Giving up car keys, and other hard decisions for older adults

Some years ago I visited my 90-year-old mother. She was living in a lovely retirement community in south Florida.

This visit was different. My mother and one of her best friends had decided to move to an independent living complex with congregate dining. My mother, my aunt (89 years old), her friend Shirley (94 years old) and I went on a field trip to tour the facility. We met with the leasing director, took a tour of the apartments, and had dinner in their dining room. The complex has a combination of independent living apartments and assisted living if residents needed more intensive care. If someone needed daytime help, it could be easily arranged.

Dinner was restaurant style with a menu and many choices. The food and presentation were quite good. In the dining room there were actually a number of men! It reassured me that my gender was not entirely an endangered species. But in this group of 85-100-year-olds, about 90% were women.

The major problem, for this trio of older adults, was that they could no longer drive (Thank heavens!). All three of them were reluctant to give up their driver’s licenses, for understandable reasons. When they surrendered that piece of paper, they lost much of their independence. Yes, they could take cabs or the bus in their retirement community. But for them it was a psychological blow — they were now dependent on others for rides. They couldn’t come and go as they please. No wonder it’s such a struggle for older adults to stop driving. And for their adult children who plead with their elderly parents to give them their car keys.

These three women were also having difficulty with meal preparation. I went shopping with my mother the day before our field trip and afterwards she was completely exhausted. Shopping, meal preparation and cleanup just required too much energy for this group of women. Also, they no longer had much of an appetite (a very common experience among older adults), and they didn’t eat very much when they ate alone in their apartments. (My mother admitted to eating a lot of canned soup.) But eating is a social activity, and they ate more when they ate together— a very good reason for the very old to have meals with others.

None of these three women really wanted to move. The thought of negotiating a new environment is stressful. They were comfortable in their familiar environments. My mother was overwhelmed with the idea of sorting through her things and deciding what to take. My brother and I reminded my mom that we would swoop down and do the entire job for her, as we did when she moved from her house into her current apartment. When she did move, it was hard for her, but she adapted relatively quickly to the new environment.

Change is very demanding. But my mother and Shirley had always been decisive women. They weren’t afraid to make decisions, even if they were difficult ones to make. My aunt, on the other hand, was fearful and it was difficult for her to make choices. “I like the place,” she said, “but I’m not ready to move”. My cousins wanted her to move with my mother. After much, hesitation, she finally did. As it turned out, she loved living there.

Many adult children and their elderly parents consider independent living programs. It can cost anywhere between $2,000-$6,000 per month depending on amenities. It generally includes 2-3 meals a day. Activities are on-site and there is a nurse available. Assisted living involves more care and costs closer to $5,000-6,000 per month.

We are all living longer, and hopefully, we’ll have a high quality of life. Finding options for our aging relatives is one of the many challenges of adults in mid-life. The struggle to maintain our elders’ dignity, independence and well-being is the goal of positive aging.

My mother lived a full year in her independent living apartment before she came to the natural end of her life. She developed close friends and enjoyed many of the activities that were available. She was glad that she moved.

And so were my brother and I.

Paul Schoenfeld is a clinical psychologist at The Everett Clinic. His Family Talk blog can be found at www. everettclinic.com/ healthwellness-library.html.