For many older adults, driving is the key to maintaining independence, self-sufficiency, and, for some, even their identity.

But what happens when age, illness, or injury makes it difficult or unsafe to drive? When do you know it’s time to give up the keys — and how do you deal with that loss of freedom?

“Don’t wait for an accident to happen before having a conversation with a family member or friend,” advises Richard Nead, CDRS, manager of driver rehabilitation at Kessler Institute for Rehabilitation ( in West Orange, New Jersey.

“Be aware of the warning signs — such as slowed reaction time, memory issues, vision difficulties, or physical challenges, as well an increase in traffic violations or dents and scratches to the car.”

Although it can be a difficult decision, it is a necessary one. The risk of being injured or killed in a motor vehicle accident — or causing harm to others — increases with age.

The National Highway Traffic Safety Administration reports, for example, that in 2015 drivers aged 65 and older accounted for 18 percent of all motor vehicle fatalities.

According to neuropsychologist Kelly A. Kearns, Psy.D., Kessler Institute for Rehabilitation, having to give up the keys affects more than just an individual’s sense of independence.

It can lead to isolation and depression and place a strain on family members who not only must have this discussion with their loved one, but now may also find themselves in the position of providing rides to the market, doctor appointments, and other activities.

A range of issues may contribute to a person’s inability to drive, including skills that may decline with age or conditions that develop over time, including:


• Cognition – Memory, reasoning, judgment, problem-solving, decision-making

• Vision – Acuity, peripheral vision, and attention, as well as cataracts, macular degeneration, glaucoma

• Physical skills – Strength, reflexes, neuromuscular control

• Medical conditions – Arthritis, pain, dementia, and heart disease, as well as medications


“Watching for the ‘stop’ signs is the first step,” says Nead. “It’s also important to be ready to discuss this potentially difficult issue and to have a plan in place to address how to best meet transportation needs going forward.”

Kessler Institute offers the following tips:


• Ride along with your family member and observe his or her ability to control the vehicle, stay within the lane, drive at posted speeds, maintain a safe distance from other cars, obey traffic signals, make appropriate decisions when turning or at intersections, and park the car.

• Look for any confusion, poor judgment, or indications that he or she is not focused, including getting lost, braking/accelerating for no apparent reason, or forgetting where the car is parked.

• Consult with a physician who can help identify any medical issues and support the decision to continue driving or not.

• If driving remains an option, consider having the individual enroll in a course to brush up on road rules and defensive-driving techniques, or consult with a driving rehabilitation specialist, who can perform complete evaluations both on and off the road to help maintain safe driving practices.

• If it’s no longer safe to drive, be prepared for a frank but often emotional discussion. “Anger and sadness are often associated with the loss of driving, so let the individual express his or her thoughts, acknowledge their feelings, and respond with compassion,” suggests Kearns.

• Explore transportation options. From community transport and senior resources to Uber, Lyft, and other car services, there are many alternatives available.

• Create an “advanced directive for driving,” which designates a trusted individual to assist if the older driver is no longer able to drive safely.


“Although it may take some time,” notes Kearns, “helping a family member understand the need to be safe and supporting them with alternative transportation options can help them adjust to life without driving.”

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