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Who Owns the Decision?

I have talked in some of the recent blogs about when decision-making may transfer to another person from an individual whose own faculties may be failing.  Such is the case with powers of attorney as well as guardianships.  There also are decisions which need to be facilitated by a caregiver, but we need to know the difference between deciding for the older loved one or individual with special needs versus facilitating their own good decision.

In my role as a GCM I had a conversation with one of my clients recently about her car.  She is an 84-year old woman who has been living on her own since her husband died about six years ago.  Her husband had surrendered driving responsibilities to her some several years before his demise, and it was his initiative and his choice.

Recently, she asked me what I thought about her giving up driving.  The fact that she brought it up suggested to me that there may have been a precipitating event for her question.  She admitted that increasingly she had experienced vision difficulties driving at night, so she was limiting her driving to daytime.

On further probing she admitted, however, that she recently had lost control of her car and skidded off a road near the independent living facility she called home.  It had frightened her.  Her facility manager at the residence had suggested she consider selling her car and rely instead on their complimentary shuttle service to get about town for shopping and such.  Simply put, she did not want to give up her independence.  If you were the caregiver to such an individual what would you do?

The one thing you ought not do is immediately decide for the older individual under normal circumstances.  You can, however, talk about the frightening moments the older individual may have had.  In my case here, I used that experience as an opportunity to discuss what might have happened if her accident had involved another vehicle or worse, a pedestrian.  I said “normal circumstances.”  If the individual is mentally or physiccally compromised to such an extent that it interferes with safe driving, you have a moral and legal obligation to deny them access to a vehicle.  Check with your own state department of motor vehicles for the actual wording on the books in your locale.

On the positive side, it was also an opportunity to discuss how using the facility shuttle could be liberating.  She would now have the benefit of transportation without the increasingly challenging responsibility of driving.  In the end, I also encouraged her to talk with her adult children to discuss their opinions and what they could do to help.  Although both her children lived at some distance from her home, they were in a position to assist in selling her car.  That proved to be the last string for her to cut in order to part with her car and to move forward with “her own chauffer” as she came to call the shuttle.

In my next blog, I will talk about another big decision-point many older adults face – whether to move into a facility for elders and others with special needs.  I also have spoken with elderlaw attorney Eric Parker, whom you may remember from an earlier blog on advance directives.  He has some great advice on how to select a nursing facility.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.

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