Aged to Perfection

Warm sunny weather brings more summer driving!

Driving is a very personal issue that involves strong emotions. For many seniors, driving is a privilege they’ve had for decades, and their personal sense of identity and independence is often linked to their ability to drive. When driving seems so second nature, it can be difficult for people to remember that driving is truly a privilege, not a right.

So, when is it time to give up the privilege of driving?

Oftentimes, the person with dementia is the least aware that anything is wrong. They may not notice that their reaction time has changed, or that their judgment is off. The family are often the first ones to be concerned about driving, and rightfully so, as research shows that someone with dementia is eight times more likely to be in an accident than the average population.

Some warning signs to watch for if you have an elderly relative who is driving with dementia:

• Damage to the car
• Traffic tickets
• Difficulty navigating familiar routes
• Simple errands taking hours longer than necessary with no explanation
• Mixing up the gas and brake pedals
• Missing stop signs or traffic lights
• Problems with lane changes and merging
• Passenger input is required
• Family refuse to get into the car

Consider the “grandchild question”: do you feel comfortable allowing the grandchildren to ride with their grandparent behind the wheel? If your answer is no, there are likely significant concerns about your loved ones’ driving ability.

If you are concerned about your loved one's driving, you need to speak to their doctor. It is ideal to attend a doctor’s visit with your loved one; you may also write letters to inform the doctor of the changes your loved one is experiencing.

The family doctor is required to notify the Ministry of Transportation, and it is the MTO who will revoke the licence (not the family doctor). After being notified by the family doctor, the MTO will send a letter directly to your loved one (not to the family doctor). The letter will state whether they may continue to drive, they need an assessment, more medical evidence is required, or the licence is revoked.

What happens when their licence is revoked?

If the licence is revoked, it is HIGHLY advised that your loved one’s car be removed from the property. Someone with dementia may forget that they are not allowed to drive. Disabling the vehicle is an option, though it is remarkable how handy and mechanically-minded many seniors from that generation can be, so the simple options of unplugging the spark plugs or draining the battery may be insufficient. The most ideal solution is to have the vehicle removed from the property altogether to ensure that your loved one is safe, and to ensure that others are safe as well.

It is important to understand how devastating the loss of a licence can be for many seniors. It can result in loss of independence, reduced social interaction, loneliness, lowered self-esteem, depression, and increased stress on family and friends. For all of these reasons, family doctors do not just send letters to the MTO easily; they must have concrete evidence of imminent safety concerns. To minimize the negative impact of losing a licence, family and friends can assist by providing alternate means of transportation and socialization.

There are volunteer driving services that can be accessed through your local community centres or the Alzheimer’s Society. Taxi companies are often able to offer discounts to “frequent riders”. However, if your loved one is uncomfortable with public transportation, we offer driving services to help isolated seniors with grocery shopping, doctor appointments, personal appointments, and etc.  

If you are interested in learning more about our errands and transportation service contact us today!

Do you know a senior who has suffered a serious fall? Likely you do, since approximately 30% of seniors who live in the community suffer a fall each year. The consequences of a fall can be quite serious—injury, hospitalization, even death from complications.

“Falling isn’t as much about slips and trips. It’s about the failure to recover. Slips and trips happen at all ages.” - Dr. George Fernie

Did you know that falls are the cause of 90% of all hip fractures, 50% of all injury-related hospitalizations in seniors, and the 5th leading cause of death in the elderly?! These numbers also double when a senior has dementia. So, it is extremely vital in keeping seniors strong and steady on their feet.

Why do seniors fall in the first place?

There are various external factors at play that contribute to slips and trips; such as:

• Loose carpets/rugs
• Poor lighting
• Unstable chairs
• Steep stairs
• Poor footwear (e.g. slippers)

While some falls can be attributed to tripping—such as tripping over floor mats, pets or curbs—other falls seem mysterious. The person will report that they just went down and we're not sure why. In many of those mysterious cases, the fall is due to internal factors such as:

• Visual and hearing deficits
• Vestibular dysfunction
• Cognitive impairment
• Neuropathy (abnormal sensory feedback)
• Low blood pressure
• Edema/swelling
• Pain and foot drop
• Weakness and tightness
• Decreased flexibility
• Slowed reflexes and balance disorder 

What can we do to prevent falls?

Get rid of all the external factors that cause slips and trips! Ensure that your living space has no loose carpets or rugs, the lighting is bright for increased visibility, all chairs are sturdy with armrests, everything needed is on the main floor (no stairs), and that proper footwear is worn in the house.

Improve balance and stability!

The number one key to fall prevention is staying active! Physical activity has shown to mitigate the deathly consequences of falls – just walking, gardening or housework is enough for an elderly loved one.

However, when your elderly loved one refuses to do regular exercise the best option is to increase their base of support. To remain balanced, there must be a stable base of support—the wider the base of support the more stable it becomes. The base of support is the invisible box that can be drawn around your feet when you are standing. Added to this is our centre of mass—which is approximately where our belly button is located.

When someone’s centre of mass is in the middle of their base of support, they are perfectly balanced. When their centre of mass begins to reach the outer edge of their base of support, they are more prone to falling.

“She says she wants to keep living in her home. We say it starts by keeping her on her feet.” - American Academy of Orthopedic Surgeons

For example, a ballerina narrows her base of support to be only one square inch when she is en pointe. Her balance is quite precarious because her base of support has been reduced. The only way that she remains upright is by perfectly hovering her centre of mass over her base of support.  She is constantly adjusting to ensure that her centre of mass doesn't sway too far aware from her base of support.

In the case of a frail senior, their feet may ache or have bunions, causing that person to only walk on the edges of their feet, which reduces their base of support and their balance. Instead of using the full surface of their foot, they have reduced their base of support more like a ballerina.  As well, the senior’s posture may be more forward-leaning, pushing the centre of mass to the outer edge of the base of support, causing instability. A senior will not likely be crouching down to touch the ground for support, the way a football player does.

The best way to create a strong base of support is to use a walker. The four wheels of the walker expand someone’s base and provide the necessary support. Much like a football player, a well-balanced senior using a walker is less likely to fall than a senior who is precariously balancing on sore feet. If their posture is forward-leaning then the walker extends the base of support ensuring that the centre of mass remains in the middle of the base of support.

Encourage the seniors in your life to carefully assess their centre of mass and base of support to ensure that they are as safely balanced as possible. Every fall that is prevented is a great success and ensures a longer and healthier life for that senior.