No driving for rural(ish) 86 yo mum ...

[DeQuin]

Hello MNetters who have BTDT: my mum has just been told she can't drive any more. She is fiercely independent, not suffering from (noticeable) cognitive decline, and is financially OK. (Not rolling in it, but not struggling either.) She lives on her own in a house just outside a small town (good neighbours, has lived there for decades), and has a tiny bit of help with a cleaning lady once a week and someone to mow her lawn in the summer.

She is effectively already quite disabled as she is not able to walk much (she doesn't have a wheelchair as she is fiercely resistant to them, and can move around the house, and was driving everywhere else and parking right outside doors). Her eyesight is now so bad she is no longer allowed to drive.

What should we be considering? How can we help her?

DSis is wondering if she should be supporting her to move somewhere else (transport links, perhaps one of those retirement communities so she has easy access to people), but I am wondering whether living in a familiar house with failing eyesight would be better. In any event: what else should we be thinking of? Thank you for help and experience!

She’s definitely going to be best off in a familiar home if her sight is failing.

A scooter, as others have said, is also out due to her eyesight.

Find out if there’s a local on demand minibus service - Dial a Ride or similar. We have a service in my bit of Gloucestershire which is pretty much on demand for getting from the villages into the nearest town with shops, which is really useful for people like your mum.

Or: sell the car. Put the proceeds in a dedicated taxi account, along with a year’s worth of car tax, insurance, the cost of an MOT, and what she’d usually spend on fuel. Then she can see clearly that she has plenty of money to get taxis wherever she wants to go, without feeling it’s a luxury she might otherwise deny herself. That account will go a very long way. Find a local taxi firm who you’ll feel comfortable with her using. We have a small firm here with 3 cars, which gives priority to the elderly and has regular customers whom they run around town to the supermarket and back home, etc. .

think about what the longer term looks like. If she is going to move, better to do it sooner and choose a good suitable place to live. A modern sheltered housing near you or similar. It is much worse if she has a fall and is unable to get help, or has to move into a nursing home in a crisis.

ask her what she wants. Ask what her friends have done. Take her to visit sheltered housing options and promote them.

Volunteer transport. We are quite rural and have a scheme

Have you spoken to the neighbours? If your Mum has been very independent they may have been reticent about offering help. If they know the situation they can at least keep a closer eye on her. They may know about friendly taxi companies, local groups, etc.

Thanks everyone, for your thoughts. It's so helpful to get other perspectives! Based on what you all have said re failing eyesight a mobility scooter maybe isn't the best idea. 😅

Will talk to her about a contract with a local taxi company ... I think she thinks she can't afford it, but if she works out how much she spends on her car she may consider it -- and aside from anything else even if she moved, she can't move tomorrow, so is something for right now. She doesn't want to do online shopping because shopping is one of her "things" that gets her out of the house and she enjoys.

@Thewardrobehashangersin a physio and OT assessment is a good shout, thank you. In fact, your whole post is amazing and has lots of food for thought. Thank you.

@Mauvish1 also really good pointers in there thank you. Her fierce independence is absolutely not realistic but makes it tricky to put support in place for her. Will look into AA and like the idea of that possibly offsetting the cost of taxis.

I guess it's the balance of "can we make where she work for her" (both right now and in the nearish future) or are we better off moving her ASAP? We have experience with another family member, and moving her late in her decline I think was the event that created a cascade of poor outcomes. It's so hard.

Again -- appreciate all the input!

Would she qualify for attendance allowance for the eyesight and general disability and could use that towards taxis?

It's about care they need not care they get. For example done with osteoporosis and eyesight problems might be more at risk from a fall

Lots of good ideas I won't repeat. Your poor mum. It's a lot to come to terms with, but the right thing to do.

My Dad is 89 and still driving (competently) but insurance at this age is very high, and I don't think he'll renew again (and that might be a secret relief to him, although he won't admit that).

The insurance costs alone (not even counting the other costs of running a car) will cover a lot of taxis, help at home and other things.

My very elderly parents won't move. It's much too late for that. Independence is to be admired, but she will inevitably need more help -and you can best support by encouraging her to admit that, and help getting things in place.

It’s very hard. Another vote for local volunteer drivers. And another vote possibly for not moving - I agree that the local familiarity (eg knowing neighbours’ voices/general outline) and house familiarity makes a huge difference.

Google the Sensory Impairment teams for her local area. If she gets an appointment with them, ask if you can join in. There may be really straightforward things to try (eg a smart speaker? Tech to help her read her letters? A large-sized iPad - my sight-impaired dp’s mother found she could watch TV again with one of those). But I wouldn’t buy anything until you’ve had either the Visual Impairment team or an OT or both assess her.

Well done to your DM for continuing to live rurally and be so independent. I would help your DM look at how much she'd get if she sold her car - that may fund a couple of years of taxi trips. If she could use uber on her phone that may help, or there may be a company locally that you could use. I wouldn't recommend trying to decrease her outside activities (unless she wants to of course) as it'll be important for her to continue to interact with people.

Just backing up what others have said about the cost of running a car. Do a realistic summary of what it was costing: fuel, insurance, depreciation, tax, servicing etc
It may well be that taxis are more cost efficient any way and she can use that as a monthly budget towards travel

To add to my post, I also agree that local volunteer drivers are worth looking into. Her local council or social services (or Age UK?) might be able to advise.

Typically, I seem to remember when I once had to use them due to a broken limb you were expected to pay them a mileage allowance of something like 45p per mile (could be different now as that was 10 years ago).

Also, discuss a Care 365 alarm with her. This is where she wears the call button on a wrist band or on a pendant round her neck and she can use this if she finds herself with a medical emergency or has a fall (I think it might actually have a fall sensor, but not quite sure there). My 90 year old mother has one as she is of limited mobility and lives alone (carers going in regularly though). She had to use it only a few days ago when she had a fall in the middle of the night and some paramedics visited to get her up and check her over. Care 365 sent them.

For this you would probably need a key safe on the outside of the house with a spare key hung inside it. They are opened by those who need them (carers, emergency services etc.) using a combination of letters and numbers that you, your mother and your sister can agree on and can supply to those who you trust and who would need it.

People do worry about the security of key safest and I do understand that, but my mother and several of her friends do have them and in my experience they look pretty solid and bomb proof. My mother's carers use hers daily, and the emergency services were able to get in with ease when called by Care 365 a few days ago.

All things to consider that could provide more peace of mind for all of you.

If she gets rid of her car, the money she saves will pay for a lot of taxis.....

Taxis as suggested, also be prepared to help with arranging food and other deliveries. My mother had food deliveries and I knew I could step in and help arrange them, though it was never needed.

Have dealt with this scenario professionally many times.
It’s good to do a few sums and show the person how many taxis they can get for the price of running a car . But yes it’s hard to lose independence.
May help a little as if you have never taken taxis they seem very expensive!

My Mum drove until she was 89. By then her insurance was nearly £1000. She had no claims and lives in a low risk area. It was a lot of money given she was doing about 5 miles a week and never drove in the dark, when it was raining (it rains a lot here) and rarely drove in winter. It would pay for a lot of taxis but she now has her own chauffeur (me or her much younger brother).

Is she open to the idea of moving. It would be best to do it quickly if she is so she can familiarise herself with her new surroundings whilst she still has some sight. A sheltered or extra care sheltered place sounds suitable as there’ll be support and companionship on site but be aware of service charges and how long it might take to re-sell.

I live in a fairly rural area with a modest market town nearby. There are a number of local schemes that help to provide transport to people in your mothers position. Some are for specific purposes such as medical appointments, other more general but will pick up from 1 or 2 villages only. Often run by volunteers they ask for a contribution for fuel but it is a lot cheaper than taxis. It is worth doing a bit of research, maybe call Citizens Advice?

I'm in Worcestershire, and there is an on demand point to point minibus scheme here now that is £2.50 a journey and covers a pretty large area (and you can go outside the normal area to the hospitals), so have a look to see if there is anything in her area. Note, ours is advertised as booking on your smartphone rather like Uber, but you can phone to do so

Would you be able to pay privately for a carer/support worker a few hours a week who could run her into town etc and then look at increasing hours and tasks as her needs increase?

Yes, this is what I've been thinking as I read this thread!

You still need decent eyesight for a mobility scooter or electric wheelchair. You would be a danger on the road/pavement if you didn’t.

Absolutely not a mobility scooter, for her own safety and that of others. They go about 15mph, and are much less stable and protected than a car. Someone near here died recently after going over the edge of a non-dropped kerb and being tipped into the road.

What's the cause of her eyesight problem? Something fixable like cataracts, general age-related deterioration that may not get much worse, or something like macular degeneration that will deteriorate fairly rapidly and is likely to mean full or almost full loss? Different solutions will be needed for each of these.

I'd start by doing the sums on taxis and volunteer drivers where she is, and a walk round the current house looking at what could and couldn't be adapted for both sight and mobility. That may give a clear 'need to move' or 'can stay' answer, or at least help her think about which way she's inclined.

Thank you for further thoughts!

@Topseyt123 she already has the key thing, and many adaptations in the house which helps. I think the urgency to move though is for her to get used to a new place whilst she can still see as @Florencesndzebedee suggested.

Spoke to her last night and I think she is arriving at wanting to move as there is no "it all gets better" from here and she is finally engaging with her own vulnerability.

I think some of the suggestions here are not for her yet, but will be very useful in the near future: again, THANK YOU all.

it sounds like her days of living independently are numbered, sadly. The workload to keep her in her current house is going to go up exponentially as she gets less able.

It's sometimes more difficult to get homecare packages in place in rural areas because of staffing pressures and the time it takes to get round clients. Also ambulance call outs can take hours.

Moving to somewhere new with failing eyesight is a lot better than moving somewhere new with no eyesight. If she's in a town she will be better able to go shopping and keep up activities without driving too.

My MIL lives in retirement accommodation, I know a lot of older people are resistant to this but honestly it has been really positive for her. The social aspect is great for someone who is not very mobile (my MIL is in a wheelchair).