Helping a Parent Stop Driving: A Guide for Families

If you're reading this, you're probably worried about a parent's driving. Maybe you've noticed some changes. Maybe other family members have said something. Maybe you had a moment in the passenger seat that gave you a fright.

You're not alone. This is one of the hardest conversations families have. When the changes you're noticing are linked to a medical condition (such as dementia, stroke, Parkinson's disease, or other conditions affecting cognition, vision, or physical function), an OT driving assessment can help determine whether it's still safe for them to be on the road.

This is a practical guide to navigating it, written by an OT who assesses drivers in this exact situation regularly.

Why this is so difficult

Before we get into what to do, it's worth acknowledging why this is hard.

Driving is deeply tied to independence and identity. For many older people, particularly those who've driven for 50 or 60 years, the idea of not being able to drive feels like a fundamental loss. It can represent:

• Loss of autonomy (relying on others for everything)

• Loss of identity (being "the driver" in the family)

• Loss of spontaneity (no more popping to the shops)

• Loss of social connection (getting to friends, family, clubs, appointments)

• A confronting signal that they're ageing

When you suggest someone might need to stop driving, you're not just talking about a car. You're talking about all of those things. This is why the conversation often triggers strong emotions, defensiveness, or denial.

Understanding this doesn't make the conversation unnecessary, but it helps you approach it with more empathy.

Signs that a driver may no longer be safe

Some of the warning signs that an older driver may be struggling include:

• Minor bumps, scrapes, or unexplained damage to the car

• Getting lost on familiar routes

• Driving too slowly (well below the speed limit without reason)

• Confusion at intersections or roundabouts

• Drifting between lanes or not staying in the centre of the lane

• Missing road signs or traffic signals

• Responding slowly to changes in traffic

• Near-misses that seem to happen more often

• Family members avoiding getting in the car with them

• Comments from friends or neighbours

• A recent medical diagnosis that could affect driving (dementia, stroke, Parkinson's, significant vision changes)

One warning sign on its own may not mean much. A pattern of them usually does.

Start with the GP, not the car keys

This is the single most important piece of advice I can give families: don't try to handle this yourself. Involve the GP.

Here's why. In NSW, drivers with medical conditions that may affect their driving are legally required to notify Transport for NSW. In practice, this usually happens through their GP, who completes a form called the Transport for NSW Fitness to Drive form.

On this form, the GP makes a clinical judgement: can the person continue driving, do they need a formal OT driving assessment, or should they stop immediately?

By going through the GP, you:

• Take yourself out of the position of being "the one who took the keys away"

• Get a clinical, objective process started

• Remove the conversation from being about family opinions and put it in the hands of a professional

• Make sure the legal and licensing requirements are handled properly

How to raise it with the GP

You can call the GP's reception directly and let them know you have concerns about your parent's driving that you'd like the GP to address. The GP can then either:

• Raise it during your parent's next scheduled appointment

• Book a dedicated appointment to discuss it (you may or may not attend, depending on your parent's wishes and capacity)

• Document your concerns for their consideration

If you're worried your parent will be upset that you contacted the GP, it's usually okay to be upfront with them about it. You can say something like, "I've been worried about your driving. I've mentioned it to the GP because I want to make sure we're doing the right thing. I'd rather they look into it than for something to happen."

Having the conversation with your parent

Whether or not you involve the GP first, at some point you'll probably need to talk to your parent directly. A few things that often help:

Choose your timing. Not in the car right after a near-miss. Not in front of grandchildren. A calm, private moment.

Lead with concern, not criticism. "I've been worried about you" lands differently to "You're not safe to drive anymore."

Be specific about what you've noticed. Vague concerns are easy to dismiss. Concrete examples are harder. "I noticed you didn't see the car coming from the right at that intersection last week" is more useful than "You're not as good at driving as you used to be."

Frame it as safety, not capacity. The issue isn't whether they're a "good driver." It's whether their medical condition or age-related changes are making driving riskier. This is a subtle but important distinction.

Acknowledge the loss. "I know this isn't what you want to hear. I know driving matters to you. I'm raising it because I care about you, not because I think less of you."

Offer the OT assessment as a way to find out objectively. "Let's get it properly assessed, rather than us guessing. If you're fine, you're fine. If there are things we need to know about, we need to know."

What if they refuse to see the GP?

This comes up. Some older people refuse to acknowledge there's an issue, refuse to see their GP about it, or refuse to attend an OT assessment.

A few options:

Involve other family members. Sometimes the person will listen to a sibling, a grandchild, or a family friend when they won't listen to you.

Raise it at a scheduled medical appointment. If your parent sees their GP for other reasons (blood pressure reviews, chronic condition management), you can ask the GP in advance to raise the driving issue during that appointment.

Contact the GP directly with your concerns. Even if your parent won't come to an appointment, the GP can note your concerns on their file and address it at the next opportunity. In some cases, the GP can notify Transport for NSW directly if they have serious concerns.

Contact Transport for NSW. If you have genuine safety concerns and your parent refuses all other options, you can contact Transport for NSW yourself. They can review the driver's medical status and require a formal assessment. This is a last resort and can be very upsetting, but it's sometimes necessary.

What happens at an OT driving assessment

The OT driving assessment is a formal evaluation of whether a medical condition is affecting someone's driving. It has two parts:

An off-road (clinical) assessment. The OT visits your parent at home and assesses their vision, thinking skills (attention, processing speed, decision-making, spatial awareness), and physical function. Family members are welcome to be present for this part and often provide useful information.

An on-road assessment. Your parent drives for about an hour with the OT and a specialist driving instructor in a dual-controlled vehicle, in their local area.

The whole process takes 2 to 3 hours. The outcome can range from "fine to keep driving" through to various restrictions (daytime only, local area only) through to a recommendation to stop driving.

The OT provides a formal report to Transport for NSW, your parent's doctor, and your parent. Transport for NSW makes the final decision about the licence.

If the assessment recommends they stop driving

This is the hardest outcome. A few things that can help:

Acknowledge the grief. Losing a licence is a genuine loss. Don't rush them through it. Let them be upset.

Focus on what you can do. Planning alternative transport, organising lifts, arranging home delivery services, exploring community transport options.

Preserve their autonomy elsewhere. If they can no longer drive, they can still make lots of other decisions. Give them agency where you can.

Keep them connected. Isolation is one of the biggest risks after someone stops driving. Actively work to keep them socially connected.

Be patient. It can take months for someone to adjust. That's normal.

A final thought

Helping a parent stop driving is one of the harder things families do. There's no version of this that feels good. But there is a version that's safer, more dignified, and more respectful of your parent than the alternative (which is often a crash, or the police calling you, or your parent harming someone).

An OT driving assessment isn't a punishment. It's an honest, objective process that lets your family make decisions based on clinical evidence rather than guesswork. For many families, it's the circuit-breaker that resolves months of tension.

If you'd like to start this process for a parent in Sydney, the first step is a conversation with their GP. Once you have a referral, you can book an OT driving assessment at steerdriving.com.au/referral.

This article was written by Elise, an AHPRA-registered Occupational Therapist and Transport for NSW-registered driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice in Sydney.

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