Category Archives: aging drivers

Long Distance Caregiving

Carol O’dell

If you’re a long-distance caregiver, then you know the drill. You call all the time. You coordinate care from 400 miles away. You spend long weekends or vacation time visiting your loved one and hoping before you open that door that they’re OK. Worry comes with long-distance caregiving, and so does guilt, but you try really hard to make it work — and you dread the day that won’t be enough.

You are not alone. According to a recent Caring.com poll, nearly one-third of all caregivers do not live with or, in many cases, even near their loved ones. Here’s a look at a few challenges long-distance caregivers face, and tips to help manage care from afar.

Feeling emotionally connected to your family members.

Sometimes phone calls or visits filled with doctor appointments and home chores don’t allow for heart-to-heart talks. As much as there is to cover, make the time to just sit for a few minutes and allow a natural conversation to emerge.

Set up a weekly phone-chat date for the times that you’re apart. Have it at a time when you both can look forward to it and nothing competes. After you discuss some of your “to-do” list items, begin to share something personal about your own life. Ask their advice on something — anything — from the color shoes you should wear to your cousin’s wedding to whether you should get a bigger car. Let them feel as if they’re a part of your life as well.

Getting shut out.

Many long-distance caregivers, particularly those helping someone with moderate to severe dementia, find that their visits actually aggravate their loved ones — who are confused and want to “go home” or don’t understand why you keep calling them “Dad.”

Remind yourself that you’re not just there to visit. You’re there to make sure Mom or Dad are being cared for properly. (Having a loved one with moderate to severe dementia increases the likelihood that he or she is living in a care facility.) Stay out of sight if you have to, but visit the staff, have lunch in the cafeteria, and walk the grounds. Talk to the people your loved one interacts with to find out how he or she is doing. It’s painful not to be able to connect, but remember that you’re still needed.

Knowing your loved one is safe and appropriately cared for.

Audrey Adelson, author of “Long-Distance Caregiving,” writes, “Often, long-distance caregivers obtain important information from their elder or secondhand from family members who have spoken with a member of their loved one’s treatment team. This makes it difficult to get a clear understanding of what is really going on.” How do you stay in the loop when you’re not in the area?

How to manage? By having lots of eyes. Whether you coordinate care for your loved one in his or her home or an assisted living facility, start to connect with those who interact with your loved one. Call after an appointment and ask how it went. Let them know you plan to be involved, and be sure to send a thank-you card or friendly e-mail.

Managing insurance and financial needs or making sure you can trust those who do.

Trust is a big issue for long-distance caregivers. When you don’t have people who genuinely care for your loved one and communicate with you about what’s going on, then you begin to worry, and worry, and worry.

Take the time to find professionals who can assist you and your loved one. It’s worth the time and effort. Hire an elder law attorney to make sure their financial assets are protected, or check into local resources designed for seniors and their family’s needs.

Make a plan for whatever comes next.

Long-distance caregivers dread getting “the call.” Whether it’s from a concerned neighbor or from the ER at 4 a.m., it’s difficult to know what to plan for when anything could happen. Try to laugh (or scream, or sob) when all of your planning and hard work takes a dive and you have to come up with a new plan. Change is inevitable, and when we fight that it that causes us pain.

Play “what if.” Come up with the three possible scenarios — a fall, a worsening of a condition or ailment, or a refusal to move even when that’s needed. How will you handle it? Can you go ahead and do some online searches? Can you connect with other caregivers and ask how they handled a big change and ask how it’s going now? It’s easier to face the “what ifs” when you know that somehow, some way, you will get through.

Being a long-distance caregiver comes with challenges you never thought you’d have to face. Sometimes you have to let go, just a little, of all that you can’t control. Caregiving isn’t easy, and there aren’t always solutions, so grab your rearview mirror the next time you’re in your car and look at yourself and say, “You’re doing the best you can.”

For a loved one living in Raleigh, NC, contact Raleigh Geriatric Care Management to assist with your family member. www.rgcmgmt.comRaleigh ,NC

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Stress and the Holidays: Coping Strategies to Keep you Sane

By Helen Hunter,

Every year, the media bombards us with advertisements showing the “happy family” gathering for the holidays. People from different generations are together, having a wonderful time, sharing traditions of old and creating new ones as well.

It is not that way, though, for a great number of individuals. For those who don’t have families of their own, or for those who live alone and have relatives living far away, holidays often bring heartbreak and depression. Those who have been used to family celebrations in the past and no longer have that to look forward to cannot accept the “change” in the tradition, especially if they keep hearing about others who are getting together with their own families.

There are two things to remember that can help get you through the holidays. The first thing to realize is that it is okay to cry. This can be a tough time for many. It is natural to feel depressed when your friends are having the ideal family gathering. Allow yourself to express your inner feelings.

The second thing to remember is to control the holidays, do not let them control you. This requires planning. If you know that you will be alone on the holiday, start planning ahead for what you will do. Here are some suggestions for things you can do to sidestep the holiday blues:

  1.  If you cannot be with family, try to spend time with friends or neighbors instead.
  2. Get away from the source of the depression. If your home reminds you of past holidays spent with a loved one, go on a cruise, or take a vacation to another part of the country, or go abroad.
  3. Get involved with an activity. Volunteer at a local senior center, church or community center that serves meals on the holiday, or give your services to a hospital. If you know that someone will be alone and cannot get out for the holiday, visit. If the person lives far away and you cannot physically visit, make a phone call. In helping those who are less fortunate than yourself, you can forget some of your own troubles.
  4. Invite others who are also alone to your home to share the holiday. You can prepare a meal for them, or you can go out to a restaurant. Company always helps ease depression.

Be gentle to yourself, especially if you have recently lost a loved one. If you do not feel like celebrating, don’t! If you do wish to celebrate, keep it simple. Remember the TRUE reason that we celebrate the holidays!

The important point to remember here is that if the old traditions cause heartbreak and depression, change the tradition – start a new one!

Also, be sure to review your expectations and be realistic. Not everyone is jolly, generous and loving all through the holiday season. As Wayne A. Van Kampen from the Bethesda PsycHealth Reporter wrote, “ Somehow (during the holidays) persons feel pushed into hiding, covering over, or denying the reality of sadness, fear and tension. Perhaps what is needed most is simply a more honest embracing of ourselves, others, and the realities of life.” Not everyone will have a happy family gathering just because it is the holiday season. Old resentments are likely to resurface, no matter how hard we try, when people are thrown together for an extended period.

In addition, there are a number of strategies that can be used in planning the holiday celebration.

These strategies include the following:

  • Delegate responsibilities and activities so that one person is not taking on more than can be accomplished without help.
  • Do not assume responsibility for the entire household’s holiday happiness.
  • Work minute by minute on your attitude. Postpone becoming angry and show understanding and calmness. This technique should be used not only during the holiday period, but every day!
  • Any task that you have chosen to do, whether it be the cooking, cleaning, gift wrapping, card addressing, organizing, decorating or shopping, is to be viewed as a choice that you made. Try to have fun in tackling these tasks, which will make the holiday easier and keep your spirits positive.
  • Start traditions that make the most sense to you in your life now. It doesn’t always have to be done the same way every year.
  • Do things together as a family that you all truly enjoy.

Make the holiday season a time for you and your loved ones to have fun and to share special memories. When the entire season is over, sit down, relax and count your blessings. Remind yourself as to how lucky you are. When you make an effort to have a joyous, stress-free holiday, you can avoid the stress. The key is to plan ahead, and to ask for and accept help from others.

Raleigh Geriatric Care Management www.rgcmgmt.com

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Holiday Family Gatherings: A Time for Enjoyment & Meaningful Discussions

Once again we’re preparing for families to come together over the holiday season. We long to see how our seniors are doing, especially those who are far away from us and living independently.

Are they ok? Have they been eating well? Is the house in good repair? Are they paying all the bills on time? Have they been keeping things from us?

Hopefully, during our visit with them to celebrate a time of family sharing we will be able to observe them for any signs that they need a little bit more help. There are many things we should be on the lookout for in their home, their own health and appearance, the car, the home and the yard.

Another important thing we should do while we are visiting our senior loved ones is talk.

“Talk about what specifically,” you ask?

Serious Discussions with Parents & Other Senior Loved Ones

We might find some discussions hard to begin and others may be taboo in your family or culture. Unfortunately, once your parents reach a certain age (and you as well) it is recommended that these uncomfortable discussions happen and the answers clearly brought out into the open.

Whether you want to or not, some things are just better to know.

  1. Do they have any advance directives? Is there a living will created about which you should know? What are their wishes for end of life care? Do they have a DNR or a healthcare proxy to speak for them if they can’t? It is important to hear directly from them what they anticipate their end of life to be. What if they get into an accident or have a medical emergency? If you don’t talk openly about this eventuality it will be more difficult, especially if you are at a long distance, to make decisions in an emergency without prior knowledge. Do they have burial plans already?
  2. If they have executed these documents, where are they kept? Can you get a copy? Does the doctor know about them and do they have a copy on file? Do they need to be updated?
  3. If they don’t have them created, can you do this during your visit so all their wishes are documented in case of an emergency? Now is a good time to get important documents executed while you are there to get the necessary information. These decisions must be made before your senior is no longer competent to make his wishes known legally.
  4. Do they have a will? Who is the executor? Where is the will kept – who is the attorney? Where are the contact numbers for lawyers, doctors, and other people if you need them?
  5. Are they still competent to drive safely? Has the car been damaged since your last visit? Take a ride as a passenger to test them, even if it is without them knowing your purpose for going for an ice cream cone together.
  6. Are they declining in functional status? Does it look like they are having difficulty keeping themselves neat and tidy? Are their clothes clean and in good repair? Are they shaving? Do they have unexplained bruises? Are they appearing thin or weak? Are they having trouble balancing themselves when they walk or get up from sitting? Do they need more help?
  7. Is their home still adequate to age in place? Is it where they want to be or would they rather come closer to you, go to a senior living area or move to a smaller home that is easier to care for alone? Some seniors enjoy living in an assisted living facility where they have less responsibility and more opportunity for social engagement. Is their current home accessible to transportation services if they can no longer drive? Is their home in good repair with adequate safety modifications to prevent accidents? Can you work on some modifications while you visit and schedule other more involved upgrades for when you are not there?
  8. Are they depressed or isolated? Some seniors choose to stay home and reduce their visits to places, people and events that they once frequented for a variety of reasons. Perhaps they are afraid to drive, don’t want to go alone, can’t leave the house for too long for fear of needing a restroom quickly, or have side effects of medications that keep them from being active. Seniors need to be social, mentally stimulated and engaged to prevent boredom and loneliness. It might be a good time to get them reconnected, take them to the senior center and arrange transportation if necessary. Find things for them to be active and involved from home. Set up some technology and teach them to use it so they can use social media, Skype or Facetime to engage with distant family and friends.
  9. What about their finances? Do they have enough money to meet their needs? Are they paying their bills? Do they have a supplemental insurance policy or long term care policy which you should be aware? Are they struggling to make ends meet? Are they getting the benefit of all — well — benefits to which they are entitled?

~by Kathy Birkett

Assistance is offered with Raleigh Geriatric Care Management in North Carolina www.rgcmgmt.com to help you and your aging loved ones navigate the myriad of senior resources and services.  lwatral@rgcmgmt.com for more information. 

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A Retirement From Driving Does Not HAVE to Equal House Arrest

~Matt Gurwell, Retired Highway Patrolman, founder of Keeping Us Safe

It goes without saying that for any of us, driving represents freedom, control, and of course, a degree of personal independence. But this is particularly true for the older driver. Here are five reasons a senior driver may not be willing to retire from driving, despite what may be obvious and quantifiable safety reasons:

1) For a senior driver, losing the ability to drive can be an obvious emotional set-back. In some cases, this set-back can be even more complicated when combined with recent losses such as the death of a spouse, a close friend, or a recent diagnosis of a serious health condition.

Imagine for a moment that only months ago your spouse of 50+ years died unexpectedly, and now your adult children are trying to take your car away from you. Or that just last week you were diagnosed with cancer, and today your family doctor compounded your anguish by suggesting that for safety reasons you stop driving, effective immediately. The recipient of all of this wonderful news would certainly feel like a tsunami of doom has just reached their beach.

2) A senior driver may believe that if he/she can no longer drive, they will become a burden to others. This may be the furthest thing from the truth, but it becomes very real in the eyes of the beholder. Imagine for just one minute that you can suddenly no longer drive…ever. Although completely unwarranted, it is human nature to feel at least somewhat burdensome asking others for help getting you to and from your doctor’s appointments? Taking you to get groceries? Driving you to the hairdresser or barber? Taking you to visit an old friend?

3) Many seniors see a surrender of their driver’s license as an acknowledgement that their physical wellness, agility, mental sharpness, reflexes, sight, hearing or memory are beginning to deteriorate. Or that an illness or pre-existing medical condition is “getting worse”.

4) Many older drivers believe that if they give up their driving, they will have fewer social opportunities than what they are accustomed to.

5) Despite everyone’s best efforts, driving cessation can sometimes trigger depression in elderly people which, in turn can cause a noticeable deterioration in your loved one’s physical health.

There are obviously many, many more examples of the emotional distress driving cessation can cause for an older driver. The good news is; a retirement from a long and successful driving career does not have to be all doom and gloom, and does not have to be the equal of “house arrest”.

The Beyond Driving With Dignity Program is offered in parts of North Carolina.  contact, lwatral@rgcmgmt.com of Raleigh Geriatric Care Management

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Geriatric Care Managers Explained

Geriatric care managers (GCMs) are usually social workers, psychologists, nurses, gerontologists, or others with both training and experience in a number of aspects of elder care. They can assess needs, handle crises (such as an emergency hospitalization), help place an older adult in a long-term care facility, help solve family disputes, locate community resources, or simply fill in for family caregivers at doctor appointments and assist with other daily care.

For many families, senior care planning and coordination can be overwhelming. In some cases, a loved one’s health needs are at a crisis point and there are too many decisions to make all at once. Or you may live too far from your loved one to check on her regularly. Some aging seniors are resistant to receiving care. In other situations, family conflict can be a major issue.

GCMs are like a quarterback, coordinating all the different moving parts of senior care — from logistics and scheduling to emotional support and family mediation. Their experience can guide you through the challenges you face.

 

What Geriatric Care Managers Can Do:

Assessment. When you first hire a geriatric care manager, he’ll meet with your loved one (and family members, if appropriate) to evaluate the current situation. He’ll assess your loved one’s physical environment and mental, social, and emotional functioning and independence. Based on this assessment and conversations with family members, the GCM will identify your loved one’s care needs.

Plan of care. Once the assessment is complete, the GCM will make recommendations about the types of care your loved one needs. He’ll meet with you to review these recommendations in detail and get your feedback. He’ll note recommendations in a written plan of care. As care progresses or as care needs change, the care manager will note progress in the plan of care and make updates as needed.

Coordination of services. A geriatric care manager can be as actively involved in the care of your loved one as you need him to be; be sure to clarify expectations at the outset. Most GCMs know all the senior care providers in your area and are well prepared to help you find the best match for your loved one. You can expect him to help you find agencies to provide in-home care, hospice, or skilled nursing care, as well as to coordinate the comings and goings of the caregivers. If your loved one needs residential care, the GCM will help you find the best assisted living or nursing home that meets your loved one’s needs and fits within your budget. Some GCMs will also help with day-to-day care for your loved one — picking up prescriptions, taking your loved one to doctor appointments, or visiting for regular check-ins.

Family support. GCMs also provide invaluable support to family members as they cope with a loved one’s decline or illness. They can help smooth communication and mediate disagreements.

Ideas, products, and innovations. GCMs are always on the lookout for new types of services and tools to make caregiving easier and to help keep your loved one safe. Many will be able to tell you about new technologies, tools, or aids that help your loved one maintain independence and mobility for as long as possible.

caring.com

In Raleigh , NC, contact: Raleigh Geriatric Care Management. www.rgcmgmt.com lwatral@rgcmgmt.com

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Why Do People With Alzheimer’s Wander?

By  Frena Gray-Davidson

Don’t think Alzheimer’s experts know any more than you about Alzheimer’s behaviors. They don’t. So, your guess is as good as theirs. And, speaking as a longtime Alzheimer’s dementia caregiver, frankly I think caregiver guesses are better than most other people’s. So there! In my workshops, I always encourage family caregivers to guess. If the first guess seems to be wrong, guess again. Always be prepared to try something new when dealing with solving a difficult behavior.

And, by the way, it’s only difficult for you, which is really worth thinking even harder about. Not that you don’t matter because, of course, you do. It’s just that sometimes we’ll label a behavior as difficult and then we’ll fight to stop that behavior. To retrain our person. To make them learn that it’s not what we want.

Boy, now there’s a way to make yourself feel crazy. When we’re specially stressed, we caregivers can get stubborn and locked into our own demands. That’s because of the tightening up we experience as stress. Weary, grieving and overwhelmed, we just don’t tend to say to ourselves, “Now, how can I find a better way to solve this problem?” No, we tend to mutter between our clenched teeth, “If he (or she) doesn’t stop doing that, I’m going to go crazy!” So, figuring out how to find a solution to any dementia behavior problem should be preceded by a warm scented bath, or a session at the gym, a movie you love and then your own self-consulting care plan conference.

So now let’s fast-forward to that relaxed state in which you can ask yourself, ”What exactly is this behavior about and how can I find a solution?” People don’t do things only because they have dementia. Yes, they do have short-term memory issues. And, yes, they are usually unable to do rational step-by-step thinking. Even given those two unfixable issues, people with dementia have a very wide range of possibility in the behaviors they demonstrate.

So, why is your person doing that particular thing? That’s what you have to make guesses about. Your person is targeted on doing what will bring a desired emotional result. That you don’t want them to wander is your problem. Even if you pointed out that certain things are dangerous for them, it means nothing. Why not? Because they don’t remember what the problem was with what they did. And anyway, they feel like that’s what they want to do. And you can’t fight dementia.

So, why does your Alzheimer Dad go wandering? Make some guesses. Ask questions. Ask him, and then ask yourself:

Is he bored? Probably;
Is he restless? Sometimes;
Is he stuck with absolutely nothing to do? Yes, often.
Is he just not used to being this person with dementia? Undoubtedly.
Think about the average person who has dementia. They’ve lost their previous life and have nothing to replace it. Caregivers can be so busy that those they care for are often left in a kind of limbo They can be left doing nothing, having nothing and unable to figure out for themselves what to do.

I always look at the problem things they want to do as their communication to us. So, a walker wants to walk. As my nephew would say, “Duh!” First, everyone else can go walking any time. Except for people with dementia. We even label their walking as wandering. That’s our caregiver jargon which says we don’t want them to do it. It’s dangerous for them and inconvenient for us. If we don’t help find alternatives, however, they will walk out when we’re not looking.

WHY DAD WANDERS

The biggest reason never stated for people with dementia wandering is that this is the way they can self-medicate their anxiety and sense of displacement;
That feeling of displacement drives them to walk out of the front door and straight off down the road, going forward endlessly. It is a feeling that instigates walking and it is dementia which keeps it going. Once people have begun walking, they tend to be unlikely to ask for help or directions and they tend to go straight ahead.
Boredom and restlessness also drive people out of their front doors to find presumably some kind of variety.
This is why the smart caregiver creates an activity plan. For your Dad, maybe he needs a drawer all of his own full of the kind of stuff that used to interest him. Maybe he was a handyman around the home. Then screwdrivers, nails, a hammer – all the equipment of fixing up might keep him happy indefinitely. Maybe a tool box all jumbled up with stuff he can sort out.

How about having him sweeping up the leaves in the backyard? Filling bird-feeders with seed? If you get him weeding, be prepared for the consequences of a person with dementia who no longer knows a weed from a treasured garden guest.

When we craft an activity plan for our family member with dementia we look for something which evokes what was familiar in a way that doesn’t hold to forgotten standards. And as the caregiver, we commit to letting go of our standards of perfection.

The activity works simply by absorbing the person. Sometimes, your Mom could wash and dry the dishes. So what if you have to redo them? Mom felt useful and helpful and it brought back to her a life in which she was the woman who held the family home together.

These activities fill time, yes, but they also remind people who they were when they did not have dementia. I doubt they think it through in that way, though. I suspect they simply feel a more peaceful, more settled sense of belonging.

The desire in the dementia wanderer is often simply to want to go somewhere, anywhere but where they are. In assessing problem dementia behaviors, we always look at both the obvious message and the metaphor. Dementia allows people to operate at a number of different mental levels all combining into this present moment – which in itself might actually be South Dakota, 1926, for the person with dementia. Time zones may blend as that person’s life has now blended into its own story, nearing completion.

How do we bring satisfaction to the wanderer? Well, obviously, an actual walking program is a great idea. The caregiver need not be the one to do this. Ask a family member, a neighbor, a high school kid you trust, a volunteer from the senior center – any of whom can be great company on a walk. Hire someone to do the daily walk – it’ll be a good investment.

To organize this, you plan it, you set the boundaries in time and distance, you train the walker who’ll go with your wanderer. You explain dementia. You prepare them.

Add to this, a driving program. Most people with dementia love a drive in the car. It’s the most active passive entertainment for an elder. It should probably end at an ice-cream parlor or a fruit stand or somewhere else involving food.

The company of others who also have dementia is often very comforting, so look for a good day activity program. How do you know it’s good? See if people are having a good time. Talking like friends. Enjoying the quality of the connection. Dementia is often a lonely condition. The actual activity almost doesn’t matter as long as it clearly connects people by the heart.

The goal of all this is to tire out your family member so that restless dissatisfaction does not speak so loudly to them. Maybe get them a good pet friend, one of those older pets that are so understanding and seldom get adopted..

By the way, don’t forget to secure your doors. You want to know when your person heads for the great outdoors. This doesn’t have to be sophisticated. The things people I know have used successfully have been:

a set of brass bells hanging on a door-handle;
that cheap set of buzzer and five activators that you can put on doors. Not at all expensive — I think around $7 and in most budget stores and hardware places;
a warning door chime;
an ankle bracelet that sets off a perimeter alarm.
Or for the cunning escaper, firmly locked doors, deadbolted and you have the key.
If your person does get out, unnoticed by you, of course you need to go find them. Before you do that, call the police and give a description. Ideally, you would already have lodged a photo with the local police station just in case.

If you have already tagged them with a GPS unit, then your search will be much easier. Check on-line to find great prices on personal GPS systems. It’s something you can tag on the back of someone’s pants each day, for example. Not in pockets or a handbag or wallet – which can be lost or stolen.

If you are looking for someone not tagged, know that people with dementia are most likely to simply continue walking in a forward direction. If you have straight highways from your door, I’d follow those first. If you’re calling out for them, call by name, not by role. So Frank, not Dad. That’s because they may be in a much younger time-zone state of mind where they weren’t a Dad.

I know you will already have got a non-removable ID on your person. Not in a pocket but on a bracelet, anklet or dogtag. You can get these from the Alzheimer’s Association but they’re much cheaper from your local Walmart or equivalent. Put on their name, something like “memory-impaired” and the most relevant phone number.

Have your emergency wanderer kit already – all the numbers, all the friends and neighbors who’ve already agreed to help. Call everyone. Don’t be embarrassed – people love to help in a real emergency.

May all dementia journeys be safe ones.

Raleigh Geriatric Care Management*  www.rgcmgmt.com

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Beyond Driving with Dignity; The workbook for older drivers and their families

As a way of providing an additional tool for families working with an older driver, Keeping Us Safe has developed the “Beyond Driving with Dignity” workbook.

It was specifically designed to help your family by providing you with a “roadmap to success” in your quest to overcome the challenges of an older driver’s safety. It is designed to be used by families as a tool to meet the demands of a potential problem when you become suspect of the senior driver’s ability to remain a safe driver.

Timely and appropriate use of this workbook and of all available resources will help keep families from making many of the common mistakes encountered by others as you move toward a possible driving retirement for your loved one.

Working through this instrument will help your family make driving-related decisions that are not only in the best interest of the older driver, but simultaneously find themselves in the best interest of highway safety in general. This workbook was designed to be used by your family in the confidence and comfort of your own home, most likely seated right at your family’s kitchen table

Here is the table of contents:

  1. Beyond Driving with Dignity
  2. Introduction
  3. Welcome to “Beyond Driving with Dignity”
  4. How to use this workbook
  5. The Certified “Beyond Driving with Dignity” Professional
  6. Older driver demographics
  7. Initiating driving-related conversations
  8. The Older Driver in Your Family
  9. Understanding an older driver’s fears
  10. Understanding a family’s fears
  11. Working the Plan
  12. Where do we start?
  13. Vision concerns
  14. Hearing concerns
  15. Memory concerns
  16. Reflex and reaction time concerns
  17. Medication concerns
  18. Strength and flexibility concerns
  19. General health concerns
  20. Let’s take a ride
  21. Making Tough Decisions
  22. Coming to a risk-reducing decision
  23. Dimensional Performance Recap
  24. When dementia is making the decisions
  25. Maintaining Independence
  26. Vehicle adaptations
  27. Limit driving, not living
  28. Appendix Title
  29. A note about diabetes and driving
  30. A granddaughter’s essay
  31. Resources
  32. Endnotes and Bibliography

To order inquire at Raleigh Geriatric Care Management, http://www.rgcmgmt.com, or email, lwatral@rgcmgmt.com.

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