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A fraught decision: Older drivers agonize over when to give up the keys

Driving means mobility ― for some, a sense of identity ― and many wait as long as they can to relinquish their licenses.

Louis Axtman helped his mother, Wendy Axtman, 86, out to her car in Stow. Louis takes his mother grocery shopping and to doctors appointments but Wendy still doesn't want to give up her license.
Louis Axtman helped his mother, Wendy Axtman, 86, out to her car in Stow. Louis takes his mother grocery shopping and to doctors appointments but Wendy still doesn't want to give up her license.Blake Nissen/for The Boston Globe

They vividly recall their teenage years, when a set of wheels brought freedom and adventure. But now they’re more cautious on the road, wary in the rush of traffic. They endure the admonitions of concerned children, half-wondering if the kids are right.

As the ranks of older drivers swell ― folks in their 70s, 80s, and beyond who’ve spent half a century cruising country lanes and crawling through city traffic ― many face one of the most agonizing decisions that come with aging: when, or whether, to turn in the car keys.

“You get worried about going out at certain times,” said Barbara Clark, 93, of Framingham, a retired nurse who gave up driving three years ago. “Toward the end, when I got home, I’d sit in my parking space and say, ‘Thank God I’m back here.'"

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Some aren’t as lucky. A report issued last year by the National Highway Traffic Safety Administration showed the number of deaths in US crashes involving drivers over 65 climbed steadily during the past decade, to 7,359 in 2017, the most recent year for which the agency compiled data. But because the older population increased by nearly a third in the same period, faster than any other age group, their fatality rate declined in the same period and was lower than that of younger drivers. The data showed older drivers were the least accident prone overall and the most likely to wear seat belts.

Still, the risk-reward calculus remains daunting. Retired machinist Joe Luiso, 87, is one of only about a half dozen residents who’ve kept their parking spaces at the Carmel Terrace assisted living home in Framingham. Last year, he was involved in a minor fender-bender. “It was my first accident in 50 years,” he said. “My mind was somewhere else.”

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Luiso, however, isn’t ready to give up his car. "Driving gives me a sense of independence,” he said. “When there’s a family function, I jump in the car.” But, he admitted, his adult children are "more nervous than I am” when he’s on the road.

At a time when older Americans make up nearly a fifth of the nation’s drivers, it isn’t just family raising concerns. A loose network of auto insurers and medical professionals is also trumpeting safety behind the wheel to the more than 40 million seniors with active licenses. And yet, the decision to stop driving remains intensely personal.

Many say they dread “the conversation” with grown-up children. Those children find talks about driving fraught, and they often avoid them.

“Adult children need and want to see their parents as strong and competent,” said Lissa Kapust, director of the DriveWise safety assessment program at Boston’s Beth Israel Deaconess Medical Center, which tests older drivers and deems them safe or unsafe. “A son will remember in a crystal clear way how his father taught him to drive. How’s he going to tell his father that he’s no longer capable of driving?”

Kapust said everything about giving up driving is emotionally charged. “More than any other issue," she said, "this will bring families to their knees.”

Jamie Cole, 60, a Smithfield, R.I., seamstress, lives with her 88-year-old mother, Peg Sankey, a licensed driver who hasn’t sat behind the steering wheel since last fall ― but badly wants to. Rather than muster the courage to have the talk, the dutiful daughter tries to anticipate her mother’s needs and gamely offer her a ride to her destination.

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“She says, ‘I just want to go to the Dollar Store or the grocery,’ and I say, ‘I’ll take you,’” Cole said. “I’m not going to ask her to give up her license. But she can’t go anywhere if I have the keys in my pocket.”

Though they are, more or less by definition, the most experienced drivers on the road, some seniors struggle with concentration, worsening night vision, or medication-induced drowsiness. And advanced lighting technology — brighter headlights on cars and powerful light-emitting diodes installed in traffic signals — can be hard for older eyes to tolerate.

Swampscott widow Jessie Lipson, 90, turned in her license eight or nine years ago because of poor eyesight. Giving up driving was “a terrible adjustment,” she said. “I couldn’t just take myself to a doctor’s appointment or the supermarket.”

Lipson now hires drivers to take her shopping or to community events. She tries to make the most of every trip; mobility is no longer something she can take for granted. “You can’t do the things you always did," she said. "I can’t run out and buy a loaf of bread when I need it, so sometimes when I’m at the store I’ll buy two loaves instead of one.”

Seniors often delay hanging up the keys for as long as they can. But a collision or health reversal can force their hand, sending them to a driver assessment program to undergo a battery of cognitive and on-road tests.

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When she gives post-assessment feedback at the DriveWise program, Lisa Cohen, a social work program leader in the cognitive neurology unit at Beth Israel Deaconess, will sometimes ask older drivers to take a deep breath.

“If it’s bad news, I’ll say, ‘I understand this is disappointing,’ ” she said. “But as much as it’s a loss, I tell them driving is no longer safe, and they don’t want to put themselves or someone else at risk.”

Reaction varies. “Sometimes they’re grateful and relieved. Sometimes they’re angry and in denial.”

For the many seniors who choose to stop driving but keep their car keys at the ready, relief and denial can coexist for months, or even years.

Carmel Terrace resident Peter Palmer, 97, a retired engineer, still has his license but has left the driving to his 88-year-old wife, Jeanne, this winter. “It’s slippery outside now,” he said, by way of explaining his passenger status. He added, “I expect to go back in the spring.”

Some frame their decision to abandon their vehicles as a gesture of family solidarity.

“I gave up driving at 90,” said retired nurse Julia Puliafico, 92, another resident of the Framingham home. “I believe your reflexes get slower, and when that happens you shouldn’t be on the road. And my grandson needed a car, so I gave him mine.”

But the lack of mobility may be contributing to a loneliness epidemic seen among older Americans. Driving is often what links people to their exercise class, their place of worship, their favorite coffee shop.

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“Clearly, there’s both a psychological and a practical aspect of giving up driving,” said Richard Marottoli, medical director of the Dorothy Adler Geriatric Assessment Center at Yale-New Haven Hospital, who has studied the impact of no longer driving on outside activity and depression.

These days, technology offers car-less seniors more options, freeing those who can pay for rides from depending on neighbors. Unlike past generations, seniors relinquishing licenses are a mouse click away from delivery or ride-sharing services.

But in remote settings, ride-sharing services can be harder to access, and family and friends often pick up the slack.

British-born Wendy Axtman, 86, who lives in rural Stow, kept her license to shuttle her husband around when he was no longer able to drive. After he died two years ago, Axtman began experiencing pain in her back and ultimately stopped driving. Fortunately, her son Louis moved back home from nearby Ayer and takes her shopping or to appointments when he’s not working.

Yet she’s holding onto her license ― just in case, she said. “I don’t think I should be driving,” Axtman said. “But I’m frightened to turn in my license because I don’t want to give up my freedom.”







Robert Weisman can be reached at robert.weisman@globe.com. Follow him on Twitter @GlobeRobW.