Mike Lama drives his mother on her errands every Thursday. He figures it's the least he can do after taking the 90-year-old's car keys away.
Lama's mother Grace has a history of fainting spells and he was constantly worried she would black out while driving. "Her own physical response has been my concern. Her ability to quickly react has been an issue for me for quite a while," Lama said on ABCNEWS' Good Morning America.
While he said he did not want to take away his mother's ability to drive, he, like many adult children with elderly parents, felt it was his duty. Yet when Lama and the rest of the family decided it was time to stop Grace from driving, she didn't agree.
"No way!" she complained. "I felt like I was a good driver. I've always been independent. I've always had a car of some kind."
Grace even snuck the car out once to drive herself to the store after her family asked her not to drive anymore. "I felt guilty about it — and I never did it again," she recalled.
Lama is sympathetic: "Having to give that up, I think, is [an] extremely difficult thing for the rest of us to understand."
Her family eventually sold Grace's car and now she relies on her son, friends, relatives or a shuttle service for senior citizens to get around.
"So, it's final," Grace said. I'm adjusting."
Road Tests Get Protests
In most states it is up to an elderly driver's family to decide whether or aged drivers should continue to get behind the wheel.
Illinois and New Hampshire are the only states that require older drivers to pass road tests before their licenses can be renewed. In both states, drivers more than 75 years old must pass an on-the-road test before they can get behind the wheel on their own again.
In some states, efforts to introduce tough driving tests for elderly drivers have failed outright. In California, for example, the 86-year-old man who on Wednesday crashed into a Santa Monica Farmer's market with deadly results would have been required to pass an on-road test when he renewed his license two years ago if a recent reform effort had not been defeated.
California's Bill 335, introduced by former state Sen. Tom Hayden and approved in 2000, had a requirement that anyone 75 or older must pass an on-the-road test. But the requirement was dropped after senior citizens' groups protested.
So when laws won't do the job, argued Good Morning America's parenting contributor Ann Pleshette Murphy, it's the responsibility of the elderly driver's children to do it instead.
Yet there are ways adult children can manage the stressful, and often awkward, task of testing their parents' driving abilities, Murphy suggested.
"Get in the car with them when they're behind the wheel so you can see how they're doing," Murphy said. If the elderly driver doesn't seem to have an acceptable reaction time or if the driver seems unsure and confused, their family will have to act, she added.
If an elderly driver has a negative response to the family's pleas, it may be time to turn to others for help, said Murphy.
"If you have to bring in a higher authority, you can go to a doctor's appointment with your parent. You can also have the parent take a test. The AARP and The National Safety Council will offer a safe driving test," she added..
Look for Signs of Diminished Capacity
As a family physician in Shreveport, La., Dr. Michael O. Fleming has experience with elderly patients who continue to drive despite problems.
Fleming, president-elect of the American Academy of Family Physicians, says this issue has become one of the most sensitive and difficult areas for primary care physicians.
"Driving is many times the last vestige of independence that these folks have and they feel that they can drive short distances safely," Fleming said. "We all know that there is no difference between short and long distance, but they will persist with their doctors and their families. By requiring a driving test, potential problems could be picked up."
Fleming says family members of elderly drivers should first look for the somewhat obvious signs of diminished capacity to drive.
If the driver frequently gets lost, or has had a number of fender benders, it's a good idea to step in, recommended Fleming. Less obvious signs can be forgetfulness, falling asleep during activities such as conversations, or problems understanding or carrying out simple instructions, he said.
ABCNEWS' Medical Editor Dr. Timothy Johnson suggested family members of elderly drivers should look out for strained vision, significant problems with hearing and memory loss, problems resulting from prescription drug use, or muscle stiffness that can affect reaction time.
After 33 years as a family practitioner, retired physician Gabor Somjen of Dover, N.J., agreed it's reasonable to have a physical exam when a license is renewed after the age of 75, but warns there is no magic number.
"There is no fixed age when one has to be tested because they are some very active, capable 80-year-old drivers and some very unreliable 70-year-olds," Somjen said. "There is no set criteria to allow a person to drive. An overall impression and a physical exam should do the job."
Johnson and Murphy concur. It's very important for the family member to get in the car with the elderly driver, they said, but "you don't assume that they can't drive," Johnson added. "Not all elderly drivers are a danger on the road."
In the case of Mike Lama and his mother Grace, everything worked out in the end, even though she was quite upset about her son's intervention initially. During one errand day, she turned to her son in the driver's seat and said "I'm glad you're here." Responded Lama: "Well, me too."