The driving conversation

Jim Van der Berg is fifty-nine and runs a dairy farm near Chatham that his parents started in nineteen sixty-two. His father, Henk, is eighty-four, Dutch-born, and still drives his pickup to town every morning for coffee with the same four men. Last month he clipped a mailbox. Last week he missed a stop sign. There's no bus for thirty kilometres, and Jim milks at five.

So here's the question. How do you talk about driving before there's a crash, what does the law ask of doctors, and how does a driver over eighty keep a licence in Ontario?

Start with why the keys matter. A twenty sixteen review of sixteen studies found that older adults who stop driving go on to have worse health and function, and in five pooled studies, nearly double the risk of depressive symptoms. Those are observational studies, so stopping may not be the cause. But the lesson holds: plan transport and company, not just the keys.

Few people talk about it early. In one small American survey of a hundred and sixty-eight drivers over fifty-five, only about one in five had talked with anyone about what they'd want if their driving declined. Yet more than half said they'd sign a plan naming who would help decide later. Most thought the driver, the family or a doctor should decide, not the licensing office.

Now the law, from the Highway Traffic Act and its regulation. Physicians, nurse practitioners and optometrists must report certain conditions to the Registrar, including a cognitive impairment that affects judgment, memory or reaction time and substantially limits daily life. The driver handbook lists only doctors and optometrists, but the regulation includes nurse practitioners, and the regulation governs.

From age eighty, Ontario drivers renew every two years. About three months before the licence expires, a letter arrives. Your parent watches a short education video online, then books a ServiceOntario appointment. There they do a vision check and an exercise of about five minutes: drawing a clock set to ten past eleven. Some are then asked for a road test or a doctor's report. Follow the letter; it has the current steps.

Now, their side. For Henk, the truck is freedom, company and who he is. It got him to church, to the co-op, and to those four men every morning for thirty years. It's fair to guess losing it feels like losing his last job. So don't start with the keys. Ask him: if the day comes, who would you want to help you decide, and how would you still get to coffee?

Let's change one fact. Henk has a dementia diagnosis. Now his doctor may have a legal duty to report to the Registrar, and the licence decision may leave the family's hands. That doesn't make the conversation less important. It makes the ride plan urgent. A Canadian website, driving and dementia dot c a, built by Toronto researchers, has pathways for families. And a small trial of a caregiver group found families felt more prepared.

The mistake families make is taking the keys with no ride plan. Hiding them, or disabling the truck, ends the coffee, the church and the co-op in one move, and the research says isolation is the real danger. Volunteer drivers through the Red Cross or the Legion, local paratransit where it exists, and a neighbour's standing offer all belong in a plan.

Here's the rule, in one breath. Talk early, build the ride plan first, and let the doctor and the licence office do their jobs.

This week, list every trip your parent makes in a week, and beside each, write one other way to make it. Coffee, church, groceries, the pharmacy. Then show your parent the list and ask what you missed.

Next time, a new module on dementia: telling worrying changes from ordinary forgetting, and the first steps to a diagnosis.