Archive for January, 2010

Part Four: My Mother Moves to the Driver’s Seat

January 19, 2010

My mother was never a big fan of driving. It was just something she learned to do so she could get around in the world. When she remarried, 28 years ago, my step-father assumed most of the driving. He loved to drive and he loved his cars. Aside from the few times she was alone and drove to volunteer at the county hospital or go to a meeting, when they were together, he was the pilot and she was the navigator.

The less she drove, the less comfortable she was behind the wheel. When the inevitable health crisis happened and Dad could no longer drive safely, she moved to the driver’s seat. Even though their application for paratransit service was accepted, they would not schedule a ride. The taxi company was available, but they were reluctant to use it. For doctor’s appointments, they occasionally used the special “private driver”. If a friend offered a ride, they accepted, but it had to be life or death for them to ask a favor. After nearly 20 years of cheering me on as I worked to start ITN and ITNAmerica, they had no ITN to meet their needs. It reminded me of my many older friends who have helped us with our work in communities all over the United States, and are waiting so patiently to use the service themselves. Now it was happening to my parents.

My mother was doing the driving, and we all knew that was not a happy situation. She was OK as long as they only drove to places where she knew the way, like shopping, the library or the bank. But as my father’s health declined and the doctor’s visits increased to three or four times a week in distant locations, my mother’s driving anxiety escalated to the seriously uncomfortable zone. I suggested to her that when the winter weather arrived, she would need to use the alternative transportation plan. It simply was not safe.

That was when the back up plan moved up to the first position as our parents’ free choice. We had every single thing in place for them to stay in their home, but when they thought about living in the suburbs, without ITN and without the ability to drive a car safely, they decided to move. They found an independent living place they love, put their house on the market and sold it in one month. My mother organized the entire move. I once told her that if she had been born at another time, she would have been the CEO of a large corporation.

“Sweetheart,” she said, “I am happy I have lived at this time. Look what I have seen in my lifetime. I would not change it for anything.”

Every time I try to teach my mother something, she teaches me something else. My father still copy edits so well, he finds errors in newspapers, magazines and published books. The skills and qualities that make us whole and human and wonderful have nothing to do with driving. We can all move beyond it, and we can all learn grace from the older people in our lives who do it so well.

Part Three: Planning for the Transition from Driving

January 8, 2010

I’ve been working in senior transportation and specifically on the Independent Transportation Network for almost 20 years. My parents have helped and supported this work throughout that time. In the beginning, my Dad said things like “When are you going to get a real job,” and “Are they paying you yet?” After awhile, he was proud of the progress we made.

Still, when the time came for him to stop driving, there was no ITN in his community. Both of my parents grew up in New York City, so they grew up with public transportation. My mother did not even learn to drive until she was in her 50’s. My parents were living on Long Island, in what could easily be described as a transportation rich community. They had access to trains, busses, paratransit services, airports, private bus services, limousines and taxicabs. However, by the time they reached their later years, the only way they would travel was by automobile.

I spoke with our parents about the transportation services available to help them if they limited driving or had to stop driving. Fixed route busses were out of the question, since they could not walk to the bus stop and certainly could not carry packages. My mother identified the paratransit service for her community and sent away for the application, which she completed and returned. She phoned her friends who had stopped driving and asked them for the name and number of the “private driver” who took older people to doctor’s appointments. During one visit to my folks, on one of our daily exercise walks around the neighborhood, my mother pointed out the home of the local taxi driver she thought she could trust. She called his company and made arrangements to use their services when she needed them.

So, it seemed we had a plan. Alternative transportation, access to caregivers, names and numbers for doctors and hospitals, prescription drug information—everything we thought we needed to help two wonderful people live their lives exactly as they chose, where they chose, on their own terms. We even had a back up plan, an independent living facility near my sister, where they could move, God forbid, if they needed to leave the home they loved.

The plan was in place in the nick.

To be continued…

Part Two: Say “I love you” and be patient

January 5, 2010

When it was time to speak with our parents about the transition from driving, my sister, two brothers and I began the conversation with each other by email. We agreed that transportation was only one part of the services necessary for our parents to live as independently as they wished. We decided to divide the communication according to our abilities, and we worked by consensus over many months.

We agreed, in advance, that our goal and hope was to be a support for our parents as they grow older. To that end, we needed to learn their wishes so we could help them on their own terms. We had no preconceived ideas about what was best for them, and we love and respect them far too much to presume to know their needs and desires better than they. We did have clear ideas about safety, and we anticipated that we would need to stand firm and together on that part. We understood we would need to have many conversations over many months, and we agreed that some of us would have one conversation, and others would have another.

We distinctly opted to avoid an “encounter” situation. Maybe we would have done this eventually, if our parents had not been reasonable. But they were paragons of reason. I’m not saying this was easy for them. I don’t think it is easy for anybody. I’m saying that they were willing to have the conversations, and together, we had a successful dialog, instead of a confrontation. Our family experience really resonates with Liberty Mutual’s national survey, which found that an overwhelming majority of seniors are much more open to having a conversation about their driving than their children think. The survey found that 94 percent of seniors would not be embarrassed discussing the topic, and 80 percent said that such a conversation would not make them uncomfortable. Ninety-two percent of the seniors said their children “have a right” to raise the issue with them.

In our family, I started the conversation with my mother. I waited until we were together, and since we live several states apart, that took awhile. I spoke for all the adult children, and I said, “We love you. We want to be sure you and Dad have everything you need to live exactly as you choose. To support your wishes, we need to know more about your needs.”

My mother was half perplexed, and half ready to assure me that she was in control of everything and needed nothing. So I listened and said, “Well, what if the time comes when we need to help you? How will we know what you want?”

“I’ll tell you when the time comes,” she said.

In my family we always say, “God forbid,” before something bad that might happen.

I said, “God forbid, you have a stroke and cannot speak. How will we know what you want or need?”

“I see,” she said.

“I’m assuming you want to stay here, in your own home,” I said.

“Yes, of course,” she said. “Moving out of this house is out of the question.”

“OK, I said, “then that is what we want for you. How do we help you to do that?”

That is as far as we got in that conversation, but it was enough to get started.

Soon, other siblings had conversations with Mom, and she in turn, had many conversations with Dad. Our talks continued for half a year, slowly, lovingly, gently, steadily, respectfully. My brother in the insurance business talked with them about how they might activate their long term care policy, when the time comes, and how they might choose a personal care assistant. My sister, a healthcare professional, asked them for a list of their doctors, with contact information, and about medications they need. My step-brother, an experienced business man and a good negotiator, volunteered to have the conversation about driving with our Dad, who is actually my step-father. He waited for a time when our parents were visiting his home, when he could be alone with his father.

When he emailed us that they had a good conversation, we were all surprised and happy. This was the conversation we were all dreading. My step-brother reported that our father said his driving was just fine. My step-brother did not argue with him but asked Dad if he would agree that he would not be driving forever, and that driving until he crashed was not an option. Dad agreed. My brother asked him if he thought he would need to stop within the next 5 years. (He would be 98 then.) Dad agreed that was likely. Then, my brother concluded, we needed a plan for when that day arrived.

My part of the conversation was senior transportation, and we worked on it, as I hoped we would, while they were both still driving.

To be continued…