A retired social worker creates a support group for senior drivers.
_State Driving Laws
Across the nation, state legislatures are scrambling to find solutions to growing transportation safety concerns.
DJ Rawlings clutched her gym bag and peered out of the front window of her tiny one–bedroom home at an assisted–living community in Eugene, Oregon. Rain danced against the window panes on the predictably damp February morning as she waited patiently by the door. Her husband, John, lagged behind, gathering his towel and bathing suit for their weekly swimming class. A few moments later, John breathlessly called his wife into the bedroom. She found him hunched over on the edge of the bed. For DJ, the labored intonations of his jumbled words were all too familiar. She reached for the phone. John was having a stroke.
Although he survived the stroke, the blood clot that stole John's consciousness that morning also robbed him of the ability to drive. Oregon, like most states, inactivates drivers' licenses for residents who experience a significant loss of consciousness. To regain his license, John, eighty–four, would have to pass a series of examinations administered by the Department of Motor Vehicles (DMV): a standard vision test, a written test of driving rules and a road evaluation. The Rawlings family knows the process well. Three years ago DJ, now eighty–one, lost her driver's license to the same culprit as her husband: an unexpected stroke that resulted in a loss of consciousness and several weeks of intense physical rehabilitation.
Until recently, DJ and John were among the thirty–three million drivers over age sixty–five on roadways in the United States. As the baby boomers mature over the next few decades, the proportion of senior drivers is projected to increase dramatically. By 2020, more than fifty million Americans will be over age sixty–five, and 90 percent will be licensed to drive, according to the American Automobile Association. This shift in national demographics, dubbed the graying of America, spurs a new set of mobility concerns as seniors begin to outlive their abilities to drive.
Like DJ and John, many currently licensed drivers in this age group could suffer from a sudden loss of driving abilities, and the price tag is hefty. It is currently estimated that more than 80 percent of the daily trips taken by those over age sixty–five are made by car, according to the Transportation Research Board. The individual catalysts for this change in mobility vary. The loss of driving privileges often comes as a result of a family decision, a traffic incident or a sudden and devastating medical condition, like a stroke. Regardless of the cause, drivers and their families face the same question: how do we handle this abrupt loss of driving ability?
Inside DJ and John's tidy residence, brilliant snapshots of their active past line the walls of every room, offering bursts of color on an otherwise bleak winter morning, one week after John's stroke. The series of delicately framed photos, all taken by John, could be pages from a textbook about U.S. geography. DJ inches down the short hallway and points to the images captured throughout the years: the quiet piers off the coast of Bangor, Maine; a series of bright red barns nestled at the base of the Grand Tetons; the brown, dusty expanses of Death Valley. As she retires to her chair, DJ's vivid blue eyes meander from photo to photo and she reminisces about the cross–country drives that filled their early retirement years. Then her voice drops suddenly.
"We had to give that up several years ago," she explains. A year ago DJ and John began steering motorized scooters across the property of their assisted–living community, carefully navigating the short distance to the main dining room a few hundred yards away.
When DJ lost consciousness
in the hospital that day,
she also lost her driver's license.
DJ's razor–sharp perception and dancing eyes belie her physical limitations. Thin plastic tubes protrude from her nostrils and trail down her chest to the oxygen tank hidden behind the olive green leather chair that swallows her slender frame. She smoothes a strand of her short, wispy gray hair and explains that she began relying on supplemental oxygen fifteen months ago due to congestive heart failure.
Her current health problems began with her stroke on a similarly gray winter afternoon exactly three years ago. When DJ lost consciousness in the hospital that day, she also lost her driver's license. A week later, DJ entered a rehabilitation program and DJ and John sold their second car. In the weeks following her return home, DJ wrestled with the sudden changes in her life, particularly the unsettling feeling of helplessness that accompanied the loss of her driving privileges. Experts point out that mobility and perceived self–sufficiency are essential to quality of life. In a largely surburbanized society like the United States, cars have become the primary means of satisfying this need for mobility.
When DJ began showing signs of recovery, DJ and John's oldest daughter, Joan, optimistically gave her a packet of re–licensing information from the DMV. Though DJ never pursued the option, it is unlikely she would have passed the series of re–licensing tests. By that time, she had begun to experience vision loss in her right eye. An estimated 90 percent of the sensory input needed to drive is visual, and ultimately it was DJ's visual impairment that resolved the permanent loss of her driving privileges. "It was a terribly hard thing for me to accept," she confesses as her delicate gold earrings tremble, lightly grazing her jaw–line.
"One thing that has kept
us alive all these years is trying
to figure out a way to go together."
But DJ and John handled the loss of her ability to drive with a technique they have relied on for decades: teamwork. For nearly sixty years, DJ and John have been each other's support system. "The one thing that has kept us alive all these years is trying to figure out a way to go together," DJ explains. Each time one falters, the other instinctively hops in the driver's seat.
In 1972, John, a former pilot, sustained major leg injuries when the small plane he was flying crashed in rural Idaho. While he underwent a string of surgeries and endured several months of intense physical rehabilitation, DJ assumed the driving responsibilities. Nearly three decades later, when DJ had her stroke, John returned the favor and became the permanent designated driver for the pair.
After DJ's stroke, the couple's strong partnership continued to deepen through their team approach to driving. Though confined to the passenger seat, DJ provided a reliable sense of hearing when John gradually lost the ability to hear in his left ear last year. John's partial hearing loss is one of several sensory impairments that often accompany the aging process. Beyond marked declines in sight and hearing, aging individuals often experience decreases in attention, perception and decision–making abilities and demonstrate slowed reaction times.
Despite minor impairments, DJ and John were able to retain mobility for several years by combining efforts, a luxury many seniors do not have. With John at the wheel, they were able to make weekly trips to the grocery store and attend swimming classes at a local pool three times a week — a routine they have maintained for more than a decade.
Although they never had a major accident, the minor sensory and cognitive impairments they demonstrated significantly increased their risk for traffic incidents. Joan and her three siblings perceived this risk in the months prior to John's stroke. As the only child living in Eugene, Joan faced the issue on a daily basis.
While she expressed some concern about her father's ability to continue driving, she ultimately elected not to press the issue. "I felt like I had made enough pushes in taking away independence," she explains. "Like raising kids, I learned that with parents you have to pick your battles. Mom and Dad moved to the assisted living community last year with our strong encouragement. In the end, we chose not to battle Dad over his driving."
This battle, left uncontested for many months, was decisively settled by John's unexpected stroke. In its wake, the family is facing an entirely new set of issues. Now their participation in daily activities like shopping or social engagements presents major challenges. In addition to logistical concerns, the Rawlings family must also tackle the psychological distress and decreased levels of self–esteem and dignity that often accompany the loss of driving privileges.
"When Mom stopped driving, the decision wasn't tied up with the issue of independence, because Dad could still drive them both," Joan explains. "That's what makes this step so hard. It's extremely painful to watch your parents grow older and gradually lose their independence."
In the days following her husband's stroke, DJ sits in her strangely quiet home, her other half missing, and grapples with the implications. Later this spring, DJ and John had planned to travel to Wilsonville, Oregon to visit high school friends and to spend several days in Bandon, Oregon— one of John's favorite spots to photograph. Both trips have now been cancelled. DJ's eyes briefly travel back to the photos on the living room wall, and she lingers in the past for a quick moment, before returning to her current situation, "Now my biggest problem is how to get to the hospital to visit John."
After John's stroke, Joan took several days off work to help ferry her mother to the hospital. When Joan returned to work, DJ reluctantly sought the assistance of friends. "I finally got up the nerve to call a friend and tell her what I needed … but it was so hard. She was delightful and happy to help." She pauses briefly and shudders. "But asking for help is the hardest thing that I do."
As DJ struggled to accept her dependence on family and friends, John began to grasp the severity of their dilemma from his room in the rehab unit. Slowly, he began voicing his concerns to his family, desperately searching for a way to retain independent mobility. His initial response was directed toward the well–oiled partnership on which they have relied for almost sixty years. "I have our solution," John excitedly said to his wife. "You take driver's training. You can be re–licensed."
After some thought, DJ said, "I don't think I would be able to pass the tests because of my vision." Both Joan and her sister delicately reinforced to their parents that the chances DJ would be able to drive again are minimal.
The next day John suggested a new solution to his family. "When do you think that I could get re–licensed? Maybe a few months down the road?" he expectantly asked Joan and her husband.
"You know Dad, it's not when," Joan softly began. "It's if … "
Clang. The doorbell rings loudly. The phone shrills. In the span of a second, DJ and John's small residence comes to life. DJ briefly glances at her husband before reaching over her oxygen tank for the phone. "Hello, this is the Rawlings." Clang. The doorbell rings again. John cranes his neck towards the door. Clang. He slowly reaches for the handle of his walker and unsteadily rises.
"Dad! What are you doing?" Joan rushes in from the back of the house. "We just went over this." She continues in a thinly patient tone. "You can't get up on your own, remember? Someone else needs to be in the room to help you."
"It's extremely painful to
watch your parents grow
older and gradually lose
John blinks, his eyes lost behind thick glasses. "Okay," he finally concedes, easing his small frame back into the brown cushioned chair in quiet resignation. It is John's second visit home since his stroke; he has not yet been permanently released from the hospital's rehabilitation center. Despite his daughter's persistent reminders, he continues to resist the recent changes in his level of independence. Learning that he cannot stand up on his own is only the first lesson.
"It will kill John when he realizes that he can't drive … that we can't drive," DJ later admits in a somber tone. For decades, John has guided his family with a steely determination. "He always listens to me, but he wants to make the decisions," she explains.
Amid the unusual silence that now envelops her home, DJ slowly began to accept her new role as the decision–maker with a firm sense of resolve. "Now I have to step up to the plate." Determined to solve their transportation needs by the time John is projected to return home, she promptly began navigating local transportation options.
Her strong aversion to relying on family and friends immediately prompted DJ to seek alternative solutions to their transportation needs, but like many seniors, she lacks experience with public transportation. Many experts advocate the use of taxis for seniors, citing that most services offer reduced fares, but for seniors in rural areas this option proves far too expensive. Even from DJ and John's home in the outskirts of Eugene, a round–trip fare to the hospital costs nearly thirty dollars. Although Eugene boasts one of the nation's most extensive bus systems, DJ's bulky oxygen tank prevents her from using the regular bus services. Nationwide, more than 25 percent of women over age seventy–eight have difficulty using standard public transportation systems, according to the Organisation for Economic Co–operation and Development, based in France.
RideSource, a division of the Eugene bus system geared towards seniors with special needs, provides inexpensive fares and curb–to–curb delivery; however, seniors must be pre–approved to use the service. With Joan's help, DJ filled out the lengthy application for RideSource. Within a week, DJ and John were approved to use the services, and DJ purchased a stack of RideSource tickets to prepare for John's return home. She recently arranged rides to their swimming class with a neighbor.
While RideSource appears to be a viable option for alleviating many of their transportation challenges, both DJ and Joan know that the issue is not fully resolved for John. The need for independence runs deeper. "I know that he won't try to drive when he first comes home," Joan says. "But it will certainly be an issue for him."
John will return home on Wednesday. Their car sits idly in the garage and the RideSource tickets are tucked in a neat packet on the kitchen counter. DJ is fully aware of the tumultuous emotional cycle John will embark upon when he returns home to live a drastically different lifestyle. "We'll play that card when we get to it," she says with firm resolution. "Right now we're taking it one day at time."
First, John must learn to walk again.