How to Know When It's Time to Stop Driving: A Guide for Seniors and Their Families

Written By Nicole Ravlin

Driving represents independence and freedom for many older adults. However, there comes a time when safety concerns may outweigh the benefits of continuing to drive. This guide is designed to help older adults and their families navigate the challenging decision of when it might be time to stop driving.

Our goal is to provide a comprehensive resource that:

  1. Helps identify signs that driving ability may be declining

  2. Offers guidance on how to approach this sensitive topic with loved ones

  3. Provides information on alternative transportation options

  4. Explains how to involve healthcare professionals in the decision-making process

  5. Outlines available support systems, including Medicare and Medicaid resources

This guide is not meant to make the decision for you, but rather to equip you with the knowledge and tools to make an informed choice that prioritizes safety while respecting the dignity and independence of older adults.

Remember, every situation is unique. Use this guide as a starting point for open, honest, and compassionate conversations about older adult driving safety.

Monitoring Driving Skills 

  • Vision changes including difficulty with eyes adjusting at night, glare recovery difficulty, difficulty seeing road signs or other objects, and difficulty seeing in low light or with glare recovery

  • Hearing impairment affecting ability to notice horns, sirens, or vehicle noises

  • Slower reaction times

  • Difficulty with neck rotation or body flexibility

  • Confusion at exits, with any changes in the roads, or when navigating familiar routes

  • Increased irritation or anxiety while driving

  • Multiple traffic tickets or warnings from law enforcement

  • Minor fender benders or near-misses, hitting the curb more frequently, new dents or scratches on the vehicle

  • Difficulty staying in the lane or difficulty parking correctly

  • Getting lost more frequently, even in familiar areas

Who Can Assist in Making the Decision

How to Support Your Loved One Who No Longer Drives

Although they may no longer be able to drive themselves, it is important that your loved one be able to continue being active in their community and engage in the activities that give them meaning and fulfillment. 

  • Research and arrange alternative transportation options (public transit, ride-sharing services, community shuttles).

  • Help set up grocery or meal delivery services.

  • Organize a schedule of family members and friends to assist with transportation.

  • Look into older adult living communities with built-in transportation services.

  • Explore additional social activities that don't require driving.

  • Discuss the financial benefits of not owning a car (insurance, maintenance, fuel savings).

  • Emphasize the positive aspects of not driving (less stress, more relaxation time).

  • Help them maintain their independence in other areas of life.

Remember: This decision should be approached with empathy and understanding. The goal is to ensure safety while preserving dignity and independence as much as possible.

Starting the Conversation

Initiating a discussion about driving cessation can be challenging. Here are some strategies to approach this sensitive topic:

  1. Choose the Right Time and Place

    • Select a quiet, private location where everyone feels comfortable

    • Choose a time when everyone is calm and not rushed

    • Avoid having the conversation immediately after a driving incident, which might make your loved one defensive

  2. Use "I" Statements and Express Concern

    • Start with: "I'm concerned about your safety when you're driving."

    • Avoid accusatory language like "You're not a good driver anymore."

  3. Listen Actively and Empathize

    • Allow your loved one to express their feelings and concerns

    • Acknowledge the emotional impact: "I understand this is difficult to talk about."

  4. Focus on Health and Safety, Not Age

    • Discuss specific health concerns that might affect driving ability.

    • Avoid generalizations about age and driving.

  5. Offer Alternatives and Solutions

    • Come prepared with information about alternative transportation methods.

    • Discuss how family members can help with transportation needs.

    • Discuss options for restricting driving to local, familiar roads and avoiding driving at night.

    • If appropriate, establish a plan with indications for their future driver retirement.

  6. Suggest a Professional Evaluation

    • Propose a driving assessment by a driver rehabilitation specialist or the DMV/BMV.

    • Frame it as a way to get an objective opinion on their abilities and/or whether there are any adaptations or modifications that could help them continue to drive safely.

  7. Involve Others If Necessary

    • Consider including a respected family friend or the older adult's medical provider in the conversation.

    • Suggest attending a support group for older adults transitioning away from driving.

  8. Be Patient and Persistent

    • Understand that this may require multiple conversations.

    • Be prepared to revisit the topic as needed.

  9. Lead by Example

    • Discuss your own plans for eventually stopping driving.

    • Share stories of others who have successfully transitioned away from driving.


Other Information to Note

Medicare and Medicaid can offer some assistance with transportation, which can be helpful when transitioning away from driving. Here's what you should know:

Medicare

  1. Medical Transportation

    • Medicare Part B covers ambulance services to and from hospitals or skilled nursing facilities when other transportation could endanger your health.

    • This is typically for emergency situations, not routine transportation.

  2. Medicare Advantage Plans

    • Some Medicare Advantage (Part C) plans may offer additional transportation benefits.

    • Check with their specific plan to see if they cover rides to medical appointments or pharmacies.

  3. Programs of All-Inclusive Care for the Elderly (PACE)

    • For those who qualify, PACE provides all Medicare and Medicaid covered care and services, including transportation to medical appointments.

Medicaid

  1. Non-Emergency Medical Transportation (NEMT)

    • Medicaid is required to provide NEMT for eligible individuals to and from medical providers.

    • This can include trips to medical provider's offices, hospitals, or pharmacies.

  2. Home and Community-Based Services (HCBS) Waivers

    • Some states offer HCBS waivers that may include transportation services.

    • These waivers can sometimes cover non-medical trips, like grocery shopping or social activities.

  3. Dual Eligible Special Needs Plans (D-SNPs)

    • For those eligible for both Medicare and Medicaid, some D-SNPs offer additional transportation benefits.

Steps to Take

  1. Contact your State Medicaid Agency to learn about available transportation services.

  2. If you have a Medicare Advantage plan, check your plan documents or call your plan provider to ask about transportation benefits.

  3. Look into PACE programs in your area if you need comprehensive care and services.

  4. If you're dual-eligible (qualify for both Medicare and Medicaid), explore D-SNP options in your area.

  5. Consider working with a social worker or case manager who can help navigate these benefits.

Remember: Benefits can vary by state and individual plan. Always verify coverage and eligibility for specific services.


Taking A Deeper Dive: Additional Resources

The information in this guide has been compiled from various reputable sources. While much of it is general knowledge in the field of elder care, specific data and guidelines often come from organizations specializing in older adult health and transportation safety. Here are some key sources you may want to cite or explore further:

  1. AARP (American Association of Retired Persons)

  2. National Highway Traffic Safety Administration (NHTSA)

  3. HealthinAging.org

  4. The Association for Driver Rehabilitation Specialists (ADED)

  5. Centers for Medicare & Medicaid Services (CMS)

  6. National Institute on Aging (NIA)

  7. American Automobile Association (AAA) Senior Driving

    • Offers resources and tools for older adult drivers and their families

    • Website: https://exchange.aaa.com/safety/senior-driver-safety-mobility/

  8. The Hartford Center for Mature Market Excellence

  9. Alzheimer's Association


This information is researched, shared and updated by CareForTom.org. 

Appreciation to ADED: The Association for Driver Rehabilitation Specialists for fact-checking this resource.

Last Update: October, 2024

©2024 Care For Tom Foundation and CareForTom.org

Nicole Ravlin
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