The Key to Talking About Keys: Insights for Having "the Driving Conversation" with Aging Parents

The Sacred
by Stephen Dunn

After the teacher asked if anyone has
     a sacred place
and the students fidgeted and shrank
 

in their chairs, the most serious of them all
     
said it was his car,
being in it alone, his tape deck playing
 

things he’d chosen, and others knew the truth
     
had been spoken
and began speaking about their rooms,
 

their hiding places, but the cars kept coming up,
     
the car in motion,
music filling it, and sometimes one other person
 

who understood the bright altar of the dashboard
     
and how far away
a car could take him from the need
 

to speak, or to answer, the key
     
in having a key
and putting it in, and going.

“The Sacred” by Stephen Dunn, From Good Poems: American Places Selected and Introduced by Garrison Keillor. Viking Press, 2011.

April is National Poetry Month and sometimes it takes a poem, like this one by Stephen Dunn, to help us remember what is at stake in having the driving conversation with aging adults. It illustrates the psychological sway driving has over and above the logistics of our everyday needs. It is a touchstone of adulthood, autonomy, and freedom of choice. When an aging loved one is approaching a time when they are no longer able to safely drive, the topic can sit in the room like the proverbial elephant that no one is acknowledging.  In fact, 36% percent of adult children polled by the website Caring.com and the National Safety Council said that talking to their parents about the need to stop driving would be harder than discussing funeral plans (29%) or selling the family home (18%).The conversation can be difficult to broach in the first place and sometimes it’s even more challenging to remain in the dialogue over time.

As one adult daughter recounted, “After Dad’s stoke, he wasn’t physically able to drive and it wasn’t an issue, but as he started to recover it was difficult to get him to recognize that driving again was too risky. He could have another stroke at any time. He reluctantly agreed to hang up his keys knowing we would be there to support him and take him wherever he wanted to go. I remember the day that I found out he had driven to the store without telling anyone. I was so angry and felt like I couldn’t trust him anymore. I also understood that he didn’t want to be a burden to us. He just wanted to grab his keys and go, like we all take for granted every day.”

Having the courage to start conversations that matter is easier said than done, especially when there are relational dynamics at stake. Here are 5 insights for adult children having the driving conversation with aging parents 

TIP 1: Honor Others' Choices

Our choices are often the largest source of dignity, freedom, and power we have as adults. The car is a huge symbol of choice. We choose what type of car we drive, what music to play, where we want to go and when and the route we take to get there.  As we age, we can experience a series of losses that seem to constrict our choices. When we can no longer live in the family home, go where we want to go, do activities we used to enjoy, or see far-away friends, the question becomes: whose life are we living? No longer driving can feel like one of those deep losses along the way. When we acknowledge these dynamics we can frame the conversation as a choice of “this” instead of “that”.  Rather than saying “no” to driving, look for alternatives to say “yes” to, that support the life your loved one wants to live.

TIP 2: Share Your Honest Feelings Responsibly

When all of your sentences begin with “you”, it can often feel like a pointed attack in the conversation. “You just don’t see well”; “You shouldn’t be driving if you get that lost”; “You didn’t even know how you dented the bumper.” To see Newton’s third law in action, you will get an equal and opposite reaction to this directed language. When expressing your observations in conversation, start with yourself and illustrate the impact they have on you. For example, “I feel responsible to help you be safe and I experience a lot of fear around this topic of driving.” “I want you to feel freedom to live how you want mom, but I also feel like this diagnosis is going to make us get creative about how we do things from now on.”

 It may seem obvious, but the best way to engage an aging adult in conversation is as an adult. We often hear the line, “I’ll take the keys away” in two instances: when we are grounding our teenagers and when we are worried about aging parents. This statement is a threat to take something away and assumes a position of authority, which might be appropriate for a young driver, but isn’t an effective strategy with aging parents. Go ahead, try it. The key to having an effective conversation about keys is to not let your fear do the driving.    

TIP 3: Protect the Solitude and Space of Your Aging Loved One

When we can no longer drive, the private life and the communal life become more blended. Sometimes you need to get out of the house, you need to run an errand, or you need to be alone. When you depend on someone else to relieve your cabin fever, take you to the bookstore, or spend a lazy afternoon in the park, it can be difficult to be alone in the ways we need. In one of the most powerful scenes in the film, The Intoucbales, the caregiver comes in the middle of the night because his quadriplegic client and friend is deeply distressed. The caregiver instinctively takes him for a ride through the city in his favorite sports car he can no longer drive himself. You see the client with the seat leaned back and the window rolled down and you can almost feel the relief as the fresh air pours through the window and no words are spoken between them. As the poet Rainer Maria Rilke reminds us, “I hold this to be the highest task for a bond between two people: that each protects the solitude of the other.” When you, as the adult child, are offering to provide transportation as an alternative, ask candid questions not just about what your loved one needs to do, but what they want to do and how you can protect their space.  

TIP 4: Pay Compassionate Attention While Keeping an Open Mind  

Determining if someone is a safe driver takes a complex and compassionate act of paying attention. There are 40 year-olds that are terrible drivers and 80 year-olds that are attentive and safe. The truth is that when we are driving, a web of internal factors is interacting with a web of external factors. Age, medication side-effects, fatigue, physical ability, vision, health, stress,  are all interacting with pedestrians, city development, other drivers, weather conditions, the handling of the car, etc.

Knowing when there is a one-off situation and when it’s time to have the driving conversation is a delicate operation. Have it too early and we can strain a loved one’s freedom and trust; have it too late and we can risk their safety and the safety of others. It’s important to remember as an adult child that you are not ultimately responsible for the outcome and circumstances, though it can feel like it. The best that you can do is pay attention, look for patterns, ask generous questions, keep an open mind, and to start an honest and nuanced conversation.  Periodically ride with your loved one and stay attuned to changes in their driving patterns. Here are a few things to look for:

  • New dents or scrapes in the car
  • Increase in traffic or parking tickets
  • Decreased reaction time
  • Pain when checking their blind spot
  • Lack of awareness of others around them
  • Lack of focus when multi-tasking in the car
  • Increased frustration on the road
  • Dizziness or changes in gait
  • Changes in navigation or getting lost
  • Irregular changes in speed
  • Difficulty making decisions and adapting to circumstances  
  • Avoiding driving at night

TIP 5: Start Early and Call in Reinforcements

One of the most effective ways to have the driving conversation is to start talking long before it is critical so the aging adult can be part of the conversation. Coming with a solution-focused mindset also opens up dialogue rather than shutting it down. April is Occupational Therapy month, and it is helpful to remember that for some aging drivers, occupational therapy can help them become better drivers and maintain their independence longer. Occupational Therapists are also qualified to provide an unbiased evaluation of driving skills and make recommendations. According to Ashley Opp, production editor for The American Occupational Therapy Association, “Older drivers typically enter an occupational therapy driving evaluation clinic with a fair amount of anxiety. Although this is understandable, older drivers should understand that occupational therapy practitioners excel at helping people do the things they want to do- such as driving.”(full article of  Behind the Wheel: Occupational Therapy and Older Drivers)

 

 

Published on March 30, 2015.