Papa’s life is like a big word search puzzle. Every day as he completes his puzzles he continues to look for additional words that are not on the list and when he finds them he smiles, I got it! He sees words everywhere. The most common time we see this is when we are out on the road or walking through a parking lot and he looks for words (or initials) in the license plates he sees. There are a lot of “W’s” in these plates. There is a WR and there’s a WM, I keep looking for WRM and when I find it I am going to ask that person if that is their initials also. Papa is amazed at the different license plates he sees and has asked if he can put any word on a plate. One day he will say he wants to get GAM in his car, those were Grandma’s initials and he wants her to know the car is still hers. The next day he will again ask if he can put anything on a plate and will follow that he wants to see WRM 1933 on his car. I will never forget that one! Our first response is that he has to take a driving test first to which he quietly replies, I don’t think I want to drive anymore.
One of the first decisions that families make after a person has been diagnosed with dementia is how long will they be able to continue driving. This must be an individual decision based on the person and their specific circumstances and it should be continually evaluated. Dementia is progressive. Papa was formally diagnosed with dementia in 2013, but his family has seen significant changes in his demeanor over the past several years. While Papa might be a bit sharper some days, his memory loss, decreased cognitive function and disorientation will all increase, and while we can hopefully maintain what he has for some more time, he will never get back what he has lost. There is no cure.
Papa has driven in Virginia, but it has been very restricted. He has built up his confidence, became familiar with a couple of streets in our neighborhood, and has shown us he could safely drive to a few local restaurants or stores all within a three-mile radius of our home. Do we want him on the freeway? No. Do we want him driving in rush hour, at night or in bad weather? Not a chance. Do we worry he will get lost? Of course. I would be lying if I said we do not worry. However at the time we felt he could safely operate a vehicle in our neighborhood without being a risk. He drives slower, but not excessively slow. He has not been in any accidents. He had the tools to call us, to use the GPS or to ask for outside help if he needs it. We have ridden with him to observe his driving, and at the time we were confident he could freely travel in this small bubble without being a risk to himself or any one else on the road. Do we feel the same way today? I don’t know. Papa had to take a temporary driving hiatus due to a medication change and we have not recently completed another ride along.
We have discussed Papa’s car and driving along with his goals on increasing his radius and venturing a bit farther out since the day he moved to Virginia. We explained that once he sold his home he would have to make permanent changes to claim this as his state of his legal residency. He understands that and knows that in order to become a resident he will have to get a valid Virginia driver’s license. The test entails taking a computer based knowledge test and because of his age he may or may not be required to take a behind the wheel test. I picked up a drivers manual and he has been slowly reviewing over the past few months. Doug sat with him at the computer on a few occasions to take practice exams, but I believe he is just as worried about using a computer for the exam as he is in retaining and passing the knowledge portion of the test.
This week we realized we will have to speed things up; Papa has to make a decision now. Papa received a letter from his current insurance provider, a company he has been with for almost 50 years, informing him that they will drop him as of May 1st because they do not provide service in Virginia. That leaves us two weeks to complete the requirements needed to license and register himself and his vehicle in the state in which he resides. Before he can register and insure his car he must have a valid Virginia driver’s license. Papa is nervous, we are worried, and we are on a pretty tight timeline.
One minute Papa talks about selling his car, and the next minute he talks about continuing to drive. He does not think he will pass a driving test. By not taking the test there is no risk, no possibility of failure. He can do that, and in the long run it might be the easiest option for him to give up driving now while it is his choice. This would be fine, until he mentions going out for breakfast or to the store. Driving is independence. I worry that by not driving, by losing some of his freedom he may age quicker, he runs the risk of becoming depressed and maybe his memory will fail even faster.
We can encourage him to take the test and continue to evaluate him as he drives to make sure there are not any safety concerns. If he passes, great, nothing is lost. But is worrying about not passing the right reason to not take a test? How will this affect him? If he does not succeed will this crush his confidence? If he is able to get a license will we be at this same crossroad in the near future determining it may not in his best interest to continue driving?
Ideally it would have been easiest if his doctor suggests that he should not be driving any longer. This takes the pressure off of Papa; he doesn’t have to try to take the exam. But things are never that easy, and as his physician mentioned, even if someone passes a written exam it does not mean they should be driving. Perhaps an occupational assessment is in order.
During Papa’s break in driving we found a few alternatives so he did not feel trapped in the house. Papa is a ROMEO (a Retired Old Men Eating Out breakfast club) and we found him rides to these gatherings. His new friends from church have been very generous in offering to pick him up for ROMEO or other gatherings, which to Papa’s excitement all seem to revolve around food. We have taken him to his appointments, come home from work early or even worked from home on the occasional workdays. Our long winter is finally a thing of the past, allowing him to increase his daily walks. Papa might be slow but he is now in the routine of making sure he walks with us daily, although most days it is just for a Power Bar at the end. I walked today, can I have a candy bar. Because we have kept Papa busy, I honestly don’t think he has missed not being able to drive during this time.
Overall, I believe I am more worried about how Papa will feel once we help him make yet another life changing decision. But maybe I am over thinking this; maybe this temporary hiatus will turn into the transition for a permanent solution. Papa is pretty strong and maybe this will be another adjustment that he will weather much better than I envision. And of course, we can remind him that if he is being chauffeured, he has more opportunity to look at all the license plates. Papa hopes to solve his word search, because somewhere in the state of Virginia someone is already driving around with WRM 1933, and we want to find it!