Knowing When an Older Client Needs to Give Up Their Car Keys

One of the most difficult things to give up is our independence. For the elderly who have been driving a vehicle for decades, taking their car keys permanently from them might feel like cutting off one of their legs. As their caregiver, you might feel hurt for them, too, as you see them struggle with their feelings when they lose their driving privileges.

Some older drivers might readily accept their situation and hand over their driver’s license and keys, but do so with a heavy heart. And then there will be those who will not give up without a fight. They will bargain, cry, shout, curse, and even insist on driving without a license. The challenge lies in dealing with these clients.

For older people whose physical and mental conditions make them unfit to drive, particularly those with worsening dementia, the main issue is their safety and the safety of their passengers and others on the road. As a caregiver who is helping them with their activities of daily living, you should be alert for these signs that your client may need to stop driving for good:

1. Straining to see road signs clearly because of visual problems, such as tunnel vision
2. Frequent fender benders, traffic warnings, or tickets
3. Getting lost on a familiar route or forgetting where they are going
4. Confusion between the brake and gas pedals
5. Drowsiness or chest pains when driving

When riding with them:

a. Delayed reactions to people and cars on the street
b. Hitting curbs or denting the car frequently
c. Difficulty backing out of the driveway
d. Difficulty parking
e. Frequent close calls or near misses
f. Difficulty making safe turns or maintaining the correct lane
g. Other cars frequently honking at them
h. Driving too fast or too slow

If you notice any of the above signs while caregiving, you must inform the client’s family and your supervisor of your observations immediately, so that your client’s ability to drive can be properly evaluated by a physician. The physician will determine if the client should be allowed to drive or if they need to follow certain restrictions, such as only driving to nearby shops or taking familiar routes. Remember that acting quickly may mean saving your client’s life.

Knowing if your client is still fit to drive is only half of the story. When the physician says it’s time to take away the car keys permanently, the next big challenges are breaking the news to them and making sure they do not drive anymore:

- Support the client and their family as they discuss this painful change. If the client resists and insists on continuing to drive, the physician may be the best person to tell the client why they can no longer drive.

- Show empathy and be an attentive listener. Suddenly losing driving privileges is a huge adjustment for an older client. Let your client express their anger, humiliation, and frustration, without being judgmental of them.

- Know how you can help the client get to the places they want to go, whether by driving them yourself or assisting them in taking the bus or a taxi. Always refer to the care plan when helping clients make these decisions.

- Check in with the client often. Depression can set in because their independence has been limited.

- It is important to lessen the impact of the client’s inability to drive due to changes in their physical or mental conditions. Invite them for some socialization while reminiscing with them. Talk to their family and find out how clients can still go to family gatherings and special events.

- Help your client develop routines and look for activities that do not require driving. Introduce gardening, yoga, or swimming, if this is feasible and safe for them.

- Depending on what you and the family have discussed, help keep the client from driving by hiding the car keys or clamping the steering wheel of the car.

Caring for an older client who suddenly has lost their driving privileges can be very challenging. Expect that the client will not give up their car keys without fighting to keep their driving privileges. An extra dose of patience and understanding can go a long way toward making your client’s transition easier.