when we’ve got big problems and things. And especially when we think about dementia, we want to make sure that any new learning is happening before the dementia has progressed.
So beginning to learn how to use things like shared ride services and things like that can be helpful early on.
Jeffrey Snyder, Broadcast Retirement Network
How do, you know, obviously the obvious thing would be, you know, someone gets lost, although I don’t believe I have dementia, but I’ve gotten lost before. I mean, we all have GPSs. What are some of the things, the telltale signs that we as individuals or family members who care about our others should be looking for?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Sure, we’ve all gotten lost, but we’ve not all gotten lost on a familiar route. So, you know, if somebody leaves to go to the grocery store and they haven’t returned for an hour and a half, they’ve likely gotten lost and we wouldn’t expect them to be able or, you know, to be lost during that sort of a familiar route. But other telltale signs can be things like dings that you might find on the car that weren’t there previously, or if your loved one complains that they’re exhausted after they’ve been driving, that’s the stress response that they’re experiencing, whereas normally somebody wouldn’t be exhausted running their daily errands.
Jeffrey Snyder, Broadcast Retirement Network
Is there, thank you for that. Is there a, I don’t even know how to ask this question, but is there an age or a common variable that you see across all people that may have Alzheimer’s or may have dementia when it comes to driving, or is there just like one thing that really sticks out that just makes it so, you know, you mentioned getting lost, you mentioned some of the things, but is there anything that really says, hey, this is not going well for mom or dad?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Yeah, I wouldn’t say that there’s one thing. And in fact, attaching it to an age is really difficult as well, because lots of people age differently, right? Just like we may have matured differently as adolescents and things, so, but the memory issue that somebody might be finding in their home can absolutely manifest out on the road.
Frustration tolerance, driving can be frustrating for any of us. And if somebody has a low frustration tolerance or easily angered, that can also be an issue that we would see out on the road as well. And then just sort of problem solving, figuring out the solution to a problem that they might have encountered even at home or identifying something in the grocery store that we will find out on the road as well.
Jeffrey Snyder, Broadcast Retirement Network
Are there legal, you live in Arizona, I live in North Carolina, theoretically the audience is from all over the United States maybe even all over the world. So are there different laws? And I know you’re in Arizona, so maybe we focus on Arizona, but are there laws that, hey, this person can no longer operate a motor vehicle because they had certain criteria.
So are there things in place to prevent some of the things we’re talking about this morning?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Unfortunately, not really. So again, you’re right, in Arizona, we are what would be called a driver related or driver directed motor vehicle medical review program. So most states do have a medical review program that sort of polices this as you might imagine.
Although it depends on how strong of a medical review program they might have. Some states are very strict, others are not. But there really is not going to be one thing that will be, you could check a box and say this person is safe or is not safe to be driving.
That really requires somebody to have an on-road assessment.
Jeffrey Snyder, Broadcast Retirement Network
So to that point, how do I do an on-road assessment? Do I have, is it someone like yourself who’s an occupational therapist? Are there professionals at the DMV or do I just get in the car with my dad and judge his driving?
No offense, dad, my dad is a good driver.
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Good, good, good. Yeah, that’s a difficult thing within families. And so, yes, you certainly could go to the DMV and be tested, especially if you have a diagnosis.
I will tell you that the DMV experience tends to be fairly easy. It’s not really getting out there and looking at safety. What the DMV is typically looking for, of course, are novice drivers.
And they want to know if somebody recalls the rules of the road. Now, generally with dementia, that does begin to decline, but oftentimes people do remember that you have to stop at a red light, for instance. So a comprehensive driving assessment by a certified driver rehab specialist or an occupational therapist who is specialized in this area can be really important.
That comprehensive assessment is really done in two parts. So we could do clinical as well as a behind-the-wheel assessment.
Jeffrey Snyder, Broadcast Retirement Network
I have to think that even if you start the conversation, I would feel it’d be traumatic because I would feel like if someone came to me and said, Jeff, you can’t drive, and I’m not at that age or that stage yet, I feel like I’m losing my independence. I don’t have control and you’re taking something away from me. And it would make me angry, irritated, scared.
I mean, is that the reaction that people typically have?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Often, it’s not unusual at all to get that sort of a reaction because you’re absolutely right. We are limiting that level of independence. Really what we need to do is just change how somebody can continue to be independent.
I will often say that one of the great things that came out of the pandemic was delivery systems. And so being able to use some of those services to be able to get groceries and things like that can be helpful. But nobody wants to have everything just delivered to them and stuck at home.
And so that’s why things like shared ride services can be important or setting an afternoon that somebody can help you with running errands or going to appointments and things like that, rather than having to always be asking for help or asking a family member to take you to an appointment or to the grocery store or whatnot.
Jeffrey Snyder, Broadcast Retirement Network
Can we spend a few minutes on the ride sharing ask because, and I know you don’t work for Uber or Lyft, but you would have more of an insight than I certainly would. These companies, I think, recognize that we live in an aging America, that there are more people turning 65 every day than at any time in the history of the United States and on part of the rest of the world. So these companies, and there are probably others, are really looking to do things more with seniors.
Is that correct?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
It is, it really is. And they’ve done a decent job of changing the platform so that I could, for instance, from a different location, order a car for a parent from their home. For a long time, you had to be in the location that you wanted the car to pick you up at.
And so the actual apps have changed so that I could order a vehicle to pick up my father, for instance. There’s other apps, for instance, that can be used by older adults, for instance, GoGo Grandparent. They still use the Uber vehicles, but it’s the platform that allows them to be able to access the car and for a loved one to be able to follow that vehicle as it drives to its destination.
So you know that your loved one has made it to that destination and is safe.
Jeffrey Snyder, Broadcast Retirement Network
And my understanding is they actually, if you specify you’re a, quote unquote, mature or senior person, they actually give you more time. Because typically when a Lyft or Uber comes, it’s like five minutes, and then they’ll charge you more or they’ll leave.
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Yeah, exactly. That is true as well, for sure.
Jeffrey Snyder, Broadcast Retirement Network
Go ahead.
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
I was gonna say, one other thing might be that, you know, paratransit systems within cities will do more of a door-to-door service as well. So if somebody has a mobility issue, for instance, or needs to be picked up from their front door and walked to the doctor’s office front door, those paratransit systems can be a little bit more helpful with that.
Jeffrey Snyder, Broadcast Retirement Network
This is gonna be kind of out of left field, but you know, we’ve been talking a lot on the network about artificial intelligence. I know it’s being deployed in caregiving. Are you seeing it in occupational therapy?
Are you seeing it in the assessment of people that might be challenged by dementia or Alzheimer’s or other cognitive issues?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
No, I wouldn’t say that we do. Really the thing that we find that are affecting our aging drivers are the ADAS systems that are within the vehicle. So things like lane departure warnings or the backup cameras, the backup beeping and things like that.
So those sorts of technologies actually affect our older drivers because they didn’t know what that technology was and now they’ve maybe purchased a newer vehicle that has all these bells and whistles and they’re just not quite sure how to use them and they can be distracting to somebody as well.
Jeffrey Snyder, Broadcast Retirement Network
That’s scary. I know we had a Hyundai. We actually turned the lane departure off because it would like vibrate and it scared my wife and I.
Look, it’s a good security measure, but it was like a little bit too much. You know, a lot goes into planning, financial planning. It’s, you know, there’s the estate, there’s having a will or a directive.
Is there something, some kind of document that kind of codifies what we’re talking about this morning so that you have that conversation early? You can put it in writing and, you know, maybe the person has a cognitive decline, they won’t remember participating. But seriously, is there some kind of legal framework or something that exists where someone can document what we’re talking about?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Yeah, you know, a couple of things that come to mind. Number one, if somebody is impaired enough that another individual is going to take guardianship of them, that the driving privilege can be written out of that guardianship so that that individual is not basically allowed to drive. The other thing that we do here in our practice is at the end of the comprehensive driving assessment, our therapists fill out what we call a plans and recommendations form.
And on that form, the recommendation, for instance, for driver retirement is documented. The therapist signs it, the individual signs it, and we often give that to our family members as sort of a reminder that this has taken place and that that was the recommendation. Our recommendations do go to the motor vehicle department and they would eventually get a letter from the motor vehicle revoking that driver’s license.
And I know that I’ve had families use that letter as a reminder as well.
Jeffrey Snyder, Broadcast Retirement Network
Good point. Last question, and I know you don’t sell car insurance, but I have to wonder, you know, if you get into an accident, I mean, I would think that car insurance, you know, it’s been a while for me, but you hear me knocking on wood. I don’t want to get into an accident this afternoon.
But does car insurance, because it used to be when you got older, car insurance actually, you had more experience and car insurance would actually go down relative to when you first started driving. Does it go back up as you get older?
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Yeah, I wouldn’t say so. I’m not in the car insurance industry, like you said. But, you know, car insurance companies are privately held companies.
They get to choose what rates they’re going to charge you on sort of a level of risk. So that also would be a reason that if you are still safe to be driving, that you complete that medical review process of your local motor vehicle department to demonstrate that this mild dementia, for instance, is not affecting your ability to drive.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, really good point. Jenny, excellent conversation. Thank you so much for coming on the program.
And look, we look forward to having you back very soon.
Jenny Nordine, OTR/L, CDRS, Founder, Driving to Independence
Great, thank you so much.
