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There's help for the dreaded 'too old to drive' moment

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Kathleen Kiefer, an occupational therapist with HealthPartners.
Kathleen Kiefer, an occupational therapist with HealthPartners, shows one of the driving simulators used in the clinic’s Driving Ability Program on Tuesday. The program helps people dealing with a variety of health issues assess their driving ability.
Peter Cox | MPR News

It’s not clear whether age played a role in the recent bus stop crash of a van with an 83-year-old man behind the wheel. But advancing age can erode driving skills, and there comes a time when it’s no longer safe to drive. Coming to terms with that moment can inspire dread all around.

Elizabeth Andress' father was diagnosed with early stage dementia in 1992. He was 71.

He was still capable of doing most things and continued to drive, limiting himself to nearby drives and day driving. Then he had a couple of close calls and called a family meeting.

"My dad pulled the car keys out of his pocket and placed them on the coffee table and announced he was done driving and then he just cried," she said.

Andress said it was emotional for the entire family.

"Of course, for him it was an admission of the cognitive losses that come with dementia,” she said. “And then it was the loss of so much freedom in our car-dependent culture and also one more loss of roles that he could take in the family to be helpful."

As we age, our reactions slow, our vision and hearing can worsen — at a certain point, driving is no longer safe.

How people reach those decisions varies. Some, like Andress’ father, make the decision themselves. In some cases, family members or friends convince a person to turn over the car keys. Families can ask Minnesota Driver and Vehicle Services to test someone. Doctors can recommend cancelling a license. There are also programs that help people to assess their driving ability.

At the HealthPartners Rehabilitation-Neuroscience Center, occupational therapist Kathleen Kiefer stood in front of a black screen hitting buttons in front of her when they lit up, and watched a screen that showed a number every few seconds. The system approximates the multitasking demands of driving

"We know when we drive, we have more than a need to take a look at numbers and lights,” she said. “We have many things to look at — our speed, where we are in the lane."

There are a series of tests like this and actual on-the-road tests, which help Kiefer and her colleagues determine if someone should stop or limit their driving.

Kiefer works in HealthPartners’ Driving Ability Program.

Her job means she’s often playing the heavy, telling someone it’s time to quit driving.

"Driving retirement is not easy,” she said.

Physicians often refer people to the program. But family members refer loved ones, too.

"Oftentimes family members want somebody else to be the bad guy,” Kiefer said. “They want to maintain the respect and their loving relationship with their father or mother or whoever it is."

Kathleen Kiefer, an occupational therapist with Health Partners.
Kathleen Kiefer, an occupational therapist with HealthPartners, sits in the vehicle the Driving Ability Program uses to do behind-the-wheel training and assessments on Tuesday.
Peter Cox | MPR News

Kiefer said there are times when a family member thinks it is time to for a relative to stop driving, and the HealthPartners assessment finds them to be a fine driver.

There isn't a single age when everyone should stop driving. Kiefer said there are clues, though, such as troubles with routine tasks.

"Money management, paying their bills, taking their medication — just managing their life. They're not tracking appointments, they're not as organized, they're not taking care of their personal self as they used to,” Kiefer said. “Another big concern is when they start to have accidents or near-misses, or they start to get lost when they are driving to familiar places that they've been to before."

Elizabeth Andress' mother, Shelby Andress, said her husband’s and friends’ experiences made her vigilant about her driving ability. She’s 86 and still driving — but not far, not at night and not on freeways.

"Two years ago I was entering Interstate 94 on a ramp off Hennepin, and I've driven that, I think, hundreds of times. And all of the sudden, I was unnerved by the speed and the cars moving in and out of lanes. And I thought I can't do this again," she said.

Andress has passed a driving ability course, but she's also turning, more and more, to alternatives like her family, Uber and mobility nonprofits. She’s had to give up a bit of her cherished independence, and it has increased her dependence on her family, but she said preparing for the transition has made it easier.