Several years ago while driving home from teaching a nigh class, I was suddenly aware that I was steering my car cross eight lanes of oncoming traffic! I was following the white line, but the white line I was following was used to direct traffic when they were adding lanes to the tollbooths about six months before this incident! That was enough to scare me. I voluntarily stop driving the next day.

For many people, like me, who wake up each morning and arm wrestle with Dr. Alzheimer until they fall asleep that evening, giving up driving is the most difficult decision for them and their caregivers to make and/or accept. What I did not realize when I gave up driving, was the loss of my personal freedom to come and go as I pleased was the giant root below the surface supporting my original resistance to give up driving.

I know, I know people my age are supposed to be in love with cars. The auto industry conditioned us in the early 50s, and each year it reinforces our passions for our cars with daily doses of Viagra for automobiles in the form of advertisements. Honest, I did not love my car. I was unaware of any psycho – social – sexual response on my part when I slid behind the wheel of my eight-year-old minivan.

The struggle over what to do about dad or mom’s driving usually begins when there has been an accident or a near-miss, or even worse yet several accidents and near-misses. I know of one caregiver who simply step refused to drive as a passenger in the car and she participated in several near-misses. Others reason, plead; construct horrific “what if you run into a school bus filled with nuns, babies, and your grand-children” scenarios; and/or threaten the intervention of physicians, state and local police officers, and sometimes even God herself if their loved ones do not surrender their car keys, right now.

Usually the first attempt to resolve this issue to the satisfaction of caregivers ends in failure. Everyone leaves the room more upset with me than when they entered it. Some of us, people living with one of the diseases of dementia – especially Alzheimer’s, are honestly unaware of a problem, and are perplexed. Understandably, we b

ecome quite defensive when the entire family attacks us by trying to take our car keys away from us. This was probably not the first time these family meetings have turned on them. What about the family meeting struggle to get us to say aloud “I have Alzheimer’s disease.” “What about the time they wanted me to change my clothes because they didn’t like the way I was dressed?”

For others, this meeting is the culmination of on-going verbal attacks about our driving. “Every time I make the slightest little miscue driving everyone in the family points it out to me, and here comes that bus load of nuns, babies, and my grandchildren. What about all their previous accidents? They are all still driving, and no one seems to care one way or the other.”

Some of us have discovered it is in our best interests to pretend we don’t know what they are talking about, or create some explanation as to how it happened and hope all will also accept it as a valid excuse.

All these defenses are constructed because we are being attacked. Attacked by our own family members! “I’m not really sure why I am so opposed to doing what they want me to do, but I do know I am strongly against it. Why do people keep accusing me of acting as if I am paranoid? I’ll tell you. I am defensive, not paranoid, because you keep attacking me!”

For many of us we sometimes, or always, lack the concentration to generate insights on ourselves, our behaviors, and the consequences of our behaviors. Do we have to admit this to a whole room full of people? Do we have to figure this out for ourselves? We are the ones with the altered thought processes. “Why don’t you figure this out for yourself and adjust the ways to act towards me? Instead, you again want me to act and think as I did, like you, like your want me to. When will you ever get over this futile strategy, this continually failing goal of yours?”

“If I can think like you now, if I can generate insights like this now, why don’t I just go ahead and do this 24-7? Because I can’t! Please get it! I am personally now in a sort of twilight zone where I jump back and forth between my past and my future. It’s even harder for me to deal with because I am not aware of where I am at any given moment. Increasingly when people point out to me after the fact where I was, I still can’t figure it out.”

But………..as usual……….I digress

Back to “if you keep driving one or more of us, including you, will probably go directly to hell.” “Oh?! I just can’t for the life of me grasp why you are so worked up about this. I’ve been driving since “I like Ike” and no one ever brought up what a bad driver I was or might be.”

I’m sure many of these conversations have been repeated by many of the readers of this piece. I heard them, I read them. I know them. The solution does not lie in winning the argument(s). The Beatles were right, “there is nothing to be said that hasn’t been said” before (or something close to that). In fact, for families who have waited until “we cross that bridge,” the “you must stop driving now” bridge, there is no answer. There is however, a better process than what is currently being recommended. I am no longer sure “ganging up” with the whole family in the room is the best strategy. It may be for the family because they can support and reinforce each other, but it sure isn’t for me, nor I suspect others living with the disease. Yes, it’s intimidating to me, but that cues my defensiveness. Yes, it is overwhelming to me as I must turn and beg family members to please support me. In the long run, does this enable me to be all I can be, or is it another nail supporting the disable efforts? Does this reinforce my own sense of wholeness, self-esteem, wellness, dignity, etc., etc.? Of course Not! When will carers and healthcare professionals get it? Might does not make right, never ever in my mind. Over time your efforts to use “might” erodes my ability and my willingness to resist you. It reinforces an “I – it” view of me vs. the world. It reinforces my belief you and the rest of the world see me as an “it.” After all, you are the ones telling me how hard this is on you, and how much you have given up.

The issue of driving needs to be addressed early on in the disease process. We all need to be pre-prepared for it. We all need to agree, at least then, what/who/when/where/how, we will all determine it is time for me to stop driving. You-all need to keep remind me, lest I forget. You-all need to keep reminding me of the arrangements we have made to diminish my freedom to go when and where I want. You-all need to assemble the members of the church, neighbors, friends, volunteers who will dissolve my fears of being stuck here by diving for me. They all need to learn how to drive for me, and not drive me. Offer to try it one day a week for three weeks to see if it works. Do it now, while I don’t see it as a real threat. Go along with me to places we usually go together. Let me go by myself to places I usually go to alone. We can deal with the secret police issues latter on when I need them. Build my confidence there will be little change in my life style when I park the old mini-van for the last time. And please do it one-on-one. Don’t jump me with the gang of seven. Don’t leave it all to Mom or Dad to drop the hammer.

So far, I have suggested this to seventeen families. It has avoided the struggle in fifteen of them. Those are certainly better odds of success than the current methods produce!

Now what of those who are too far into the disease process whereby this approach can’t be used? Those sitting in the front rooms now, surrounded by uncomfortable family members. Everyone up and out of the front room. We first need to try this one-on-one, and everyone needs to participate over a couple of week period. Get your story straight with each. Get the support network together while the conversations are taking place. Offer to try it out to see if it works.

Use the “there is strength in numbers” approach as a last resort not as a first preferred course of action. Don’t threaten in hopes of scaring me, and not be able to follow through. Don’t just be firm and not offer some solution for which you will take responsibility. This isn’t all about me, at least in my mind it isn’t. It’s about what you want, not what I want.

Best would be to not wait until the car is in the shop being repaired from the accident. If you need physical proof to justify imposing every constraint you are going to have to impose on me, we are both in trouble.

Perhaps this is not “the best” way to engage this issue, but from my perspective it sure beats the coins of the realms that are currently in vogue. Waiting to cross this bridge when you come to it is definitely not the right road to start out on. Early on, early stage, everyone creating a family road map seems to be a better answer.

~Richard