Category Archives for Healthcare

When its Time to Take Away Mom and Dad’s Car Keys

Published in Pawtucket Times, April 12, 2013

On May 2, 2003, Rhode Island State Rep. Mabel Anderson was looking to buy her husband George a surprise birthday present from one of his favorite stores, Home Depot. As she was walking and pushing a shopping carriage near the front entrance of the huge box store located in the Bristol Place Shopping Center in South Attleboro, Massachusetts, an 86-year old driver getting ready to exit his parking space, accidently shifted his vehicle into ‘reverse’ rather than ‘drive,’ stepped on the gas peddle. This jolted the vehicle in the wrong direction, running over Anderson. She was transported to the nearby hospital, where hours later, she would be pronounced dead. Anderson’s tragic death almost a decade ago continues to be played out today in communities across the nation.

Aging baby boomers, coping with a decline in their driving skills because of the aging process, keep driving well into their twilight years, when for safety’s sake, they should just retire the keys.

Driving Skills Decline in Later Years

According to the National Highway Safety Administration, in 2010, older individuals made up 17 percent of all traffic accidents and 8 percent of all people injured in crashes during that year. Compared to 2009, fatalities among this age group increased by 3 percent, 1 percent for these older persons being injured.

Meanwhile, John Paul, Manager of Public Affairs and Traffic Safety at AAA Southern New England, details research findings indicating that driving can be dangerous in your very later years. The report released by Carnegie Mellon University in Pittsburgh and the AAA Foundation for Traffic Safety, found the rate of deaths involving drivers 75 to 84 “is about three per million miles driven – on par with teen drivers,” says Paul. But, once they pass age 85, vehicular fatality rates jump to nearly four times that of teens, he says.

Older motorists lose their ability to drive when the aging process kicks in. For these individuals, driving skills lessen because of poor vision caused by cataracts, glaucoma and macular degeneration, compounded with poor hearing, lack of flexibility, limited range of motion and reduced reaction time make the complex tasks associated with driving more difficult. Oncoming cognitive impairments, such as Alzheimer’s Disease and dementias, can also impact one’s ability to drive safely.

As older driver fatalities increase and the death toll tied to older-driver accidents skyrocket, a growing number of states are looking at licensing restrictions as a way to delicately approach this complicated issue.

Like many aging advocates, Gerry Levesque, AARP’s State Coordinator for Driver Safety Program, states that not all seniors are equally affected as they age. “One may lose the necessary skills needed to drive safely at age 60, while another will not lose those skills until 90”, states the 66-year-old Coventry resident.

“For older adults, losing driving privileges can be translated as a loss of independence,” notes Levesque. If this occurs, family or public transportation may not be available to replace the lack of transportation. “Older people may feel stranded or abandoned when they give up their keys,” says Levesque, noting that driving allows an older adult to pick up their prescriptions, shop for groceries or get out to socialize at the bridge club, bingo parlor or simply to be with family and friends.

“One thing that seniors have that the younger generation does not is a lifetime of driving. While they are losing physical abilities, they do have a wealth of experience from their years of driving,” adds Levesque.

Coping with an Aging Population that Drives

Over the years, states have grappled with the age-charged issue of restricting licenses of seniors not wishing to stir up their wrath. Aging advocates oppose any “blanket” solution to this problem that calls for licensing restrictions, rather it be made on a case-by-case basis. They say age should not be used as a “predictor” of unsafe driving.

In Rhode Island, the Division of Motor Vehicles (DMV) prorates its license renewal cycle for person’s age 71 and older. If you are 75 years of age or older, you license will be valid for two years. At license renewal time, the older person is required to pass a vision test or provide a valid medical examination certificate. A person’s physical or mental fitness to operate a motor vehicle is reviewed by DMV’s Medical Advisory Board whenever a case is brought to its attention by law enforcement, a physician or a family member.

With a growing aging population, Rhode Island’s Department of Transportation (RIDOT) has moved to tackle senior driving issues head-on. Two years ago, this state agency began to install a series of reflective markers or “roadside delineators” installed on the sides of roads as well as mounted on small posts and on top of concrete barriers. Especially geared for older drivers, these improvements were made to assist in making night-time driving easier and safer, while also aided driving during adverse weather

In addition to these improvements, RIDOT has installed cable guard rails along narrow medians on the Interstate where none previously existed. This safety feature significantly reduces the occurrence of head-on impacts with opposing traffic. State transportation officials have also made improvements to rural roads, by adding rumble strips, signing and roadside reflectors to help reduce road departure crashes.

Sharpening Your Driving Skills

AARP along with the AAA Southern New England recognized the thorny issues surrounding restrictive licensing and have developed special training courses to help older motorists freshen their skills to help them drive more safety, thus reducing the their risk of having their licenses revoked by state authorities.

AAA’s Senior Defense Driving Program (www.seniordriving.aaa.com) provides information about the aging process and its impact on a person’s ability to drive. The program gives tips on how a person can compensate for these changes and drive safer for a longer period of time. Additionally, a self-administered program, called “Roadwise Review” provides confidential and instant feedback on performance in key areas, allowing individuals to see how changing visual, mental and physical conditions do impact driving. In addition, the Auto Club’s “Roadwise RX” allows older drivers to look at the interaction between medications and driving.

AARP’s Safe Driving Program, (http://www.aarp.org/home-garden/transportation/driver_safety) the nation’s first and largest refresher course for drivers age 50 and older, has helped millions of drivers sharpen their driving skills. The four-hour program teaches defensive driving techniques, new traffic laws and rules of the road, as well as (and more importantly) how to adjust your driving style to those age-related changes to vision, hearing and reaction time. After successfully completing the Aging Group’s Safe Driving Program held in Rhode Island, the attendee is awarded a certificate of completion. The state mandates that the insurance carrier give a discount on their liability coverage to the policy holder with this certificate.

Surrendering the Keys

Ultimately, the burden may well fall on the family or the older motorist’s physician who must take the keys away from the driving-challenged senior for not only the driver’s safety, but for the safety of those sharing the road as well.

In the late 1990s my mother began exhibiting signs of dementia, and yet my father could not stop my mother from driving. The only solution appeared to come from making a call to the Texas Department of Motor Vehicles (TDMV) for help.

Several times mother got lost driving around our neighborhood, a once familiar area for her, ultimately ending up on the dangerous LBJ Freeway, miles from home and confused. With her driving skills rapidly deteriorating, my siblings took on the task of making that hard decision of taking the car keys away from her. After several meetings with TDMV officials, the agency finally took away her driver’s license.

As difficult as this decision was for my family to make, ultimately for my mother who was in the mid-to-late stages of dementia, did not realize that she had lost her driving privileges and her precious keys.

Kristi Grigsby, Vice President of Content of AgingCare.com, agrees that taking the keys away from an elderly parent is one of the most difficult decisions that family caregivers must make. “The loss of independence can be traumatic for a senior,” she says, noting that some elderly parents can accept the life-altering change; others understandably can not.

Grigsby warns that the consequences of doing nothing far outweigh the wrath of an angry parent. “Stories of tragedies that could have been avoided had those keys been taken away are sometimes all the inspiration needed to stand firm and make a painful decision with confidence,” she says.

For more information about taking the keys away from an elderly parent go to http://www.agingcare.com/Articles/Taking-the-Keys-What-To-Do-If-Mom-or-Dad-Won-t-Give-Them-Up-112307.htm. Information on this web site, AgingCare.com,
connects people caring for their elderly parents with experts on aging issues and caregivers who visit this site help family members make the best care decisions for older loved ones.

Herb Weiss, LRI ’12, is a Pawtucket-based freelance writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

Agency Offers Hope

Published in Senior Digest on November 2006

According to the Alzheimer’s Association Rhode Island Chapter (AARIC), it is estimated that 25,000 Ocean State residents are afflicted with Alzheimer’s disease. When you combine 100,000 caregivers with that number you have a devastating disorder that touches many people.

Don’t expect the incidence of Alzheimer’s disease to decrease any time soon, warns Liz Morancy, AARIC’s executive director. “Getting older is the biggest risk factor, and we are an aging state in an aging nation,” she says.  “The course of the disease varies from person to person, as does the rate of decline.”

“The costs to society are enormous, too, costing the health care system and business well over $32 billion,” Morancy notes. The federal government and states will be hit hard by the rising costs when they struggle to provide assistance and services to an increasing number of people with Alzheimer’s disease, she predicts.

Not every episode of forgetfulness is the advent of Alzheimer’s disease, Morancy notes, saying that it is common to forget words or information, especially when you have multiple responsibilities; you’re under stress, feeling fatigued or are distracted. She quickly rattles off many of the early symptoms: constant forgetfulness; lack of awareness that you have forgotten something; forgetting recently learned information; and memory loss that interferes with your daily life. One’s ability to use numbers and drastic personality changes can also be associated with this mental disorder.

Caregivers work a “36-hour day” taking care of their afflicted loved ones with Alzheimer’s adds Morancy. “A caregiver in Rhode Island traditionally has been a woman who is the wife, daughter or daughter-in-law of the patient. If she is the daughter, the majority of the time she is also taking care of young children. As the caregiver ages, she must cope with her own physical health problems, too,” Morancy said.

However, today “we have noticed an increasing number of men taking on the caregiver role and responsibility,” Morancy says. “A husband may take care of his wife without the assistance of children who live far away.”

There are only a few “modest drugs” that can slow the effects of Alzheimer’s disease, according to Morancy. She hopes that more effective treatments will become available in the next few years. In order to keep loved ones with Alzheimer’s independent and in their homes for as long as possible, caregivers need the support services from home care and adult day care programs.

For caregivers and their families, the Rhode Island Chapter of the Alzheimer’s Association has become a beacon of hope and a valuable resource in surviving the stresses of caregiving, Morancy says.

Established 17 years ago, the organization started off as an all-volunteer agency with a $50,000 budget. Today the nonprofit agency has eight staff members and a budget of $700,000 with hundreds of volunteers working in a variety of capacities, according to Morancy, who has led the chapter for more than 15 years.

With the 14th Annual Memory Walk, sponsored by AARIC last month, public awareness of this devastating disorder was ratcheted up a little higher, Morancy says. The group’s family support and education activities will be bolstered by the $ 250,000 raised by more than 1,300 supporters who walked the three-mile course in Providence and Newport.

“Our Memory Walk is a key funding source for us,” admitted Morancy. “Oftentimes, major private foundations do not recognize the reality of the increasing number of elderly, and they do not fund programs addressing their needs adequately. Sadly, children advocates are pitted against those working on behalf of seniors,” she says.

Morancy says AARIC offers caregiver and family assisted at 18 affiliated support groups that regularly meet throughout the Ocean State. The chapter also provides a help line and care consultation, education and training programs geared to both health care professionals and caregivers.

Additionally caregivers can obtain pamphlets, books, and videos through the chapter and participate in a safe return program that helps to locate persons with Alzheimer’s who wander away from home.  There are few people in Rhode Island whose lives have not been touched by the Alzheimer’s disease, and there are many lives that have been touched through the programs and services of AARIC.

Delegates Reject Bush’s Policies

Published in Senior Digest on January 2006

President George Bush and congressional Republican leaders supporting Social Security reform through private savings accounts, saw their policy soundly rejected at the White House Conference on Aging (WHCoA) held last month in Washington, D.C.

According to AARP State Director Kathleen Connell, who was appointed to the Rhode Island WHCoA delegation by U.S. Sen. Jack Reed, Bush’s private sector approach to Social Security reform got a big thumbs down.

The president also took a hit on his new Medicare prescription drug benefit program, which offers insurance coverage through the private sector. Delegates voted for a strategy that calls for replacing the new Medicare drug benefit with a government-run program.

By the end of the fifth WHCoA, 50 resolutions dealing with a variety of policy issues were approved by the 1,200 delegates. Most of the top 10 resolutions concern the need to create a comprehensive national strategy to address the long-term care of the nation’s frailest and most vulnerable seniors.

While the delegates took a couple of swings at Bush, the president made an obvious political snub when he failed to appear at the four-day conference and sent Health and Human Services Secretary Michael O. Leavitt, as a replacement. That goes in the record books as the first time a president was no-show at the national aging conference, held every decade since 1962.  Presidents John Kennedy, Richard Nixon, Ronald Reagan and Bill Clinton did make a showing to welcome the delegates.

Moya Thompson, WHCoA deputy director for outreach, stated the conference’s Policy Committee had initially approved 73 resolutions, sharing them with the 1,200 delegates before they arrived in Washington.  Thompson said that three voting sessions were scheduled at the beginning of the WHCoA, with each delegate having an opportunity to vote once to choose their top 50 resolutions. The 50 resolutions that received the most votes were presented at the conference.

According to Thompson, 56 implementation strategy workshops, at least one for each of the 50 resolutions, were held. By law, the resolutions must be delivered to the president and Congress six months after conference, Thompson said.

Counnell said many of the delegates felt that the WHCoA agenda was controlled too much by the Policy Committee appointed by the Bush administration and the Republican-controlled Congress. “This was very visible to those attending,” she said.

Another organizational issue, Connell said, was concern over the Policy Committee not allowing delegates to submit resolutions for a vote in addition to the selected 73. At previous conferences, she said, additional resolutions could be considered if petitioned by 10 percent of the delegates.

Connell said that the Rhode Island delegates were a very cohesive group. “Everybody was on the same page in advocating for issues. Given the size of our delegation, we were very effective,” she said.

Corinne Calise Russo, director of the state Department of Elderly Affairs, said she was pleased that the top vote-getting resolution was the reauthorization of the Older Americans Act, a priority of the Rhode Island delegation.

Russo, appointed by Gov. Donald Carcieri as a delegate, said, “Delegates throughout the nation attending the conference felt that the Older Americans Act should be enacted with increased funding for all of the act’s titles, within the first six months following the end of the conference.”

Ensuring older Americans have transportation options to maintain  their mobility and independence was another resolution that received strong support, Russo said, stressing the importance of keeping seniors independent and driving for as long as possible. She believes the resolution can be implemented at the state level by using new signage on highways, making lane markings extremely visible in rain and at night and designing larger and more visible crossing signs at busy intersections.

While older worker issues and affordable housing designed to allow seniors to age in place are in the top 50 resolutions, and are high on Russo’s agenda, she stressed federal and state policy makers must not forget the growing numb er of grandparents who are raising their grandchildren.

“We need to expand our national family caregiver programs funded by the Older Americans Act, to provide more support for older persons taking on this new role,” she said.