Safe to drive for 94-year-old man? A difficult answer

Twenty-plus years ago, my wife and I had just completed a rehab of an old 1,300-square-foot house back East. She had found a tenant, a 94-year-old man, soon to move in, but to leave for Florida for winter.

I had reservations about a one-year lease, and endured the usual jokes about buying bread by the slice or not buying green bananas. However, he was quite vigorous, bounding up (and down) stairs, and he had recently driven 1,500 miles from Florida to New England – solo. We liked him, and we knew his family.

The family had approached me with concerns about his driving. Was he safe? Rather than a family confrontation, I suggested a third party – the town cop, maybe, or the family doctor? There, the matter rested. Weeks later, on a Sunday afternoon in the emergency room, the police scanner blurted the code for “a shooting” in our town. We considered the possibility of a rescue vehicle coming in – until hearing a follow-up code for “dead.” Not our problem, we thought, until I received a call from the scene of the shooting.

I don’t know how, or why, I ever became a volunteer deputy medical examiner, 24/7, in a rural county. Maybe, it was something from medicine’s three A’s: availability, affability and ability. I knew immediately what the calling officer needed: “OK for the removal, bring him in – by the rear door – I’ll certify. ...”

An hour later, I unzipped the body bag. Our tenant. An entrance wound was visible above the right ear – from a .38-caliber rimfire – fatal, without mess.

Some states, but not Colorado, require physicians to report patients who may be impaired drivers. Extensive criteria for impairment now exist: “Physician’s Guide to Assessing and Counseling Older Drivers,” is available online.

In Colorado, physicians (or families, parent, spouse, child) may provide information to the Department of Motor Vehicles regarding physical or mental impairment or they may request the department to re-examine the driver, whether that be written exam, eye exam, road test or all.

However, the driver has the right to know who made the report to the department and to obtain a copy of same. A physician’s opinion or report, if in “good faith,” is privileged and cannot be used in any legal proceeding except in the question of the driver’s qualifications to receive or keep his license to drive. Generally, families will be the first to confront the problem. However, mental illness or dementia are formidable obstacles, and, if present, the need for third-party intervention should be clear.

Our tenant-to-be was angry about forfeiting driving. His son, passing by the ER several months later, stated: “It was about the gun.”

Unable to return to Florida by car, the father would have had to fly, unable to carry the firearm – this fiercely independent Yankee’s safety-valve.

His decision to use it was likely the last bit of control he had over his life. None of us saw his distressing death coming. Recently, I asked the son if his father had been rational. He replied unequivocally: “Yes.” Dr. Fraser Houston is a retired emergency room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.

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