Taking The Keys From Loved Ones People With Alzheimer’S Cling To Last Avenue Of Independence

Nancy Rockwell gave up her credit cards after her husband found 95 pairs of shoes in her closet alongside new party dresses she didn’t remember buying.

She gave up driving downtown after intersections she’d traveled through for years as a state attorney overwhelmed her.

But her short drive to aerobics class? No. She did not want to give that up. When she was diagnosed with Alzheimer’s disease a few years ago, she knew life would be a never-ending stream of giving up. She drew the line at her routine drive to the gym.

“I can get over there and back on my own,” she told her husband, Ed. “I haven’t had a moving violation for years and years.”

So began the heart-wrenching debate thousands of area families face each year. When someone has Alzheimer’s disease, how do friends and relatives strike a balance between keeping them safe and keeping them happy? How much independence do you take away and how soon? And how do you do it without taking away their dignity, too?

Experts say it’s the toughest challenge families face when a relative develops the degenerative brain disease. Tougher than decisions about medications. More difficult, even, than watching your mother search your eyes for recognition and come up empty.

“You can end up with a living hell if you take away too many freedoms,” warns Ray Raschko, who trains people to recognize Alzheimer’s symptoms.

When Nancy Rockwell insisted she could drive to the gym alone, her husband, a doctor, decided not to argue. After all, the folks at the gym looked out for her. When she occasionally arrived to work out in sandals and a dress, they understood. And the drive was a huge boost to her self-esteem.

“She didn’t want to lose face that she needed help getting anywhere,” Rockwell says. “It was a matter of ego, I guess.”

The last time Nancy Rockwell went to the gym, something went wrong. Ed suspects she turned the wrong way at Regal and 57th and never managed to correct it.

Eventually, a farmer who gave her directions watched the 63-year-old woman drive down a dead end 50 miles from her South Hill home. He figured she was turning around. Last week, 10 days after her aerobics class, searchers found her body in a freshly plowed field, a jacket rolled under her head. Her Ford Explorer sat less than a mile away. An autopsy showed she died of exposure.

Raschko doesn’t know the Rockwells, but he winces when strangers criticize the family’s decision to let Nancy Rockwell drive. He believes being diagnosed with Alzheimer’s shouldn’t mean the instant loss of a driver’s license.

“Safety versus freedom,” he says, summing up the common quandary. “I’m very much on the side of freedom.”

Driving is the ultimate expression of independence in a society that all but worships self-sufficiency, Raschko says. For some, giving up the keys amounts to giving up the fight for a fulfilling life.

Yet as a geriatric outreach coordinator at Washington State University, he knows the risks. Besides Rockwell, he recalls four area Alzheimer’s patients who died in the past decade after driving or wandering away and getting lost.

But, says Raschko, considering about 8,000 people in Spokane County have the disease, those are pretty small odds.

Knowing when to take driving privileges away isn’t easy. Long-term memory is the last to go, so people may retain their driving skills for years after their diagnosis, Raschko says. But because short-term memory is damaged sooner, they may not remember directions once on the road.

Some families prefer not to take any chances. That’s Mary Ann Reichmuth’s advice and has been since she got the call in 1981 that her mother, June Rector, took a wrong exit on the way to Seattle. She’d been following her husband in a car they were returning to their son.

Rector was lost for two days when, covered with scratches, she knocked on a door in Tukwila. A woman called police. The car was discovered two weeks later on a remote hillside.

“She never recovered to where she’d been before,” Reichmuth says.

The experience seared in her mind a rule for driving with Alzheimer’s: Don’t. “I think anytime someone’s been diagnosed, it’s time,” she says.

Bob Bray, a Spokane family doctor, says car crash rates rise among people diagnosed with Alzheimer’s two or three years earlier. Families should review the patient’s driving every six months, he says. How? Get in the car.

“I have never seen a situation where I felt the patient’s health was jeopardized by forcing the issue and making them not drive,” Bray says. “That doesn’t mean they don’t get angry about it.”

Bray doesn’t mind being the heavy. He’s written “Do Not Drive” prescriptions when families want help persuading someone to stop. He has also asked the state Department of Licensing to insist a patient take another driving test.

But resolving to stop someone from driving can be much easier than doing it.

Many families resort to removing distributor caps, replacing car keys with fake ones, or just flat lying.

Wandering away remains a problem, but confused people don’t usually get as far on foot.

Even after Evelyn Case sold her husband’s car, he thought he could run errands. In the middle of a cold night, Case awoke to find 79-year-old Clifford wearing pajamas and a coat, heading for the door. The former lumber store owner insisted he had a delivery to make.

Another time he made it three blocks before a stranger found him standing in her yard. “We’ve just been lucky,” Case says. Six months ago, she moved Clifford into a care home run by Holy Family Hospital.

Bernadine Wilson didn’t know how she’d ever manage to take her mother’s car keys. Elsie Kruckenberg had always loved long-distance driving. Then came the fender-bender. And then the call saying Kruckenberg dropped off a friend at the hairdresser and never picked her up.

Wilson took her mother’s license. A brother searched the house for spare keys, locked the blue Hyundai in the garage, and disconnected the garage door opener.

“You’re taking everything from me and it’s not your right,” Kruckenberg argued. And then: “You sold my car just for the money!”

Knowing people with Alzheimer’s can be combative didn’t help Wilson. For her, consolation came in the form of a support group, and for a while she served as executive director of the Inland Northwest Alzheimer’s Association.

A decade later, Kruckenberg’s eyes still turn stormy on occasion, and, with swear words she’d never have used before, she accuses her daughter of stealing her car.

Wilson doubts the longing to cruise down the interstate will ever end.

She calls to Ginger, her 14-year-old cockapoo, and hands her mother the leash. “Ginger is walking Mom,” she jokes with her husband.

Because Ginger always comes back home.

Graphic: Alzheimer’s deaths growing