When You Are Concerned - A guide for families, friends and caregivers concerned about the safety of an older driver(When You Are Concerned is also available as a PDF)
"Mom was only driving locally. Then she got lost in town. Was lost for several hours. Even ran out of gas. Somehow she called my sister. We sat on it (the problem) for 3 months. Then we went for help."
The good news is a surprising variety of help is available from genuinely caring people. Some of the folks who can help will have gone through similar situations with an aging parent or relative. You will find them to be very understanding and helpful.
Before you start, have some idea about what you want to accomplish. For example, are you looking to have your driver leave the wheel, improve their skills, or are you looking for alternative transportation? What follows is a partial listing of where to find help and what you might expect for assistance from local agencies, the medical community, licensing/police authorities and others.
Keep in mind, the issue of helping families, friends and caregivers with an at-risk or unsafe aging driver is still an emerging one for some of the organizations listed below. They may not be as fully geared up as they would like to be, but they will do their best to help you.
Where can I find help?
- State Motor Vehicle Department Office
- Local Department of Motor Vehicles Office
- Police authorities (state and local police, sheriff's department)
- Local magistrate (judge)
- Eye Care Provider
- Driver Rehabilitation Specialist/Occupational Therapist
- Area Agency on Aging
- Alzheimer's Association
- Social Services Department/Adult Protective Services
- Community Traffic Safety Board
- Transportation Authorities, brokers and independent providers
- Diabetes Association
- Legal Aid Society/Eldercare Legal Association
- Community Service Organizations (Jewish Family Services, Catholic Charities, Protestant Welfare Services, Community Action Programs, Senior Council, etc.)
- Local Driving School
- Insurance Agent
- AARP Driving Program
- Local AAA Affiliate (Automobile Association)
- Local Safety Council
Here's a brief overview of some of the organizations listed above and how they may be able to help:
STATE MOTOR VEHICLE DEPARTMENT OFFICE (DMV) - LOCAL DMV OFFICE
Here's what DMV can do: Suspend or revoke the driver's license. In New York State, you can file a request for a DMV re-examination of the driver. Your letter will need to give specific examples of the unsafe driving behavior and/or medical conditions or medications you believe impair the driver's ability and judgment.
You must sign the letter. If you request, DMV will keep your name confidential. Keep in mind DMV is required to guard against such letters being used in family or neighbor disputes to harass a driver. This means your letter will be carefully reviewed and you may be contacted for additional information (it is a good idea to include your daytime phone number in the letter).
If everything checks out, DMV will promptly notify your driver by mail to report to the "Testing and Investigation Section" of one of its district offices or to a road test site. Your driver may be required to bring a medical statement to address any conditions or medications described in your letter. He or she will be interviewed by a DMV License Examiner and may be required to take a vision, written and/or road test.
If your driver passes all of the required tests, the case is closed and no further action is taken. If warranted, however, restrictions such as corrective lenses, no limited access highways, or daylight only driving, may be imposed.
If your driver does not appear or refuses to appear, their license will be suspended. If the driver fails the written or road test, their license will be revoked. After thirty (30) days, they may reapply. They will have to go through the entire application, written and road test process.
- "People tend to unfairly criticize the DMV road test and our Examiners, too. But they forget our Examiners and their families have to share the road with the very people they pass. I don't know of a better incentive for doing the best job we can."
POLICE AUTHORITIES - (LOCAL & STATE POLICE DEPARTMENTS, SHERIFF'S DEPARTMENT)
Here's what the police can do: Talk to an impaired/confused driver and convince them not to drive; File a request for DMV to retest the driver. Issue a summons for a traffic infraction; Arrest and detain a driver who is impaired by alcohol and/or drugs (including over the counter drugs).
Law enforcement departments have a priority system for responding to events, calls and complaints. Highest priority is given to situations involving serious risk to life and damage to property. An officer will arrive with lights flashing.
If your situation is one where the older driver is at immediate risk of crashing or doing harm to others, let the desk officer or dispatcher know that when you call and give all pertinent specifics. Keep in mind the police cannot arrest or detain your driver if the person has done nothing wrong or the impairment is not alcohol or drug related (includes over-the-counter drugs).
But if your driver is clearly impaired (dazed, confused, disoriented) and/or at immediate risk of crashing, they will come and attempt to convince the person not to drive or arrange for them to be transported to a medical facility for examination.
If you are looking for general information about resolving an unsafe or at-risk situation, ask to speak to an officer who serves as the department's community relations "expert." Often this is the officer who works most closely with the community on a variety of social services issues. He or she will try to help you.
When it is apparent the driver should be re-examined by DMV, local police (in NY) can file form DMV DS-5 which will trigger a DMV re-examination for a driver.
- "We do a lot of things to prevent crashes. Helping families prevent an obviously impaired aging driver from crashing is consistent with our public safety mission. If we understand that the risk to life is immediate or imminent, you will get a (police) car."
- - ASSISTANTCHIEFWILLIAMGEORGES, CITY OF ALBANY POLICE DEPARTMENT
LOCAL TRAFFIC COURT MAGISTRATE (JUDGE)
If your loved one has to appear in traffic court to answer a summons, the judge can require your driver:
- to get a driving evaluation by a driving school or driver rehabilitation specialist;
- take a DMV road and/or written test;
- get an eye exam or full medical evaluation; and/or
- impose restrictions on driving.
As you can see, a traffic court magistrate (judge) can be of significant help. Arrange to talk to the judge about your driver's situation before the court date. If you have medical or other relevant information indicating the driver is at-risk, share it with the judge.
While local traffic court judges tend to be sensitive to the transportation needs of the older drivers in their jurisdiction, they will not tolerate unsafe driving. Your driver's case will be handled fairly and often in consultation with the officer who issued the summons.
PHYSICIAN -(NEUROLOGIST, CARDIOLOGIST, OPHTHALMOLOGIST, PSYCHIATRIST, ETC.)
A physician in New York State who agrees that your loved one has a medical condition affecting driving safety can:
- request a DMV re-examination of the driver; or
- can report the driver's medical condition (by letter, fax or e-mail) to DMV. Upon review of the physician's statement, DMV will immediately issue the driver notice of an indefinite license suspension. The suspension will remain in effect until there is another physician's letter stating that the person is safe to drive.
If you have driving safety concerns, arrange to meet with your loved one's physician. Make sure he or she understands what you are concerned about. Be specific about what you have observed. Use the check list in Chapter 4 to identify your safety, medical and behavioral concerns. Ask that your concerns be reported in the driver's medical record maintained by the physician. If the physician concurs with your observations, ask him to report your driver to DMV.
Be aware that liability and confidentiality concerns can prevent the physician from sharing information about his patient (your driver) unless your loved one has previously given permission. Also, the litigious nature of our society gives health care providers very real concerns about liability issues stemming from reporting a driver who may later be found by DMV to be safely operating. If the physician is reluctant to do anything, this is often why.
EYE CARE PROVIDER (OPHTHALMIC DISPENSER)
In New York State, a licensed ophthalmic dispenser (optician, optometrist, ophthalmologist or a registered nurse giving a visual acuity test) can:
- request a DMV re-examination of the driver's vision, or
- report the driver's vision condition (by letter, fax or e-mail) to DMV. Upon review of the statement, DMV will immediately issue the driver notice of an indefinite license suspension. The suspension will remain in effect until there is another corresponding ophthalmic dispenser report stating that the person's vision meets the minimal acuity standard.
If you believe your loved one has a vision problem affecting driving safety, arrange to meet with the driver's eye care provider. Explain your concerns and ask that they be recorded in the driver's file. Confidentiality of records can prevent you from learning the details of your loved one's condition, unless your driver has previously given permission. If the eye care provider concurs with your observations, request that he NOT provide your driver with the DMV Visual Acuity Report needed for license renewal, or if renewal is still some time off, report the vision condition to DMV to get the driver off the road.
A pharmacist can provide you with detailed information about how your loved one's medications, as well as the dosages and timing of multiple medications, affect driving safety. The pharmacist can also advise your loved one as to what extent they should be driving on the medications which have been prescribed or any over-the-counter medications they are using. Please see Chapter 7 for more information on medications, behavior and driving safety.
CERTIFIED DRIVER REHABILITATION SPECIALIST (CDRS)
Here's what a certified driver rehabilitation specialist can do: Provide an in-depth driving evaluation. The driver rehabilitation specialist is generally found in the health care community. They are certified specialists who typically help patients recovering from all manner of disabling situations including strokes and crashes to drive again, sometimes using specially equipped vehicles. In recent years, driver rehabilitation specialists have begun providing evaluations and assistance to a growing number of aging drivers referred by physicians, families and even the courts.
A patient seen by a driver rehabilitation specialist receives both a clinical and road evaluation. The clinical portion involves vision, reaction and cognitive screening. It is followed by an up-to-one hour road evaluation. A written report is prepared. Findings are shared with the driver and if the person should not be driving, the driving rehabilitation specialist will discuss cessation from driving with them. The specialist will indicate if the person needs remedial help or special vehicle equipment to make driving safer.
There are generally no loss of license penalties if the person performs poorly. But check the policy of the hospital or clinic to be certain. The cost of an evaluation may be covered if the referral was made by a physician or through a health plan.
Where do you find a driver rehabilitation specialist? Usually in clinic and hospital occupational therapy (OT) settings. But you may have to travel as not all clinics and hospital OT departments have one. See end pages for contact information.
LOCAL DRIVING SCHOOL
A driving school with state certified instructors experienced with older or disabled persons can be especially helpful in providing an impartial behind-the-wheel evaluation. There are no loss of license penalties if the driver performs unacceptably. A certified instructor will be able to provide you a written report (sometimes even a video tape) detailing the performance of the driver. The report will be helpful if the driver has to cease driving or get remedial help.
AREA AGENCY ON AGING (AAA)
Here's what an area agency on aging can do: Provide information about virtually all of the programs and services helpful to older persons, their families and caregivers. If this is the first time you have had to address an older person issue, the term "area agency on aging" (AAA) may be an unfamiliar one. In fact, every locality in the United States is covered by an area agency on aging.
The area agency on aging (AAA) will have a directory listing all of the services in their area which could be helpful to older persons and caregivers. Some of the services may be provided through their agency or via contracts with other community service organizations. Here's a list of the kind of pro-grams and services they will be able to tell you about:
- congregate meal
- programs recreation
- programs cooling
- heating subsidies
- adult day care programs
- health insurance counseling
- in-home assistance
- volunteer opportunities
- caregiver support groups
- friendly visiting
- home delivered meals
- regular & medical transportation discount cards
- respite (allows caregivers to take a break)
- Alzheimer 's and dementia programs
- housing opportunities and services
- home helper programs
- legal services
- telephone reassurance and more
The area agency on aging (AAA) is likely to have a staff member who can help you with your aging driver issue. If not, they will refer you to someone in your (or your loved one's) community who can help.
You should be able to find the AAA listed in the telephone directory under community, senior services or in the government pages, or on the Internet. You can also find an area agency on aging by contacting the state government unit on aging (SUA). The state government unit on aging will be able to give you the number of the AAA in your driver's locality.
SENIOR CENTER DIRECTOR, SENIOR HOUSING ADVISOR/SERVICES DIRECTOR
Here's what they can do: Provide direction and guidance. A senior center director or senior housing services director will often have had experience resolving a number of unsafe or at-risk aging driver situations in the course of their regular responsibilities. In addition they are also an excellent source for information about local services such as transportation.
Here's what they can do: Provide help with an especially difficult transition from the wheel, advise about interventions, and provide support to you and your driver. A diagnosis of Alzheimer's Disease ultimately means cessation from driving. Your local Alzheimer's Association, Alzheimer's Disease Assistance Center or local Alzheimer's group will have genuinely caring people with enormous expertise in helping families and caregivers deal with the driving issue and so much more. You can find your Alzheimer's group through your area agency on aging, the Internet or your telephone directory. See end pages for contact information.
TRANSPORTATION AUTHORITIES, BROKERS & INDEPENDENT TRANSPORTERS
One of the easiest way of finding out about transportation is by contacting the area agency on aging in your family member's locality. The next source for information is the State Department of Transportation (SDOT), Passenger Transportation Division (see end pages for contact information). They will be able to provide you with information about the public transportation services operating in your loved one's area. They will also be able to tell you about services for people with special needs and paratransit (door to door or curb to curb) services.
Additionally, a variety of community organizations use publicly financed vehicles. SDOT can identify the organizations in your family member's area and provide contact information.
COMMUNITY SERVICE ORGANIZATIONS
Community service organizations provide helpful programs ranging from day care for kids to day care for aging persons and most everything in between. They are often operated under a variety of religious and non-religious auspices such as: Jewish Family Services; Catholic Charities; Protestant Welfare Services; Community Action, grange, senior council and other umbrellas.
Community service organizations operating senior meal, transportation, housing, in-home services, recreation and counseling programs will often have a person on staff who can help you with at least some part of your situation. Have the area agency on aging identify the community service organizations most likely to be of help for your situation.
If your loved one's insurance agent is someone they have known for years, the agent may be able to help in any discussions you have with your loved one about leaving the wheel. Most agents not only have access to general aging driver crash data, but also the disheartening details of crashes involving their aging clients. That information can be helpful in educating your at -risk driver to the potential downside of remaining on the road when they are at-risk.
AARP has extensive information on caregiving, driving and just about anything else of interest to older persons and their families. In addition, AARP operates the widely known "55 Alive Mature Driving Program." The program not only provides excellent information about driving safely but also about when it is time to cease driving! See end pages for contact information.
AMERICAN AUTOMOBILE ASSOCIATION (AAA)
American Automobile Association members will find an informative monthly publication, helpful maps, travel information, services, extensive safety information and more. But you don't have to be a member to get their various safety publications or participate in their approved motor vehicle accident prevention course. In fact, helpful brochures covering virtually everything from self-evaluation of driving skills to fitness training for driving, are available from your local AAA affiliate or the AAA Foundation for Traffic Safety. See end pages for contact information.
LOCAL SAFETY COUNCIL
The National Safety Council (NSC) and local branches operating under its umbrella are sources for information about the NSC "approved motor vehicle accident prevention course." The National Safety Council also has helpful safety information not just related to driving. How do you keep your loved one's home safe? How can you prevent falls in the home? The National Safety Council can help. See end pages for contact information.
Your telephone directory is also a resource for finding senior services. Senior service information is usually listed after the phone company's own pages. Sometimes these pages are called the "inside interest pages." The "blue" government pages sometimes list municipal senior services.
Don't have an Internet connection? No problem. Your local library does and its librarian will help you find what you need, including any on-line updates to this very handbook!
If you are on the Internet, you already know how helpful it can be. Check the Web sites listed in the end pages for periodic updates. Also check our Web site for on-line updates and links.