By JUDD MATSUNAGA, Esq.
Here is an interesting story. Years ago, a 90-year-old Japanese man from Montebello was driving on Highway 60 when his wife called him. “Daddy, please be careful. The news on TV said there was a car going the wrong way on 60 via Montebello!” The husband replied, “Mom, it’s not just one car is dozens!!!”
Do you know that Japan requires new drivers to place a multicolored marker on the front and rear fenders of their car to tell others that there is a newbie behind the wheel. But, due to an aging population, Japan also requires a similar symbol for older drivers, as many seniors have difficulty seeing or hearing. The fix is recommended for drivers over 70 and mandatory for drivers over 75. (Source : https://en.wikipedia.org/wiki/K%C5%8Dreisha_mark)
Good idea? You bet. When you drive, different regions of your brain cooperate to receive sensory input (through sight and hearing), prioritize information, recall related past experiences, anticipate likely scenarios, analyze options, plan ahead, use good judgment, synchronize movement responses and juggle more than one task at a time. And, due to the nature of driving, each of these required tasks must be completed at an adequate speed.
This is not the case in America. America is all about the rights of the individual, i.e., “It shouldn’t be about age, it’s about driver ability.” Each person with dementia may exhibit a different pattern of difficulties depending on specific areas of brain damage – one or more of these functions may be impaired. It is the particular profile of these difficulties that may constitute a motor risk in some people in the early stages of dementia.
Since Rafu Shimpo the community is aging (even the Sansei!!!), I found the following useful information from a guide to safe driving from the Hartford Center for Mature Market Excellence and MIT AgeLab. According to the guide, more than 5 million people in the United States suffer from dementia, with Alzheimer’s disease being the most common form. And that number is expected to increase as the population ages.
If you have a loved one with dementia, deciding when a person with dementia should stop driving is difficult, as you must balance safety considerations with the person’s sense of independence, pride and control. The challenge with driving and dementia is to preserve a person’s sense of independence for as long as possible, while simultaneously protecting the safety of that person and others.
Often family members will allow a person with dementia to continue driving even though they believe it is unsafe. They might not want to hurt that person’s feelings or worry about what other people might think. Some want more support from family, friends, or professionals before intervening, and others want to delay taking on the responsibility for transportation.
At the other extreme, some family members overreact to common driving mistakes such as failing to stop at a stop sign. They may attribute these errors to illness, when in fact the person may have always had the bad driving habit. A single occurrence of misbehavior does not mean the person should stop driving. But it signals the need for increased monitoring and evaluation.
For most people, driving represents freedom and control. It’s a way to access health care, buy basic necessities, be productive and stay in touch with family, friends and the community. Stopping driving can be a deeply personal and emotional issue.
“Our children talked to him about not driving. They don’t know it, but he cried that night. Driving is extremely important to him. I don’t want to strip him of his dignity. – Wife whose husband suffers from mild dementia.
As we age, even those of us without dementia can experience physical changes that affect driving, including vision problems and slower reaction times. In response, most people will change the way they drive by avoiding driving on certain roads or at night. They can usually assess and regulate their driving without the intervention of their family and can continue to drive safely throughout their lives.
But it’s different for people with Alzheimer’s disease or other dementias, particularly because the disease can be gradual and unpredictable. Drivers with dementia often modify their driving by driving less at night or in unfamiliar areas, but as their abilities decline, they lose the ability to determine when to stop driving. They are likely to minimize the complexity of driving and overestimate their abilities.
“My sons and daughters had a meeting without me and decided they wanted me to stop driving, but they’re making a big deal out of nothing. I am very comfortable on the road. I’ve been driving longer than they’ve been alive. — Person recently diagnosed with dementia.
They may lose the ability to be aware of their own neurological and thinking issues. They may make excuses or blame others for their high-risk driving behaviors and may say things like:
• “Just because I got lost doesn’t mean I can’t drive.”
• “I make sure to watch where I’m going.”
• “I’ve driven for many, many years and haven’t had an accident yet.”
Do you have a relative with dementia who still drives? Do you worry about him driving? Or do you just hope his ride is “good enough?” Driving, of course, can be an immediate and life-threatening problem, making it a family priority. Most dementia information warns against driving, but doesn’t help you figure out when to stop. According to AARP, here are some warning signs of dangerous driving:
● Delayed response to unexpected situations
● Being easily distracted while driving
● Decreased driving confidence
● Having difficulty moving or maintaining the correct lane of traffic
● Hitting curbs when turning right or backing up
● Getting scratches or dents on the car, garage or mailbox
● Have frequent close calls
● Driving too fast or too slow for road conditions
If you’ve noticed your loved one exhibiting some of these warning signs, it means it’s time to talk to them. But how are you supposed to sensitively approach the topic of stopping or limiting driving and having a productive conversation? First, it’s important to remember that limiting or stopping driving is a complex and emotionally charged discussion.
For example, the Hartford Center guide included a section titled “Sound advice from experienced caregivers” which I thought would be helpful: Caregivers who struggled with driving and transportation issues were asked, “If you could do it again, what would you do differently? » and « What advice would you give to others who are in similar situations? They revealed four basic principles that can help you and your loved ones navigate these decisions.
1. There is no easy answer, no right way. You must consider the personality and abilities of the person with dementia when making decisions throughout the course of the disease. You need to consider the roles and relationships within the family that influence decisions and their outcomes. Each family must choose strategies that will work in their unique situation.
2. Start discussions and planning early and involve the person with dementia. Ideally, a person with dementia should transition from driver to passenger over a period of time. The driving agreement with my family can serve as a starting point for constructive discussions about driving. Open, early and ongoing communication can help the person with dementia and their family agree on a plan of action before a crisis occurs.
3. Base your decisions on observed driving behavior over a period of time. Regular monitoring and evaluation of conduct can help caregivers respond appropriately. A diagnosis alone may not be sufficient reason for a person to stop driving, but when it is clearly no longer safe for the person to drive, caregivers should take action immediately. In retrospect, many caregivers regret allowing a loved one to drive longer than it was safe.
4. Get help when making and implementing driving decisions. It is not healthy for anyone to have one person take all the responsibility for decisions about driving and dementia. Caregivers can make reasonable requests of both family members and other family members and should look to others for help in meeting the person’s emotional, social, and transportation needs suffering from dementia.
In conclusion, people with dementia rightly want to drive as long as it is safe. Family members must constantly balance the need to respect a person’s desire to drive against the need for safety. Doctors, occupational therapists, lawyers, care managers, financial planners and local Alzheimer’s disease support groups can provide information and insight to strengthen the family’s efforts – helping to ensure that the person with dementia receives the best support.
Judd Matsunaga, Esq., is the founding partner of the law firms of Matsunaga & Associates, specializing in estate/medical planning, probate, personal injury, and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. The opinions expressed in this column are not necessarily those of The Rafu Shimpo.