When to take the keys from Mom? Difficult conversations in senior care.

The Dr. Phil Show is no stranger to tackling contemporary relationship and mental health issues in a straight forward, no nonsense manner. This week a woman in the audience asked Dr. Phil "When is the right time to take Mom's car keys?"

Naturally Dr. Phil probed for a bit more information. It turns out Mom is in her 80’s, lives on her own and the adult daughter lives almost 1000 miles away. Mom is still driving. Mom is showing classical early signs of dementia.  For example, Mom will sometimes forget where she is going and has to turn around. Mom doesn't want to give up driving at all. The daughter also stated that she found out from Mom's neighbor that she was in an accident recently and totaled the car. The daughter was seeking advice on how to approach these difficult questions while maintaining their loving relationship.

Keeping aging parents in their home and safe are critical priorities for adult children and other loved ones. "Aging in place" is the overwhelming desire of the aging adults themselves. Senior living communities are expensive, and with ever lengthing life expectancies making the senior's money last through their last years is an important consideration. This segment hit home for so many of our clients facing these types of issues. In this situation, an in-home caregiver could be the perfect answer to keeping mom safe and having someone be the eyes for the family and for the doctor.  

Some common signs that you need to have this conversation now include:

• Failing to follow traffic signals and warnings
• Driving at inappropriate speeds - either too fast or too slow
• Becoming agitated when driving
• Getting lost in familiar surroundings

Dr. Phil's guest, Freda Lewis-Hall, MD FAPA and Chief Medical Officer of Pfizer answered the question beautifully when she said this is a series of conversations to have with your parent, family (and caregiver). It’s not just one conversation. She referenced a Get Healthy, Stay Healthy article, Alzheimer's, Dementia, and Driving, that we believe is a great a resource for caregivers, particularly when deminished mental capacity such as Alzheimer’s and Dementia are in play. She stressed this is not about age and driving, it is about diminished mental capacity and driving. Another excellent resource is the Alzheimer's Association's Safety Center.   Dr. Lewis-Hall suggested an appeal to the Mom's sense of responsibility for other drivers on the road might help sway the decision.

Giving up driving is a particularly difficult conversation to have, particularly because this is so closely linked with the aging parent's independence. Alternatives must be considered and at least mentally organzied before you bring up the subject. Senior caregivers, whether hired directly or contracted through an agency, may be an ideal solution, particularly when other family members are not local. 

As a last resort, Dr. Phil stated you must either yank the keys or disable the vehicle - allowing your aging loved one to continue driving when they have lost the mental capacities needed for safety is NOT an alternative.