A car is the ultimate symbol of freedom and independence — especially for the Baby Boomer generation, who grew up during the pinnacle of car production.

But as our parents and grandparents get older, driving may become more difficult for them and more hazardous for passengers and other drivers on the road. Reaction times slow, and sometimes vision starts failing. They might still feel independent, but many of us grow nervous every time they take the keys.

“As we age, it’s more difficult to practice safe, defensive driving whether on the highway or in a town,” said Geisinger primary care physician and internist Stephanie San Andres Cabello, M.D.

A number of medical conditions, from vision problems to dementia and arthritis, can contribute to difficulty driving.

There are no specific driving rules for elderly people in Pennsylvania, which means they can continue driving as long as they renew their license on time and maintain car insurance on a vehicle. So, how do you know when it’s time for your older loved ones to stop driving?

If you frequently ride in the car with your grandparent or parent when they drive, look out for telltale signs like trouble switching from the brake to the gas pedal, difficulty turning to look behind them, trouble seeing signs or road markings from a distance, or getting lost.

“If you notice that your parents are having a harder time driving, suggest they visit a doctor for a formal assessment,” said Dr. Cabello. “If you fear it might be time for them to stop driving, getting confirmation from a doctor first can make this discussion easier.”

If you rarely drive with your parent, take the opportunity to ride in the car with them, or look for other signs that they might be having a harder time behind the wheel, such as traffic citations or warnings, or dents and scrapes on the vehicle.

Telling your older loved one that he or she needs to stop driving can be difficult — and it takes some planning.

Simply telling your loved one he or she shouldn’t drive anymore in one short conversation probably won’t be effective. Instead, think about what your parent or grandparent uses their car for and make arrangements for other family members or friends to fill in as drivers.

“You need to approach your elderly loved one with a plan for how they’ll get to the grocery store or to doctor’s appointments or social events,” said Dr. Cabello.

You should also plan for more than one conversation about no longer driving.

When you’re prepared to discuss driving with your loved one, start by explaining that you’re asking them to stop driving for not only others’ safety, but their own safety, too.

“Acknowledge that no longer driving is going to be very difficult,” said Dr. Cabello. “Show that you have thought this through but are doing it for the benefit of everyone.”

Then, present your plan for how he or she can get from point A to point B.

“Reassuring your loved one that they’ll still be able to get around, along with listening carefully about their concerns, can help ease the pain of this difficult conversation,” Dr. Cabello said.