On Tuesday, May 17th, 2016, six panelists came together at the Brookline Senior Center to talk about driving retirement, the importance of early planning, and strategies for helping seniors navigate the transition.
The panelists all agreed that the process of retiring from driving can happen suddenly or gradually and can be either expected or unexpected. Panelists also agreed heartily with Officer Jim Reardon of the Brookline Police Department, who noted that "there's no set age where somebody loses the ability to drive. It's totally individual, considering different medical conditions or other factors."
However, as social worker Amanda Gasser-Wingate of BIDMC's DriveWise® program pointed out, "the thing about driving retirement is that we know it's going to happen for almost everyone. We know that people outlive their ability to drive by up to ten years. So for most of us, it's not a potential; it's almost a certainty."
Unfortunately, not everyone is able to acknowledge this reality, and few of us make any real plans for the time when driving is no longer an option. Primary care physicians see this phenomenon all too often. Dr. Suzanne Salamon of BIDMC's Gerontology Division observed, "I find that with my patients, it usually happens suddenly, and usually not voluntarily." She lamented the fact that she rarely witnesses an ideal, gradual, well-planned transition from driver to passenger. "I usually see the crisis retirement,'" she remarked.
Dr. Salamon also mentioned the importance of not only being honest with patients who she feels are not safe to drive, but also of helping to support and guide them through the process of planning for new ways of getting around. She compared a sudden, unexpected loss of driving ability to the discovery of a serious medical condition, noting that "you would never give someone a cancer diagnosis without also working with them to come up with a plan of what you're going to do next."
Like health care providers, the involvement of law enforcement professionals also frequently comes during a moment of crisis. "By the time it gets to me, it's usually a problem," Officer Reardon commented. He noted that the police usually get involved after an accident or when following up on a report from a concerned loved one. A senior's driving record, the driver's own account of any violations or accidents, and even the condition of the car itself are all taken into consideration by the police.
One interesting fact raised by the panel is that anyone can make a report to the Massachusetts Registry of Motor Vehicles (RMV) if they are concerned about a driver's skills and safety. The RMV's Michele Ellicks explained that family members, neighbors, driving instructors, and other "non-experts" can all report a concern to the RMV. Reports from third parties cannot be anonymous, and they do not lead to immediate or automatic suspension of a driver's license. Instead, the driver is mailed a form that must be completed by his or her physician and returned to the RMV for review.
On the other hand, reports made to the RMV by experts such as police officers and health care providers do result in an immediate suspension of a driver's license, pending a formal hearing on their ability to continue to drive safely. As a result, Officer Reardon, Dr. Salamon, and the DriveWise® team carefully consider all factors, risks, and possibilities before making such a report to the RMV. Health care providers who are considered experts in terms of making these reports include:
- nurses (RNs and LPNs),
- physicians and osteopaths,
- physician’s assistants (PAs),
- occupational and physical therapists,
- optometrists and ophthalmologists, and
- certain podiatrists who are licensed health care providers under the provisions of M.G.L., Chapter 112.
Many seniors are not aware of the fact that you can voluntarily surrender your drivers license at any time and be issued a free Massachusetts ID card--all through the mail. You will need to update your photograph in person only every ten years, and the ID card is accepted everywhere that a driver's license is accepted, including airports and passport offices.
Licensed social workers can provide seniors and their loved ones with invaluable information about non-driving options in our community. Emily Kuhl, a case manager with the City of Newton, advised seniors and families to reach out to social workers at their local Councils on Aging, Aging Services Access Points (ASAPs), or medical practices. In addition to providing information and referrals, social workers are trained to help seniors and their loved ones navigate challenging conversations and think through decision-making cooperatively. "At any stage, it's really important to know what the options are and to be able to have that conversation, no matter how difficult it is, and to try to be as understanding and empathic as one can be," she advised.
The panel unanimously agreed that it is better not to wait for an accident or serious diagnosis to start to prepare. Certain events or behaviors might prompt seniors and families to start preparing and looking into non-driving options. Some of the early signs mentioned by the panelists include:
- damage to vehicles that the senior does not remember or cannot explain
- dismissing the significance of damage to the car or denying fault for accidents
- tiring or get fatigued easily
- cutting back on where, when, and under what conditions the senior will drive
- seniors finding themselves feeling isolated and limited by their desire not to drive under certain circumstances
- getting lost when traveling to familiar locations
- difficulty reading road signs, seeing lane markings, etc.
- passengers stating concerns about a senior's driving
- an increase in the number or frequency of violations or accidents
- taking medications that can affect mental function, such as lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), diphenhydramine (Benadryl), or even blood pressure pills
- certain medical conditions, such as Parkinson's disease or a history of strokes
The RMV offers a handy "Safe Driver Checklist" to seniors or loved ones who would like to assess themselves informally for early signs that it may be time to start early planning and preparing for driving retirement.
DriveWise® Occupational Therapist Ann Hollis encouraged everyone to integrate transportation into their overall retirement plan. "Here in Brookline, you probably have more resources than people in more rural areas," she said. "Some people actually think about moving because they start planning ahead, and they live in a place where really the only option is to drive, which means they might eventually become isolated. So that's also an early part of the planning: thinking, 'if I cannot drive, am I in the right place?'"
The panel made a number of recommendations for resources and strategies that can help manage the transition to driving retirement. Early planning, exploring alternative transportation options, and having conversations with family and social workers are all wise steps. Other pieces of advice included:
- Take an inventory of where you currently drive and explore other ways of getting to those destinations.
- Avoid putting too much faith in finding a "one size fits all" option; as Amanda Gasser-Wingate advised, "don't put all your eggs in one basket. If you truly want to maintain your independence, you really have to take a multifacted approach."
- Talk with peers, especially those who have already stopped driving.
- Connect with existing organizations such as Councils on Aging, ASAPs, and MassMobility.
- Learn to use (or get help using) the Web to expand your research capabilities.
- Add up all the money you spend each month on driving and maintaining a car; then, look into what other transportation options cost and how that same amount of money might be used for other options to get you where you want to go.
- In cases of cognitive decline or limited insight, sometimes more direct methods of stopping drivers (such as taking the keys or selling a vehicle) are a family's best option for keeping the driver safe and preventing potentially catastrophic accidents.
Finally, many people are not aware of the availability of formal driving skills assessment programs. The RMV offers a list of seventeen such programs across the Commonwealth. These teams of experts take an interdisciplinary approach, weaving together social work, occupational therapy, physical therapy, medicine, and other disciplines to help drivers get an objective assessment of their own skills and limitations. It is true that if the health care providers at a driving skills assessment program determine that a driver is truly not safe, they are obligated to make a report to the RMV. However, these programs are potentially also an excellent way for families and seniors to get reassurance of a driver's safety and competence and to receive professional advice on how to keep driving safely for as long as possible.
The TRIPPS program is grateful to this valuable panel of experts, who generously donated their time and expertise to share with us their perspective on the process of driving retirement.
Please join us on June 16th, 2016 at 6pm for the second part of this panel discussion series. On the panel at this second session will be seniors from our community who get around without driving. Some take the T, some use paratransit, some love the buses, some take taxis, some use ride-hailing apps, and others walk or cycle. These seniors will describe their own experiences, discuss the drawbacks and benefits of using various modes of transportation, and talk about overcoming some of the barriers that can keep other seniors from exploring and using non-driving options. Both events are free and open to the public. Light refreshments will be available. For help with transportation to and from this event, please call 617 730 2644. Please call 617 730 2644 or go online to reserve your seat.
Many thanks to Linda Shepard Salzer of Ways2Go for taking photos during this event!