Alzheimer's Almanac:
the driver's license

By Melissa Leandra Guerra

The driver's license has been one of the tougher hurdles. Driving his own vehicle was one of the last vestiges of Dad's independence, one of the last exercises of his own will. Looking back at the step-by-step process that rendered my father without his license, and in talking to other caregivers for Alzheimer's patients, I understand that the best thing to hope for is that the Alzheimer's patient realizes for him/herself that they no longer want to drive. I've heard of this happening after a series of fender benders or near-brushes with bad accidents. I wish an accident on no one, but if there is one, make sure that it makes it onto the patient's driving record.
We'd come up with ways to disable his vehicle, though we never did, and certainly we had tried on many occasions to suggest to him that his driving days were over, which always led to arguments that had become increasingly futile, his obstinancy eclipsing our well organized reasons and our promise that he would still be able to get around.
My sister Amanda told us that the Texas Department of Public Safety might be an ally in revoking my father's license. In the end, it was true, but the agency wasn't as helpful as you might think it would have been to help us get someone off the road who presented a danger not only to himself but to others. I called the local DPS office and was told that my father would have to give up his license voluntarily and if he didn't have any accidents on his record, there was nothing they could do. After I explained the situation for the umpteenth time, they finally gave me an address in Austin for the DPS division that might help. My father did have three minor accidents over several months, but he was not cited and so his driving record was clear. I quickly sent off a letter to the DPS once again explaining the situation. Unfortunately, the DPS responded not to me but to my father with a letter that said that someone had reported there might be a problem with his driving. They specified that a package from the Texas Department of Health (TDH) would arrive and that he and his doctor would have to fill out some forms. I was able to intercept this package, and exercising power of attorney, I gave my father's doctor permission to fill out these forms and to forward them to the TDH. Unfortunately, the TDH sent yet another letter addressed to my father explaining that if he didn't fill out the forms they would have no recourse but to recommend to the DPS to revoke his license. Had I known not answering the first letter from the TDH was going to speed things up with the DPS revoking his license, I would have ignored it.
Finally, after about four months the DPS wrote to say that since my father had not complied with the forms, his license would be revoked in 30 days.
Now came the really tough part. Since he ignored all of his doctors and wouldn't listen to his children about not driving, we had the task of telling him about the letter. I was advised by several friends and my sister Amanda who does not live here not to be the bearer of bad news so that at least one of us could remain in his good graces. However, since there were no other takers, the task fell to my sister Meg and me. We approached him, and I started to explain the substance of the letter, pointing only to the word "revoked" at the top and summarizing the rest in my own way.
He said, "I'll just shoot myself if I can't drive," which prompted Meg to hastily run to the bedroom to hide in her clothing the old .22 propped in the corner. She exited my parent's house like Chester in Gunsmoke, dragging the leg that would not bend for the length of the rifle, never stopping to check if or not there had been a round in the chamber. She deposited the weapon in my house next door, abandoning me for the moment, but returning to try to make sense of an argument that had reached its boiling point.
The DPS letter gave my father the option to appear before a judge and to fight the revocation. He made no attempt to read the letter. He was angry and indignant and said he would take the matter up with his attorney.
Knowing we agitated him with enough bad news for the night, we left.
The following day, our other sister Sandra called to say that my father wanted to go somewhere, but that she had stopped him for the moment. I dropped what I was doing and came home to take him on his errand, using my set of keys to his car. I didn't want to talk about the driving issue, so we just chatted on our way to his errand. That evening as I was getting ready to take my parents to Mass, I decided to run late on purpose. When I got to their house I told my Dad that we were out of time and that I hadn't brought my key to his car. He said I could use his key but only if I gave it back to him when we got home. I of course said I would. On the way home from church, I knew this was my opportunity to take away from him the only other set of keys to his vehicle. But was I strong enough to take them from him and never give them back?
Within two seconds of pulling into their garage, I threw the vehicle into park, had the door open and was out of the vehicle and headed out the garage to my house next door with his set of keys. My father would later call me a liar for not returning to him his keys when I had said I would, as Meg would be called a thief for taking the old .22 out of their house. To an Alzheimer's caregiver this is called therapeutic lying -- do what you have to do, say what you have to say.
I walked into my house and quickly reported to Meg in San Ygnacio to tell her what I had done. I was excited and worried, but I didn't cry once while we talked. But then the doorbell rang and it was both my parents at my doorstep. I left the phone on in my pocket and Meg listened to my conversation with my parents. My mother asked me insistently and sternly for the keys to the snappy SUV they had bought not long ago, and I who have never disobeyed my parents or denied them any request told her I couldn't give them to her because my father would get them and per the State of Texas he didn't have a license to drive. I kept my calm as I explained to her that he couldn't drive and that by continuing to drive my father was exposing her and others to grave danger and liability.
My father told me never to come to his house again, that I was a liar, that he had no use for me, my father, the man with whom I have had such a long and dear relationship. When my parents left, I got back on the phone with Meg. She told me she was proud of me, which prompted me to sob uncontrollably. She told me to get out of the house and that she would drive in from the ranch to find me. Unfortunately, she was 45 minutes away and so I sat in the parking lot of HEB for close to an hour crying as I waited. We ended up at IHOP for another couple of hours, knowing we had done the right thing but weeping nonetheless and talking until we had collected our strength. I got home close to midnight, emotionally spent. Meg drove home to the ranch in a state no doubt similar to mine, but there, it was done -- he wouldn't drive again.
A couple of days later, Dad calmed down and told us with dignity and a tight upper lip, "This is the way it has to be," which made for another round of high-pitched emotion as we understood the weight of his acceptance of the new plan.
We were fortunate enough to have one of Meg's dedicated staffers at the paper diversify his job description by becoming the driver for my parents when one of us cannot help them. Several afternoons a week he, along with their daytime caregiver, takes them to a variety of appointments and errands across town.
The driver's license issue is settled but somehow not forgotten. My father asked Meg only yesterday if she would help him get a car. When she declined, he became angry. Angry with her, he'll forget he's been angry with me because I said no, too, then it will be her turn again. And so it goes. This afternoon he has asked his stockbroker to help him get a car.
When I think of this process -- this spiral downward of mind while will persists -- that sometimes moves mercifully fast and other times arduously, painfully slowly, I contemplate the functions that have fallen from my father's judgement to ours. Asserting control over my father's life has seemed unnatural and out of the order we assume our lives should follow. Control over finances and the ability to drive, however, have been the two most important aspects of my father's life over which we have learned to exert our own judgement. The first he gave up willingly when he was well and because he trusts us implicitly. The latter -- his ability to move through the world on four wheels -- he gave up with much resistance.
My parents' house was painted inside and out twice within a year; my father, falling prey to a glib painter, had lost the judgement to know it did not require painting again. His minor accidents in the car were simple things like taking a left from the right lane on a one-way street (the other guy was uninsured and without a license, so my father was not cited). In another accident, he misjudged the distance from the car next to him. He didn't think he hit anyone, but the police showed up at home and wanted to see the car.
As a caregiver for an Alzheimer's patient, I've understood that a sense of humor is one of our most vital survival tools. After the crying, you need to laugh a little, and now and again there's a hilarity that runs through things -- the smart Armani clothes and leather goods he came home with when he was last mobile and still knew how credit cards worked; Meg limping out of the house with a rifle in her clothes; becoming our father's sons; my father's 30-year point of reference -- "I haven't had this (guacamole, calabacita, ice cream, pie, a cold beer, etc.) in 30 years."
Our father built the foundation for what we know of love and in his house we find the heart of love in lessons of patience, trust, and kindness. There are times he thanks us for the smallest of gestures, his eyes brimming with tears, and I am thinking to myself, "Oh, Dad, all the things you ever did for us."