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What Could Be Wrong With That?

The call came from a CA resident to where we advise families of elders about age-related issues. Daniella, the daughter of an 85 year old woman sounded calmly concerned. She said that she was “a bit worried” about her mother. She related that her mom lived alone in a mostly rural area in another state. Initially she did not specify any particular problem.

I asked about her mom’s home, who was around in her town and what the mother’s physical capabilities were. She said her mom did pretty well on her own and that she just loved to drive. She related how her mom made several long trips each year to visit Daniella and they enjoyed the visits. Daniella had very strong feelings, she said, about not wanting to take away her mother’s independence. She was the appointed person on the Power of Attorney and healthcare directive. I pressed for a further explanation of why she sought advice from me.

What Was The Problem?

She went on to describe that her mother had always been very independent and that she never wanted to rely on anyone to take care of her. Again there was no clear description of a problem except for an aging person living alone. I pressed further about the long car drives. “Well”, Daniella said “I guess the problem is, she’s legally blind”.

This could not have been a clearer example of how the intention to refrain from “taking away mom’s independence” had reached the point of ridiculous danger to her mother and everyone else on the highway on those long drives. It was irrational.

Safety First!

No matter how hesitant anyone might be about taking protective steps to keep an aging parent safe, there reaches a point when safety trumps everything else. In this case, a person with the legal authority to stop her mother from literally driving blind didn’t care to face her own personal discomfort. She failed to act. She allowed her mother to take on an extremely risky matter, driving, because her mother loved to drive.

As we age, there are likely to be a lot of things we love to do that we have to give up at some point. I have heard hundreds of elders tell me personally that they used to love to play tennis, to golf, to do other physical things that their bodies could no longer do. They were able to accept these normal changes of aging even if they felt sad about them and felt the loss. If allowing a loved one to drive long hours on freeways at high speeds when legally blind sounds ridiculous to you, it sounded that way to me too.

The Advice

I advised Daniella that she had a duty to protect her mother as the person her mother had appointed to take responsibility for healthcare when needed. Now was when it was certainly needed. As her mother had been diagnosed as legally blind, she would have been unable to pass the vision test in her state for renewal of her driver’s license. But as we know, many states will renew a driver’s license for years with no requirement for re-testing due to any particular age. It was that way for Daniella’s mother. Her license was still valid for two more years and the motor vehicle department had no way of knowing about her vision loss.

The Excuse

To my ears, “I don’t want to take away her independence” was an excuse. Daniella didn’t want to have to break the bad news to her mother that she absolutely had to give up driving right now. It was going to be a burden to go through the inconvenience of finding alternate transportation for her mother daily and to come and visit Daniella. Think of how many other drivers Daniella’s mother endangered every time she got behind the wheel, say nothing of danger to herself. Compare facing the potential consequences of a fatal car accident with the inconvenience of finding another way to get around. Which would be harder?

An aging parent’s independence is a frequent issue for adult children. Some of them step in and do the work when danger to the aging parent arises. They take on their responsibility willingly. Others, like Daniella, choose not to deal with what is in front of them and pretend that things are okay when it’s obvious that they are not. Daniella needed an objective viewpoint and some direction. She got it in two consultations. She learned what words to use, how to approach the subject with her mother, and how to acknowledge that this was likely going to be a difficult adjustment for her mom. We practiced how to have the conversation with her mother.

The Elder’s MD Can Help

I advised her to notify her mother’s primary care physician of the situation. The doctor could inform the motor vehicle department, by using a form they supply, of the need for re-testing for licensure in case the mom refused to stop driving. If she did have to go into their offices for re-testing, she would most likely have had her license suspended.

Daniella did not follow up afterwards to let me know whether she actually took control, got rid of her mom’s car and made arrangements for her mother to manage transportation without driving. I had an uneasy feeling after our consultations. Daniella was still reluctant even with long conversations about the matter. My hope was that she stepped in and removed the imminent danger she saw.

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