E-mail updates
Follow on Twitter
Subscribe to RSSShould a physician be held responsible if an elderly patient causes a car accident while driving?
A Los Angeles jury recently decided that Dr. Arthur Daigneault was not responsible for the wrongful death of 90-year-old William Powers, whose longtime partner, a dementia patient, drove into the path of an oncoming car, according to a report by The Los Angeles Times. The driver Lorraine Sullivan, 85, survived, but Powers died of his injuries weeks after the crash.
The Orange County, Calif. jury cleared Daigneault, but the case raises the question of whether the physician should have reported his patient -- who had suffered memory loss since 2007 and was prescribed an Alzheimer’s drug in 2009 -- to local health authorities or urged the California Department of Motor Vehicles revoke her license.
The victim’s family thought Daigneault should have done something. They sued him for wrongful death, arguing that he should have deemed the driver, a danger on the road and gotten her driver’s license yanked.
Daigneault, who had been involved in taking away driver's licenses from other patients he had seen, said that he did not think Sullivan’s condition was severe enough to warrant doing so in her case. The jury, after 30 minutes of deliberation, agreed.
Daigneault could well have been right in not reporting Sullivan. Every day there are horrible accidents that involve wrong turns, driving the wrong way and other fatal errors by drivers of all ages. But, statistics show that older drivers are more likely than younger ones to be involved in multi-vehicle crashes, particularly when turning at intersections, as Sullivan did. Drivers ages 80 and older have the 2nd highest fatal accident rate of any age group. Only teenage drivers are more dangerous, according to Federal Highway Administration data.
In the next 20 years, the number of elderly drivers in the United States will triple.
Should every state require doctors to report their concerns about the ability of older drivers to safely be on the road? Only a few states, including California, require or encourage doctor reporting. Relatively few require a road test for drivers over 75. Most states do not even require a vision test for older drivers. Tennessee does not require drivers over 65 to even renew their licenses.
Defenders of the elderly’s right to drive note that there are plenty of other people out on the roads who pose huge dangers. Reckless teenagers, novice drivers, drunks and the distracted driver contribute a great deal to the more than 90 people killed on American highways every day. The very old are, however, the biggest and fastest growing risk. And they are the ones that should be the easiest to get off the road.
States need to take this problem far more seriously and toughen their reporting laws. Doctors should put privacy on the back burner and err on the side of reporting to state motor vehicle departments when they have concerns about a demented or impaired older patient who is still driving. So should you if you are worried about grandma or grandpa. Even if your older family member does not go to a doctor, if you think their vision is failing or their memory is badly slipping, then the right thing to do is to let officials know.
Driving is a treasured right in America. But when age takes a toll on driving skills, putting the elderly, their passengers and others on the road at grave risk, then medical providers,family and loved ones should speak up loudly -- before that next wrong turn is someone's last.
Related:
Older drivers and 20-somethings equally dangerous?
Older drivers make mistakes even when healthy
100-year-old driver hits 11 near Los Angeles school
More from Art Caplan:
Aging dads, autism link won't change vaccine debate or speed cure
Leave a Comment:
Grandpa was a good ol tough cowboy in his prime, but when he started ridin the horse backwards and running over chickens in the farm for no apparent reason with his 54 Chevy, grandma Ethel had to call the cops......she thought he'd lost his mind.
What she didnt realize was that Grandpa Ernie had indeed lost his mind....through Alzheimers
It's not a matter of absolute age.
It's a matter of abilities.
Some people at 95 have more abilities than some others at 55.
We just need to test those over 80 a little more often.
.
yes yes yes...Doctors absolutely should report to the DMV if they feel that a patient of theirs ability is compromised enough to longer be ale to drive safely...God know many children are hesitant to do the deed themselves. We have had many heated discussion over this very topic. It started when it was reported the touching story about how the elderly couple died holding hands together...Touching my @#$##...i was pissed, he not only seriously injured another driver but killed his wife, not sure how talk shows go the touching part out of it. He should have been charged with manslaughter!
Please Doctors help people out by reporting grandpa and grandma when they are no longer driving safely.
Placing all of the responsibility on the doctor to "snitch out" his patients is a cowardly and fundamentally unfair way for the politically correct liberal Nazi's to advance their nanny state agenda without actually taking any responsibility or political flak.
If there is a general concern about the safety issues of elderly drivers then pass legislation requiring drivers over a certain age to obtain a health certification from their physicians similar to the FAA requirements for pilots. Licensing periods could also be reduced for the elderly (with a corresponding decrease in price) to ensure that they are tested often enough.
Dan - Have you had to be the family member to make the call to pull the keys and the car? I am and it sucks without the backing their doctor. When my Dad went missing for over 2 hours (going to a restaurant 5 minutes from their home), cops called to try and find him and missing a fmily wedding. I took action and took the keys and the car. I called his doctor that Monday and chewed her butt for not helping me with this before hand. When you are the only one making the decisions for your elderly parents, having the doctor back you up is paramont. The last I would have needed was for my Dad to take this out on me or my Mom. Thank God he didn't, but if he had I can only imagine as at this point in time he goes back and forth, good days and bad days. One minute thinking it's 1943 and then the next he is in the present day. This dementia stuff scares the hell out of me.
If he would have caused an accident, I would have been in the hot seat, why didn't you take the keys and the car. It really is difficult to get the keys and car away from someone, let alone his license. Had his doctor written a letter to DMV when I asked her to, I could have avoided the fear of him being missng. To this day, he thinks he was gone for 5 minutes.
And honestly, what if you do not HAVE a child to report this problem? My hubby and I are in our 40's. We have no kids. If something (god forbid) happens to him, and I am alone, and become impaired, there is no immediate family to report such impairment to the authorities. I hope to heaven that I will have my faculties as I age, but who knows for certain?
ladypyrate - Do you have a trusted niece or nephew who could, if needed make these decisions for you? Now is the time to get things in writing. After watching all this with my parents, I have taken the steps so my daughters will not be burdened with many things when I get to their age or if I become ill. Find a good lawyer who can help you with these documents. My lawyer charged me $200 for 4 documents, will, living will, financial stuff for my kids and one other (can't remember what it was now, it's in my safe). I am also pre-paying for my funeral. I don't want my children being pressured into something that I do not want.
Seems to me the simplest thing to do would be to make drivers over a certain age -- like 65 -- take a road test and only let them renew their licenses yearly. After all, it's the State government that gives us the privilege of driving; it should be the State that sets up guidelines for when the privilege should be taken away.
As Rebecca says, it's difficult to physically take the keys away from someone who doesn't want to give them up. My father had Alzheimer's, but his dementia was intermittent. He would have physically started hitting people had they tried to take his keys away. One time he decided to visit my brother, who lives 15 minutes away from our house. After he and my brother went to breakfast -- with my brother driving -- we found out from Dad that he had driven to the wrong street, one over from my brother's, and walked into a house he thought was my brother's. He wandered through the house, calling my brother's name, and after about five minutes, realized that he was in the wrong house. Thank Heaven's no one was home, or he would have probably been shot. After it happened, I suggested that perhaps he stop driving, and he just glared and stuffed his keys in his pocket. I called the doctor and I called the State DMV, and there was nothing I could do.
I know some people will argue that 65 is too young, but dementia patients like routine. If the idea that you have to be tested yearly on the road is started when someone is younger and less likely to have a problem, they will be also be less likely to argue about doing it as they get older. It will have become a routine they are used to.
bicfj - I did not call liberals politically correct Nazi's, I referred to a subset at the intersection of the sets "politically correct", "liberal", and "Nazi".
The term "politically correct" was used in reference to people who go along unquestioningly with popular opinion, and particularly to those that become so focused on solving a problem with a presumed simple solution that they fail to see or otherwise unwisely dismiss the undesirable consequences of that solution.
"Liberal" refers to a group that has the tendency to spread responsibility beyond the individual whose actions cause a specific event, especially when it can be spread to persons or entities that have substantial assets available for the courts to award damages (i.e. doctors).
"Nazi" describes the ruthlessness with which this subset, believing themselves to be the "enlightened ones" prosecute those who disagree with them or are deemed to have failed to accept the responsibilities imposed on them. Take for example Karen above, who wants the man that died in the accident she described to be charged with manslaughter, even though he is apparently dead! This sort of intolerance for diversity of thought or ideas is in stark contrast to the more compassionate picture I used to have of liberals. They seem to act just like right-wing jackasses when others fail to conform to their expectations. Take your comment for example.
Rebecca - I am not talking about a situation such as you describe where family members have asked the doctor to take action. However, the solution I propose might help under circumstances where the doctor is reluctant to take needed action on his or her own, but would be equally reluctant to sign a certifcate of good health for someone who was not fit to drive.
I am simply saying that I don't want to see the state pass legislation to make it easier for people to sue doctors for failing to spontaneously turn their patients in to the state on suspicion that they may be unsafe drivers, without any standard to make such a judgement. After a few successful lawsuits, doctors would be forced to err on the side of caution and would be turning people in for little reason.
This is in direct conflict with the doctor-patient confidentiality rules and would only serve to make the elderly reluctant to discuss certain symptoms with their doctors, or to avoid seeing their doctors at all, out of fear of losing their licenses. The same arguments have been used successfully to limit what parents can learn about their teenager's doctor visits, and is similar to the rational behind needle exchange programs.
As I said before, if the people feel that the state needs to take action, then the state should pass a law requiring a physical examination for people over a certain age before they can obtain or renew a drivers license. This would give the doctor an opportunity to formally address the issue. All he or she would have to do is refuse to sign. If some unscrupulous doctor sets up practice to rubber stamp them, he will be sued out of business.
A doctor, such as your dad's, would still be free to report a patient believed to be an imminent danger to himself or others.
We took my grandmother's away when she was 84. She can barely see, has very slow reflexes and early onset dementia. We discussed it with her and her doctor and agreed she could no longer live alone so either my parents or my husband and myself stay with her and drive her where she needs to go. I think it's important to remember that driving is a PRIVILEGE not a right! Instead of just talking about removing the driver's license, perhaps you could see what kind of support system they have in place. Do I think Doctors should be held accountable...that's a slippery slope. I certainly think they should be the first to tell their patient they don't think the patient should be driving and to notify authorities if it continues to be an issue, but as far as a law, that's tough. Just because someone is old, doesn't mean they can't drive, but if there is a known condition that could affect their driving ability, then yes, they should definitely be held accountable. In Florida, we have more than our share of people who should have never been let behind the wheel of a car and Alzheimer's sufferers who just drive into lakes or drive off and go missing. What about their kids or care givers...why aren't they held accountable, especially for many mental incapacities which family don't need a doctor to tell them there is an issue?
There's an old joke that goes like..."When I die I want to go in my sleep, just like Grandpa, and not screaming like all those people in the back seat". The corollary is something similar. At some point we either decide we have a responsibility to protect ourselves from all those out there who have no business behind the wheel of a car or truck or motorcycle, or not. If there were something out there killing 30,000 Americans a year, you'd think we'd do something about it. Everyone is pissing themselves silly over the cost of health care. Think about it...a lot of the accidents that happen are not covered bu insurance...who do you think pays for that; You do. Who do you think pays for every accident that happens...You do. It's reflected in the cost of insurance for everyone that has insurance, plus a healthy (pun intended) chunk of what you play in taxes. As long as you're happy paying those bills, believe me...they'll let you.
Driving is not a right, it's a privilege. My father was in a major accident almost 3 years ago. Although he was not at fault, he should not have been driving. The result of the accident was he is no longer able to live alone and finally a doctor told him he can't drive any longer. He's been living with me since. His Florida licence was up for renewal in June and the only requirement was that he pass the vision test by a FL licensed doctor or a VA physician. Not one question about his reflexes, his diabetes, heart condition, memory or neuropathy. He's 88 and the renewal would have allowed him to drive untested again until he was 92. I'm sorry but that is just crazy and bordering on negligent.
I grew up in Sarasota, FL. As far as I'm concerned it's an established fact that the elderly cause more accidents and general mayhem on the roads than any other group of drivers you can produce. Even if they aren't even directly involved in an accident I've seen plenty of geriatrics create the conditions where an accident is likely to occur. Build a machine that randomly drives a car without regard to surroundings and you've got the same kind of thing.
Nope. It's the young cocky pups, feeling their oats, not understanding consequences or responsibility, who are the biggest threats on the road. I was one just ten years ago, testing and learning my limits. Check the stats.
Dudditz-
While there are roughly twice as many accidents caused by the under 20 set as the over 75 set, those under 20 are more than 6 times more likely to be drunk or impaired by alcohol. Which means that they made a bad choice there, but the elderly are just making bad driving choices when they get in accidents.
Plus the elderly can create dangerous situations without being in an accident themselves.
I know it's cliche but we've all been behind that little old lady driving 30 mph on the highway with her left blinker on from when she left the house. While that little old lady might not be in an accident, she raises the chances for everyone around her because they are switching lanes and speeds to try to get by.
I believe, in California, doctors are required to report to DMV any physical or mental issues that might impair a person's ability to drive. EMT workers, police officers, AND family members may also request a re-examination of a person's driving ability by DMV.
It may be helpful to point out, that most urban areas have access transportation services, which transport the seniors and disabled around. And many cities provide a pass at a small charge, much less than a regular bus pass. The complaint I have heard is that access services in the L.A. area require a window of a couple of hours for pick-up, so the user may have to wait a long time. But this is less of a problem in smaller urban areas, such as north San Diego county.
Most have little or no problem with the laws requiring doctors to report suspected abuse of anyone they see. Potential deadly danger is given as one reason why. Granny or Gramps controlling a self propelled machine with a weight of a ton or more - yet mentally or physically deficient - certainly qualifies as potential deadly danger. (My local DMV has pissed off more than one old person by refusing to give the a license after they fail the sight and sign test. The old person in question usually makes some snarky remark about going to "insert name of their state of origin" to get their license.)
Driving in general is a really "touchy" subject. Impugn someone's driving ability, be they young or old, and watch the reaction. It's as though you just called them and their ancestry the most vile name imaginable.
Why are our egos so closely tied to our ability to drive well? Figure that out and maybe we can get more people who should no longer be driving to give it up voluntarily. For the rest, there's therapy.
Don't even THINK of blaming a doctor for the actions of one of his/her patients... WTF? Let's keep their responsibilities inside the "health" domain and not "safety". The job carries enough responsibility already.
Let me know how that works out for you, when you're the one needing to make the decision and don't have the backing of your parents doctor until it's almost too late!
What is this about a RIGHT to drive? Better re-read the constitution. There is no right to drive in it. As my drivers ed teacher told us, driving is a PRIVILEGE, not a right and as such has rules to be followed or your license can be revoked.
My 85 year old mother was loaded up on cancer drugs & pain meds and totaled 2 cars within weeks. One accident involved others (her fault), but in the other one, she drove through the closed garage door and the support beam to the side of the door. I tried contacting authorities here (NY) and no one could do a thing. She died a few weeks later but we are all lucky she did not take more people with her. She lived a selfish life and was not worried about potentially harming others.
My father has noted dementia, proven by tests showing the blood is no longer getting to his brain properly and by his behavior, yet he is still driving. Again, there is no place to report to and nothing can be done. He is 84 and no one can stop him. I fear for their neighbors and whoever is on the road in his path.
I do think doctors should report those who are a menace and the state should test them. If a dr knows of child abuse, they must report. If a psychiatrist or psychologist knows their patient is a threat to the safety of others, they must report them. I don't see how this is different. I'd sue like crazy if someone hurt someone I cared about and the doctor knew they should not drive. Eventually, doctors will get tired of being sued when people start winning. This case may not have been very cut and dried, but that does not mean the next one won't win. The public safety, including the elderly person's, is at stake.
Diana - Call DMV where you live at ask what the procedures are for having a license revoked. Here in Iowa, my Dad doctor could have sent a letter to DMV stating that he was no longer able to drive and a letter would have been sent to my Dad requesting that he come in and turn his license in and get just a State ID. Unfortuantely I ended up having to be the "bad" guy and just take the keys and car.
What is the role of family members in this matter? Are they too cowardly to confront the impaired older driver and try to get them to voluntarily give up driving? If they can put it on the doctor then they can wash their hands of the whole issue and feel no guilt for depriving him or her of some autonomy. Certainly doctors can and should discourage anyone who is impaired from driving, but to lay the responsibility solely on them and threaten lawsuits is a cop out.
Marc-CA - Basically a family members hands are tied. I am an only child, taking care of not only my children, but my elderly parents. In my case the situation could have turned bad had my Dad been having a bad episode the day he got lost for 2 hours. I ended up taking the keys and the car, but I did call his doctor, because I had asked her to please send a letter to DMV and she said it was just old age. My Dad would never have said anything and would have done what DMV said to do. It did not help that my Mother for some time covered for him at his appointments. I ended up keeping a detailed log of everything that was going on, but his missing episode came before the doctors appointment that I was to take him too.
In Iowa, a letter can be sent by the doctor to DMV stating that a license needs to be revoked. A letter is then sent to the driver to come in and turn in the license and get a state ID. Had I sent a letter all that would have happened was him being forced to take a drivers test (actual drivng, not written). Had he been having a lucid day, he would have passed and I right back to where I was. This is a catch 22 situation. Doctors need to listen to the family members when they are begging for help to keep not only their elderly parents safe, but the communities in which they live safe. I know had he caused an accident I'd be getting reamed to high heaven because I didn't do something, even though I was trying to do something with no support from his doctors or my Mother.
When doctors start sharing personal information with others without the persons permission, that is when people will stop trusting them.
If you are concerned about an older driver, call your DMV, tell them your concerns, they can arrange for that person to be re tested even if their not up for renewal.
Had you rather your older loved one tell the doctor they have been having chest pains or other health problems or keep their mouth shut and say I am fine because they fear who the doctor will share that information with?
doggiemom - The letter to send to Iowa DMV is a generic letter that states based on the doctors advice a license should be revoked. Nothng about the persons medical history is revealed.
In Idaho I was told that I HAD to have a letter from the doctor for the State to do anything. My opinion of Dad's driving wasn't enough.
I suspect it saves on Medicare and Social Security to permit them to continue to drive?
I have an even more fundamental question to ask.
When should they no longer be permitted to vote?
My Grandmother was never a stellar driver, but when my Grandfather died she took over the driving (mostly of me (grand-daughter) or her older friends without cars). When we lived in Brooklyn we never drove, but my we ended up in Vermont - not a great place for public transportation unless you live inside Burlington (we were just outside). When I was in my teens with a new license we travelled to her brother's house out of state. Grandma didn't know the area, had the beginning of macular degeneration, etc. She couldn't read the exit ramp signs, she drove onto the shoulder constantly - I finally had to ask her brother if I could do the driving of his Mercedes - he said, if there was one scratch I had to pay, I called other family to say, we can either fly home unharmed OR in body bags...my uncle said he would pay if I damaged the car. (I didn't). Grandma was 76 then, living independently. At 78 she moved to an apartment in a assisted living complex - she was healthy, so she only ate there, she didn't need a nurse etc...and she drove when she wanted.. at 85, she said her doctor recommended that she never was to drive at night. We were not told of the extent to which she could not see (she was literally legally blind) - she did not want to give up the independence of the car. One sunny day, she was driving through a construction zone of about 35ft. There was a giant, yellow Caterpillar piece of road equipment. Going under 5 miles per hour, Grandma managed to side-swipe the entire piece of equipment, leaving a bright yellow line down her car, she kept driving ...the road workers chased her down (she had no idea she hit the thing - she thought she was at least 5 ft away from it - that could be true, SHE was 5ft away, the car was hitting it. When all the air cleared over this, we realized that Grandma had gotten into - literally - about 15 accidents a YEAR for at least the last 5 years. Most of them where in parking lots, low speed - but her insurance had (years before) told her that they would not cover one more accident. So, when she got into one, she would trade names and ask if they would accept cash and not report the accident. She paid a lot of people!!!!! She saw her regular doctor, she saw her eye doctor - they all knew she was blind, but she insisted that because she knew the roads SO WELL and didn't go out at night or bad weather, she was a fine driver. We did find out about hitting the road construction behemoth, and had to take her keys away. My uncle gave her hundreds of dollars of taxi coupons - that she refused to use because she thought taxi's were a waste of money (although he already had paid - and she was well off) - so she used the handicap bus to get her hair done and complained about it until she passed away (totally blind the last 10 years)...
I loved my Grandma more than anyone in the world, but I would have been so upset if she had killed another person because of her vanity of insisting on driving when she couldn't even read a newspaper. Luckily, she never hurt anyone - but that was luck. I do think that her doctors should have informed her or the DMV that she could no longer drive. I think it's a HIPAA violation to tell the family - but if not, then the family is equally responsible in not letting a person who can't drive - drive.
Black Kettle - I am sorry you went through this, but family can only do so much. I called DMV here in Iowa when my Dad started to show signs of dementia (his sister died of complications from Alzheimers (sp)). I was advised by DMV to send a letter and they would have him do a driving test, but that I had to sign the letter because if sent anonyomously they would pitch it and he would be told who wrote the letter. I asked what if his doctor sends something, they said the doctor had the choice of 2 letters, one asking for a dirivng test and one asking that his license be revoked. I called his doctor immediately and was basically brushed off, "It's just old age." Well, Jun 16, 2012, my Dad got lost for over 2 hours going to a restaurant that is 5 minutes from his house. Cops were called to help find him, family that lived in Illinois also searched as we thought he might be having an episode thinking he needed to go to his sisters old house. He was found at the restaurant 2 hours later after pulling in asking if he was supposed to be there. When I arrived to collect him (cops there with me), I took all his keys and his car, after I took him home. I called his doctor that Monday and chewed her out for not helping when I needed the help. The only reason I was able to take the keys and car when I did, I knew my Dad would not cause a scene with the cops. It needs to be an effort by both the doctors and the family. The doctors need to listed to the concerns of family. I gave my journal that I kept on my Dad to his doctor and she apologized for not listening to me, she thought I was being paranoid. My Dad, God love him, WW II Vet, started his decline when he started arguing where food belonged, ice cream in the cabinets, cold cuts in the drawers and the best one, milk in the pantry!
My advice, keep detailed records. Also the book The 36-Hour day has helped a lot.
Rebecca - I sympathize so much with your experience. My Dad was in the military for 30 years and would watch old movies, sometimes war movies. Sometimes he would get mixed up in his head and creep around the house looking for the "enemy." I was afraid I would get shot in the middle of the night when I got up to go to the bathroom. The thing that amazed me the most was how his brain would make up stories without him knowing they were false memories.
I learned from looking after him for seven years that you pick your arguments. If he wants to say it's Thursday when it's really Wednesday, let him. If he insists he's never liked eggs when he's asked for them every day for four years, don't give him eggs. However, if he doesn't think he's supposed to take a certain medication prescribed by the doctor, then you convince him otherwise. It's a tough road to travel, looking after a parent with any kind of dementia. And yes, detailed records are a good idea.
@Marc
I'm not the best to ask as I have no relationship with my parents - however, I do know that both are terrible drivers, with bad hearts, have TOTALED cars in their own DRIVEWAY (no joke). I would not have a problem telling one or both that they shouldn't drive anymore BUT (and this I learned from what my Grandma had to say about the family member who finally took her keys)...parents are not very happy when their child takes on the responsibility of acting like they're the parent now. The parent is embarrassed, it usually has a verbal fight, it ends in years of resentment, etc....
I think an adult child taking away a parents keys should do so in a manner that preserves the dignity of the parent- and the parent - child relationship. Phrase it more like - "I know you are not a horrible driver, but as we get older our reflexes are not as good and the young kids on the roads are terrible drivers - it's not safe for you and we know that you would not want to hurt another person in a car accident, even if the accident was not your fault. Just give it a few days to think about, we love you." Something like that - you'll still get a fight, but I think it's a better way than pointing out all the parents driving faults and then demanding keys... it is a delicate situation, especially if the parent is not near public transportation (or they hate their child, in my case) :).
So many Americans think it's their god-given Constitutional right to live in burbclaves where there is no means of accessing goods and services other than by private car - not to mention the related attitude that it's outrageous to suggest an elderly American above a certain income level could or should walk anywhere, even to a bus stop. As my parents have gotten older and frailer, they have moved to progressively more remote condo or apartment complexes, motivated in large part by my mother's obsessive fear of crime. To put it bluntly, she doesn't want to live anyplace central enough to have a bus stop 'cause it would have minorities and poor people. (This is mental illness but not senility, as she's been this way for forty years.) My father no longer drives, and she's not getting any better at it - but if she ever stopped driving, they'd have no easy way of getting groceries or going to their (of course) doctor visits without placing a crushing burden on my sister who lives in the area. There is no commerce in their "neighborhood" and no public transportation. She is toying with the idea of moving to a retirement community, but one of her primary criteria is COVERED PARKING. Trying to pry the keys out of her fist when that becomes necessary will be an utter nightmare.
Jane - I wish you nothing but luck. My advice, keep a journal and keep in contact with her doctor. It is a nightmare trying to not only do what is best for your parents, but the public safety as well.
@Rebecca
Thank you for your kind words and you are correct - the family can only do so much. Grandma took the "elderly" driving class - I think it's in a parking lot, she passed (as far as I know) - she just didn't want to lose her car. Unfortunately, the way her keys were taken away from her, left her feeling betrayed by her own children - it could have been handled much better. I think you did everything you could do, the correct way.
PS - I'm a Rebecca also - and your food comment, LOL - I realize that it's not funny at all with Alzheimer's - but Grandma's fridge, two freezers and pantry could all be deemed a bio-hazard. She lived through the Depression and never threw anything out, when she lost her sight, she couldn't see the mold, etc.. and if anyone tried to "clean" out the fridge, she would get incensed! There was a way to do it, unfortunately, I think her daughter liked to push her buttons..., but Grandma would ask me if something she took out was OK to eat or not, and I gave her leeway, yes, one side of the tomato was growing a white mold, but, I would cut it out, and if the rest of the tomato smelled OK to me, we ate it... I miss her to death... so, I have to share one funny story about her - I don't want to leave this with "she was a horrible driver."
Grandma always dressed up, even for the grocery store. When she lived in her apartment in the assisted-living complex they had a fire alarm at 2am - it just so happened that the temperature was -10 WITHOUT the windchill. I lived many states away, but called her each day to read the local paper (online) to her, give her the weather report etc. She told me about the fire alarm, she said people were outside for almost two hours and I knew the horribly cold weather - so I asked her if she was OK. This is what she said: "Oh, I was fine, by the time I got out of the building, they were letting everyone back in." I was flummoxed - so I said, "What on earth took you so long?" She calmly replied: "Oh, Bec, you know there were people out there with no teeth in, no hair, no hair looking good, no make-up, I AM NOT GOING OUT (I think she meant it in both dying & going outside) THAT WAY!" That was my Grandma - mom, and she was awesome!
Black Kettle -
My Dad lived through the Great Depression (born 1923 and he is still kicking). We moved back home (my daughters and I) after I was laid off in 2008. Long story short, he asked me to go to the basement to get toilet paper. I went down there and it was a "goldmine" of toilet paper. I went back upstairs and asked, "Why do you y'all have so much toilet paper?" He looked me square in the eyes and without batting a lash replied, "I lived during the Great Depression and I will not wipe my a-- with a Sear and Roebuck catalog page ever again." I replied, "They don't make Sears and Roebuck catalogs anymore." I could even finish my thought!
Rebecca - I always feel lucky to be raised by my Grandma, she (and Grandpa when he was alive) taught me so much. Especially, to be kind to elders - family or strangers. Of course "A penny saved is a penny earned" & my still favorite saying "Cakes are DONE, people are FINISHED." I still can ask a question to my Grandma in my head and know what she would say to me - it was always, kind, yet honest advice. In my teens when I went through a "punk" fashion phase - with my hair - Grandma saw it and said: It's your hair, it's not my favorite cut." That was all she said, and it was said kindly, and because of that - I didn't want her to be disappointed by my hair, so I grew it back to the way she liked it - for her.
Oh my, even I remember the Sears and Roebuck catalogs (especially the Christmas editions) - you could knock someone out with those! Thanks for reminding me - :) Becka
Black Kettle - Dad now talks more and more of the past, WW II, The Great Depression, jumping friehgt trains to Wyoming to be a cowboy and his Dad's gas station, which I swear my Grandfather was a bootlegger! I wish I could get him to write these stories down, but he won't and when I try to sneak a recording device, he clams up!
About your Grandma going out "dressed", my Grandma was the same way. "Never know who you're gonna see." That's what she always said, or "You never knew who would show up at your door."
Rebecca - my Grandma had a habit of repeating stories x 30, it was her way of wanting to participate in a conversation - because she didn't have much to talk about except the food she ate or what I read to her in the newspaper. I let her tell the stories - some new ones would branch off and loved hearing them. She wasn't senile, her world just became much smaller when she couldn't drive and couldn't see at all - she also needed to wear her hearing aids - but vanity prevented that (she had them, but never used them). If she was in a crowed room you practically had to scream in her ear because of the background noise and her hearing loss. The older she got, the more she talked about her early days, my Grandpa, etc...those memories stuck much better than if I asked, "What did you have for dinner last night?" When she could write I asked her to write as well, but she didn't, I think she thought that it wasn't that important. Also, with the isolation of losing her sight, she was always telling me that she felt like she was losing her vocabulary because she couldn't read anymore...I know she was embarrassed by that, but she never sounded silly, I usually knew what word she would say, I only filled it in for her if she started to get frustrated about it while telling a story. About going out, Grandma would say, "You never get a second chance for a first impression."
I commend you for taking care of your parents, I know it can't always be easy or rather it's not easy at all but I think you have good karma!
I thought the state was responsible for licensing drivers. I don't think docs should snitch out patients. That will just discourage elderly patients from seeking care.
Jmcdtucson - Yes the state is responsible for licensing drivers.
You don't think doctors shouldn't snitch out patients?!?! Doctors have no trouble sending letters when someone has had a seziure. The letter to DMV is a generic letter from the doctor, no medical information is released. The doctor should be there to help the family when these decisions are being made. It can be a lot less stressfull (especially for an only child) if the doctor helps.
Seizures are a diagnosable medical condition, as are other ailments such as Alzheimer's, stroke, etc. These clearly fall within the purview of the doctor, and may require that the doctor recommend suspension or forfeiture of the driving privelege.
However, in many cases, only people (usually relatives) who are in daily or frequent contact with an elderly person who has occasional lapses of attention or lucidity are in a position to judge that person's risk factors behind the wheel. They should report these observations to the DMV.
Unfortunately, many, if not most, families have members who disagree with each other or don't get along. They may have hidden agenda that only they are aware of. Doctors know this happens and are not likely to seek revokation of a patient's driving priveleges based solely on what they report. Absent obvious symptoms or one of the diagnoses cited earlier, the practitioner is unlikely to take the drastic step of recommending that the patient's driving privelege be terminated.
Marc - it is soooo true that only people who are in frequent contact can see what's actually going on. My father went to the doctor one time and told him all about how he had gone fishing the day before. They talked about what flies he used and what he caught with each. The doctor believed him completely until I told him afterwards that Dad had actually snoozed in his recliner all day the day before and hadn't touched a fishing pole in years. Like I said earlier, the brains of people with dementia make up stories, false memories, and they believe they are totally true. That's a very difficult situation to deal with. Imagine someone telling you that you really didn't go to work yesterday -- or whatever you remember doing. You would call them a liar and resent them. This is what their brains do.