How To Ensure Your Aging Parents Safety When Driving


It is estimated that by the year 2030, there will be 58.9 million people in the U.S. over the age of 65—and many of these individuals will still be drivers.

While many older drivers are still safe at this age, these drivers have a higher risk of serious injury related to motor vehicle accidents than their younger counterparts on the road.

By age 75, the crash risk is higher, not only due to increased frailty but also to the tendency for older drivers to drive less overall with less time on the road with current traffic conditions.
And by age 85, your older driver is four times as likely to die or be seriously injured, due to an automobile accident than an older driver who is 70.

What can adult children do to keep their parents safe on the road?


DO

Do have an open and honest conversation

Start by having an honest conversation with your loved one. Recognize that this conversation is tough, and you may attempt the conversation about stopping driving over the course of several weeks, months and even years.

A wonderful resource for starting this conversation can be found in a kit titled, At the Crossroads.

This is a boxed set of articles researched and gathered by MIT AgeLab, Boston University School of Medicine and The Hartford. While it is described as a support group kit on Alzheimer’s disease, dementia and driving, the foundations presented in the kit can be used for numerous medical concerns related to older driver safety.


Do talk with a doctor to discuss your concerns

Once you have discussed your concerns with your older driver, make an appointment with his or her doctor to see if your concerns are shared by your loved one’s doctor.

It is likely that this topic has already been discussed--especially if there is a long-standing relationship between the doctor and your older driver. The doctor will likely discuss current medical status, medications and how overall health can influence driver safety.

It is possible that a small change, such as a change in the timing of when a medication is taken, can have a big influence on driver safety.


Do request a detailed screening from a physician

Ask your parent’s doctor to administer the screening included in the Physicians Guide to Assessing and Counseling the Older Driver. This tool, created by the American Medical Association and the National Highway Traffic Safety Administration, presents recommendations for physicians on assessing and counseling older patients on medical fitness-to-drive. These recommendations include a quick set of easy-to-administer tests.


Do plan alternate transportation options

A change in an older driver’s community mobility is more than just the ability to hop in the car to get some bread and milk. Being able to drive is often associated with personal freedom, self-efficacy and even a right of passage.

If this right is given up or taken away, older drivers are more likely to become isolated in their neighborhood and in their home. This potential isolation can be the start of other medical problems, including depression that may further symptoms of dementia.

To reduce this risk, begin planning alternate transportation options for your older driver. Family members, church or civic organizations, as well as recreation centers and senior centers often fill at least a part of your loved one’s transportation and community mobility needs.

A great place to look for local transportation options available in your city is via local senior publications. You can find valuable information not only about community mobility and transportation, but also a host of other topics related to seniors.


DON'T

Do not fail to participate in a CarFit event

To empower older drivers to take matters into their own hands, ask them to participate in a CarFit event. CarFit is a collaboration between the American Occupational Therapy Association, AAA and AARP Driver Safety to ensure that your loved ones and their cars fit them optimally.

During a 20-minute CarFit appointment, trained technicians will review the mirror and steering wheel angles, airbags, seat and seat belt positions, placement and usage, ignition, line of sight, neck mobility, blind spots and operation of other vehicle controls.

If problems arise during this screening, an occupational therapist/driver generalist can make specific suggestions. Or the therapist might even recommend further evaluation through a driver rehabilitation program.


Do not overlook online and computer resources

There are numerous online and computer resources that you and your loved one can use to check on driving safety and/or to enhance continued safe driving skills.

One example is the AAA Roadwise Review. This is an interactive driving evaluation that can be completed online or by ordering a CD-ROM. It tests physical, visual and cognitive abilities in a confidential manner and provides feedback to the driver about reducing the risks associated with driving.

You also might want to consider AARP’s Smart Driver™ course. This new 2014 course includes information on roundabouts, pavement markings, stop-sign compliance, red-light running and safety issues, such as speeding, seat belts and turn-signal use.


Do not forget to consult with a Certified Driver Rehabilitation Specialist

If a decision can’t be made as to whether your loved one should continue to drive, a good next step is to consult with a Certified Driver Rehabilitation Specialist (CDRS). A CDRS, typically an occupational therapist, has specialized, mentored and certified training in clinical and on-road evaluations.

The typical evaluation includes tests of driver visual, cognitive, physical and on-road skills. While programs vary from clinic to clinic, a driver evaluation can last between three to four hours.

Once the evaluation is completed, recommendations are given to the driver and the referring physician, along with paperwork for the Department of Motor Vehicles.


Do not put off the difficult conversation with loved ones

Avoiding this important conversation with aging parents typically leads to a confrontation about the topic with hurt feelings and strained relationships. Even worse, avoiding this vital conversation might mean that an accident occurs. While many accidents are fender benders, even small accidents can result in an airbag deployment.


SUMMARY

Aging does not necessarily mean a person's driving days are over. However, it is vital to ensure the safety of your loved ones on the road. This begins with learning more about how to detect problems, paying attention to any warning signs that age is affecting safety, and discussing changes in your older loved one's driving.

By reducing risk factors and incorporating safe driving practices, your aging parents can continue to drive into their senior years. Additionally, planning for alternative methods of transportation can offer health and social benefits to your loved ones.





Discussing Difficult Life Issues With Elderly Family Members


Talking about issues facing aging adults, such as finances, health, driving, help in the home, moving and death, is frequently difficult for both family members and older adults. Thinking your words through ahead of time and avoiding major pitfalls can make your important family discussions more productive.


DO

Do be prepared

When heading into a difficult discussion with an older family member, you must be emotionally, factually and strategically prepared. Emotionally, you should try to be neutral, respectful and considerate. Factually, you must do your homework. Before starting to talk, research the relevant facts or resources you want to bring to the table. Strategically, decide where, when (probably not at Thanksgiving dinner) and who else in the family should be present or informed ahead of time, so things can go a smoothly as possible.


Do include both your concerns and the concerns of the older adult

Remember that this is a discussion and not an ultimatum. Another way of thinking about the conversation is that you are talking with someone, and not simply talking to them. Listening on both sides may be something you have to ask for--and ask of yourself--more than once.


Do be honest

Honesty is a virtue, and the concept of honesty includes being diplomatic and taking baby steps on a “hot” topic. At the end of the day, stating what you feel must be said in a way that protects your rights and respects the rights of others. Being honest does not mean being heartless or demeaning; rather, it means you can make your clear case for planning, dealing with health problems, hiring help in the home, moving and driving. Rehearsing before your conversation can help.


Do work to build trust

Do not be surprised if your older relative does not trust someone trying to help them. While this may feel hurtful to you, remember that trust is always earned, not guaranteed. How you respect the feelings and dignity of the other person in the conversation will go a long way in helping to build and maintain their trust.


Do strive for realistic outcomes from the initial discussion

Working with older relatives in difficult situations is rarely solved in one day or in one conversation. For the initial discussion, ensure that there can be more discussions later--no matter what happens. Sometimes, planting seeds is all we can do to help others.


DON'T


Do not be deceitful

While there are many ways to tell a truth, lying--or attempting to hide the truth--rarely works well and can make a situation much worse.


Do not parent your parent

While you may be in a position of taking charge of many things in an older adult’s life, be aware that you are not becoming their parent. Instead, you are hopefully trying to help them maintain dignity, even though aspects of their existence need additional support from others.


Do not promise more than you can deliver

This is very difficult because it is easy to say, “I will never put you in a nursing home.” However, if this becomes necessary later on, you will feel horribly guilty. Rather than make an unrealistic promise, it is far better to “promise” what you can do, such as remain emotionally connected no matter what happens. This is vital even though you cannot promise what you may or may not do--if circumstances change down the road.


Do not threaten or coerce

As tempting as this might be, especially when the older adult is being obstinate, do not threaten or coerce. This will only fan the emotional fire and leave everyone feeling worse.


Do not try to solve or resolve everything at once

Difficult discussions and topics are challenging for emotional, symbolic and real reasons. Family lives are always a work in progress. You must work to make it “progress” in the right direction, rather than make it a rush to completion.


SUMMARY

Talking with aging family members about difficult life issues is not easy. But mapping out the conversation ahead of time and avoiding major pitfalls can make important family discussions more positive and productive for all.


Advice For Managing Your Aging Loved One's Depression


Growing older does not protect us from mental illness. Many diseases, such as high blood pressure, heart disease and high cholesterol, develop in early adulthood. And we keep them until the day we die. Depression, anxiety, schizophrenia or bipolar disorder (also called manic-depressive illness) is no different. If we don’t have these prior to becoming seniors, we are likely to develop depression and other mental issues as we grow older.

Typically, depression is underrecognized and undertreated in the elderly. In addition to the chemistry of the brain being responsible for depression, other environmental factors play a significant role as well. Some of us have a hard time with growing older. Many of us have more and more ailments as we grow older. And chronic illness makes one more likely to develop depression. It affects approximately 25 percent of seniors who have chronic illnesses, such as heart disease, diabetes, stroke, cancer, chronic lung disease, arthritis, Alzheimer’s disease and Parkinson’s disease. Most disturbing is that 50 percent of nursing home residents suffer from depression.

Depression is not the only mental illness affecting seniors; however, it is the most common. Families and friends should watch for signs of problems in older people and these signs should not be ignored. Serious mental illness may lead to disability. It may worsen symptoms of other illnesses or may result in premature death or suicide. The elderly have the highest rate of suicide out of all age groups – a fact that is not well known.

Today’s treatments of depression are so varied and effective they can make an amazing difference in a person’s life. But first, we need to watch for it and recognize it.


DO

Do listen to those with mental illness

Listen to their point of view--even it is against your own convictions. You don’t have to agree with them, just hear what they are saying. In a non-judgemental way, try to grasp their point of view even if they are talking in circles and not making much sense.


Do encourage loved ones to seek professional help

If seniors refuse to see a licensed therapist or psychiatrist, most will agree to be seen for the physical symptoms of their mental illness by their general practitioner.

Be sure to discuss your observations with them. When talking with seniors, provide specific examples of your observations. For example, “Recently I have noticed that you don’t participate in bridge club anymore, and you seem to be very isolated.”


Do understand normal grief versus impairment

Loss is a normal part of the life cycle. Elderly individuals experience the loss of loved ones, as well as their independence and career. It is normal to go through an adjustment period. When relationships, functioning and ability to care for one’s self are impaired, a person may require additional professional support.


Do include the patient in treatment decisions

Don’t talk about the patient as if he/she is not there. Offer choices in treatment when possible. For example, “Would you like me to take you to the emergency room, or do you want me to call 911?”

Unless individuals have been deemed unfit to make their own medical decisions, they have the right to consent. Discuss options with them directly, instead of talking behind their back or as if they are not present.

Do treat mental emergencies in the same way as physical emergencies

Would you hesitate to contact emergency services if your father were having a heart attack? Mental health emergencies are just as serious and deadly. Visit your nearest emergency room, or call for a welfare check if you are concerned for their safety.

Be sure to keep an accurate list of dose, medication and prescribing doctor for all medications. Communicate this information to medical professionals.


DON'T

Do not validate hallucinations or delusions

If Uncle Bob thinks the doctor is trying to poison him with his medications, using sarcasm to defuse him may actually backfire. Saying, “Yeah, I bet your doctor is trying to poison you” in a sarcastic tone is not helpful, as people who are confused due to mental illness may not understand the context.


Do not enable isolating behaviors

It is vital to encourage participation in family activities and functions. Often, seniors will decline invitations to go out, but once they are out, they will interact and feel much better.


Do not keep information from providers

You might not think it is important to share that your mother talks to herself all the time. But in fact, this could be an important piece of the puzzle. Share information you have with providers, so they have the opportunity for the most accurate assessment.


Do not assume seniors can “snap out of it”

A diabetic cannot regulate blood sugar without insulin. Mental illness is no different. A person suffering from depression might not be able to get out bed. And telling them to “snap out of it” is not helpful.


Do not blame

Mental illness is not a reflection of character, poor life choices or a defect. Mental illnesses are common. At any given time, 50 percent of the population suffers from a diagnosable mental illness.


SUMMARY

Depression is the most common mental illness affecting seniors, and the signs should not be ignored. In fact, the elderly have the highest rate of suicide out of all age groups. While today’s treatments of depression can be extremely effective, it must first be recognized by loved ones.


For Elders Who Want To Stay In Their Homes, Finding a Good Home Care Agency is a Must


Did you know that by 2030, the U.S. government projects our population of people over the age of 65 to be 72 million, double the number that it was in 2000? Today 1/3 of Americans spend 20 hours a week or more in direct care for their parents. Stresses of everyday life, family obligations, and work requirements can make caring for senior loved ones seem almost impossible. Many Americans are turning to home care as a viable option to allow mom and dad to age in place safely and comfortably for as long as possible. How do you find an agency to care for them as if they were their own family member?


DO

Do interview at least 3 local home care agencies

Not all home care companies offer the same services. Make sure the agency has experience with the special needs mom or dad has. Good home care companies offer excellent and up to date training for their caregivers. Ask the agency what sort of training programs they require for their staff. Good home care companies utilize an array of technology that help you keep up to date, no matter where your physical location from your loved one. Have a list of questions on hand that each agency can respond to.


Do ask for testimonials or letters of recommendation

If the home care company you’re interested in has delivered a high level of care in the past they will have testimonials they will willingly share with you.


Do check for accreditations, licenses if applicable, insurance, bonded, or other associations

Carrying specific home care insurance and bonding should be absolutely required for the home care agency that you are interviewing. Also, some states require licensing, and in other states there are certifications home care agencies can attain to be part of waiver programs. Your local chapter of the BBB is also a good reference check.


Do understand your role in the family

Being the son, daughter, granddaughter, or grandson is the natural role for you in your family. Becoming a caretaker can be stressful for both you and your family member. Guilt is also a common emotion family caretakers experience. Thoughts such as “I wish I could be there more often or I wish I had my life back” are routinely shared to many home care agencies.


DON'T

Don’t submit to pressure tactics to sign a contract

Good home care agencies understand this is a challenging time and do not require binding contracts. The agency will spend time to get to know family dynamics, understand your loved ones’ needs, and more importantly customize a plan of care specifically for mom or dad.


Do not hire a friend or relative that is not a professional caregiver

Performing background checks, verifying employment history, ensuring training is completed, professional interviewing methods, validating drivers license and auto insurance, validating TB shots, paying employment taxes including workers compensation, and having back-up staff are all essential components your home care agency will do for you, eliminating the burden and time needed to complete these necessary items.


Do not give in to stubborness

Most seniors will not admit they need help and will protest when the subject is raised. It’s the period of time they grew up in, where hard work and independence made our country what it is today. Look for bruises, unused medications, bills not paid, missed doctor appointments, weight loss or gain as signs that assistance is needed. Many seniors have close bonds with their caregivers that are forged in a surprisingly short amount of time.


Do not necessarily hire the cheapest home care agency

The money we Americans pay for any service is always a top consideration. Sales and discounts are part of our culture. Home care services are one of the most intimate choices we will ever make, and having a person in our homes assisting a love one is a special decision for a family member to decide. Good home care companies usually charge a competitive hourly rate. If you receive a low quote, that may be a sign that the agency does not have all the elements needed to provide a high level of care for your loved one.


Mom and dad have made the decision to stay at home instead of moving to a assisted living facility.

You know that in order for them to be safe and comfortable they are going to need assistance. Home Care and caregivers are the fastest growing industry and jobs in the U.S. now. This is a sign that millions of seniors are deciding to age in place.

Finding a home care agency will give you peace of mind, provide the services your loved ones need to stay safe and comfortable.

And allows you the opportunity of being their son or daughter again.


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