One of the central tenets of ethical behaviour, in providing care for the elderly, is offering them the opportunity to make as many decisions for themselves as possible.
In other words, the main goal of providing elder support is not to take away independence, but to offer ways to maintain as much independence as possible for as long as possible.
Yet, with all the best intentions to do so, providing the elderly with the right to make their own decisions is not always in their best interests or safe for others.
When young adults are surveyed about the most pivotal circumstance leading to their sense of independence, getting a driver’s license is almost universally at the top of the list. The ability to come and go as you please, particularly in the context of our North American culture and urban design, generally revolves around the use of a car, particularly outside of the larger cities with more sophisticated public transit.
Survey the elderly who depend on a car, and you’ll likely find that the prospect of losing that independence is as high on the list of fears as just about any other.
Yet, there is a confidence in driving ability that may not be justified and at some point, the combination of physical limitations, mental capacities and reaction time actually makes them a danger to themselves and others.
Everyone who has been in cars with them knows it, but there is no system in place to objectively determine driving ability. If there was, a lot of people of all ages might lose their license.
Instead, we depend on a regular medical exam of drivers over the age of 80 and a reporting system to the ministry of transport, by police or relatives, that could result in a required driver’s test.
As a rule, such reports are made after an accident where the driver’s capability to operate a vehicle safely under normal conditions is questioned. Sometimes, that’s simply too late.
Most of the time, family members know that an elderly relative with compromising health issues is a danger on the road, but the desire to encourage the driver to make his or her own decision, rather than initiate some kind of intervention that poses plenty of opportunity for conflict, delays the decision for much too long.
As for the doctor stepping in, that’s not likely to happen unless a specific health condition like a stroke or heart attack occurs, or vision reaches some level of legal blindness.
I went to the doctor’s office with my own father, when he was well past the point of being physically capable of driving, only to see her ask him if he felt he could still drive, accept his confident answer and sign the paper to renew his license.
Of course, since I was living with him he never sat behind the steering wheel again, but that was more a case of happenstance than good policies to protect public safety.
As the aging population increases, it’s my feeling this has the potential to become a much more common problem.
Rather than place relatives in the position of making subjective decisions, or non-decisions, perhaps the use of technology, in the form of simulators, should become part of the licensing process.
An aging driver would be required, annually, to pass a test in such a simulator that would determine if the reaction time and appropriate decision-making abilities reached a specific threshold to be considered safe on the roads.
As much as we all wish to maintain driving independence, there has to be a limit, and a process, to ensure that our desires do not pose a threat to the safety of others.
Graham Hookey writes about education, parenting and eldercare. Email him at ghookey@yahoo.com.