Dad is still driving after Mom died and I'm worried: how to think about it without taking his last freedom first

Dad is still driving after Mom died and I'm worried. Of course you are. She sat in the passenger seat for fifty years reading the signs out loud, and now the truck backs out of the driveway with nobody in that seat. Before you do anything, know the order of operations, because families get it backwards and lose a father's trust for a year. Rides first. Then the talk. Then, and only then, the state.

What actually changes with age, and what does not

The National Institute on Aging's page on safe driving for older adults is careful not to make age the problem. It says there is not one recommended age to quit driving. What it names are the things that change: stiff joints that make it harder to turn the head to look back, eyesight that struggles with glare and night, hearing that misses a siren, slower reflexes, and medicines that cause drowsiness or lightheadedness. Its advice on each is the same: talk with the doctor. It says a person 60 or older should get a dilated eye exam every one to two years, and that the doctor or pharmacist should be asked whether any health problem or medication makes it unsafe to drive. Both questions go on the list you are already taking to his appointment.

The signs the NIA says to watch for

If you cannot ride with him, the NIA lists what to look for from the outside: multiple crashes, near misses, or new dents or scrapes on the car; two or more tickets or warnings in the last two years; an insurance increase because of driving; comments from neighbours about erratic driving; anxiety about driving at night; problems with vision, hearing or movement; complaints about other drivers' speed and lane changes; and a doctor's recommendation to modify or stop driving. Walk around the truck next Sunday. Look at the bumpers. Then ride with him to the hardware store and say nothing. You will know more after one trip than after a month of worrying.

The talk, and how not to have it

The NIA has a section titled having the talk. It says giving up the keys means a loss of freedom of choice and movement for many older adults, who fear dependence and isolation. So: be prepared, and learn about local transportation before the conversation, not after. Avoid confrontation, and use "I" messages, saying "I am concerned about your safety when you are driving" rather than "you are no longer a safe driver." Discuss skills, not age. Offer to help him stay independent. Expect him to be defensive, and consider broaching it gradually.

Notice what is not in that list. No ultimatum, no hiding the keys, no siblings ganging up at Thanksgiving. If it has to be a fight, the NIA says nothing about winning it.

The evaluation, which takes it off the family

The most useful thing on the NIA page is the idea that somebody other than his daughter can judge his driving. It suggests having driving skills checked by a driving rehabilitation specialist, occupational therapist, or other trained professional, notes that the state motor vehicle office or the doctor can recommend someone, and warns there may be fees. For a proud man, "the doctor wants you to do a driving check" lands very differently from "your daughter thinks you should stop." Let a professional be the bad guy.

How Missouri's Driver Condition Report works

This is the last resort, and you should know exactly what it is before you need it. The Missouri Department of Revenue's page on reporting an unsafe driver says that immediate family members, along with physicians, nurses, law enforcement and certain other professionals, may submit a Driver Condition Report, Form 4319. The reporter's identity is kept confidential and not released except if required by a court. After a report, the director may require a physical examination, and where there has been a loss of mobility, a driving test to evaluate appropriate restrictions. Note the word restrictions: the process can end in a daytime-only or local-only license, not just a lost one. Use it only after the talk and the evaluation, and understand that even a confidential report will be guessed at over Sunday dinner.

The rides that keep him going to church and the VFW

The NIA says to have the alternatives ready before the talk, so here they are. It notes that religious and civic groups sometimes have volunteers who will drive you where you want to go, that some areas provide free or low-cost bus, rideshare and taxi services for older people, and that the local Area Agency on Aging can help find local services. For St. Louis County and its neighbours, that agency is Aging Ahead, which has provided services for adults 60 and older since 1973. The NIA's services page adds that public transit agencies often have discounted fares for older adults, and that grocery and drug stores will take orders and deliver.

In this metro, Metro Call-A-Ride is Metro Transit's paratransit service, with advance reservations for individuals with disabilities who qualify under the Americans with Disabilities Act; trips are booked at 314-982-1505, with reservation lines open every day including holidays from 7:30 a.m. to 5:00 p.m. Whether he qualifies is Metro's determination, not ours. And the ride that solves the most is the one that comes with a person: a helper who drives him to the pharmacy, the barber, and the VFW on Thursday. The NIA's page on loneliness lists lack of transportation among the risk factors for isolation. The point of the ride is that he still goes.

Questions daughters ask

Is there an age when Dad has to stop driving?

No. The NIA says there is not one recommended age to quit, and it lists changes in vision, hearing, movement and medication rather than birthdays. The question is his skills, which the NIA says to discuss instead of his age, and which a driving rehabilitation specialist can measure so the family does not have to.

Can I report my father to the state without him knowing?

Missouri's Department of Revenue says an immediate family member may submit a Driver Condition Report, Form 4319, and that the reporter's identity is kept confidential unless a court requires it. The state may then require a physical exam or a driving test. Confidential is not the same as invisible in a family of five, and the NIA's approach is the talk and the evaluation first. Read the state's page before you decide.

Who drives him if he stops?

Whoever's name is on the card for that trip. Church rides often come from church. Aging Ahead can point to local services, Metro Call-A-Ride serves riders who qualify under the ADA, the pharmacy and grocery can deliver, and a paid helper who drives turns the errand back into an outing. Solve the five weekly trips first and the talk gets much shorter.