Play 04
Dad refuses to stop driving: the Missouri medical review, step by step
Dad refuses to stop driving. There is a new dent in the bumper he cannot explain. He still has the keys on the hook by the door. You are trying to work out whether this is a conversation, a doctor, or a letter to Jefferson City. This play is the Missouri process, who can file, what happens next, and the ride plan that has to exist before anyone talks about the keys as if they were already gone.
What Dad says
I have been driving since 1968. I only go to Schnucks. You are not taking my car.
What it usually means
The license is the last proof he still runs his own life. Losing it sounds like the house is next. That fear is real. It is not a driving test.
Your next move
Write the ride plan first. Talk to the doctor about what you saw. If you file, file the state's written report, once, in good faith, with observation or physical evidence.
Who can report an unsafe elderly driver in Missouri?
Section 302.291 of the Missouri statutes is the medical-review door. The director of revenue, having good cause to believe an operator is incompetent or unqualified to retain a license, may require an examination after giving ten days' notice in writing by certified mail. Good cause may rest on a report by:
- any certified peace officer;
- listed licensed health professionals (physicians, certain therapists, nurses, psychologists, social workers, counselors, optometrists, emergency medical technicians, chiropractic physicians);
- any member of the operator's family within three degrees of consanguinity, or the operator's spouse, who has reached the age of eighteen, except that no person may report the same family member more than one time during a twelve-month period.
The report must state that the person reasonably and in good faith believes the driver cannot safely operate a motor vehicle. It must be based upon personal observation or physical evidence, which the report has to describe, or upon an investigation by a law enforcement officer. It shall be a written declaration in the form prescribed by the Department of Revenue, with name, address, telephone number, and signature. That is the whole instrument. A voicemail to a sergeant is not it. A group text among siblings is not it.
Anyone who makes that report in good faith shall be immune from any civil liability that otherwise might result. Anyone who intentionally files a false report shall be guilty of a class A misdemeanor and liable for damages. Reports are kept confidential except by court order or in a review of the director's action. Do not treat a family argument as a filing. Do not file because you are angry he went to the hardware store. File because you saw something you can put on paper.
What happens after a Missouri driver medical review is filed?
The director may require a written test, driving-skills test, vision, highway-sign recognition, and, if appropriate, a physical or mental examination. Refusal or neglect to submit to an examination within thirty days after the date of the notice is grounds for suspension, denial or revocation. Notice of any suspension, denial, revocation or restriction is by certified mail.
Physicians are not required to report. The Department of Revenue's FAQ on physician reporting says section 302.291 authorizes reporting, and that if the director receives information from a physician indicating a medical condition has made the driver unsafe, the director will notify the driver that the current license will be revoked after ten days unless the driver presents medical examination information indicating any change in condition. The physician form is the Physician's Statement, Form 1528. It goes to the Driver License Bureau, 301 West High Street, Room 470, Jefferson City, MO 65105-0200, telephone (573) 751-2730. You do not fill out 1528. His clinician does, if that clinician chooses to report.
If the condition is temporary as reported by a health professional, the statute gives the driver a path to petition for total or partial reinstatement with a statement from a similar licensee. Appeals of revocations, suspensions, denials and restrictions run under section 302.311 within thirty days after notice. This desk does not run those appeals.
The talk, before the letter
The National Institute on Aging's page on safe driving for older adults is written for the conversation you do not want to have. Signs a loved one should no longer be driving include multiple crashes, near misses, or new dents; two or more tickets or warnings in the last two years; insurance increases; comments from neighbors; anxiety about night driving; health issues with vision, hearing, and movement; and a doctor's recommendation. NIA says there is not one recommended age to quit. Stick to skills, not age. Use "I" messages. Be prepared with transportation options before you start.
On dementia and driving, NIA says that in the early stages some people can keep driving, and that as memory and decision-making worsen they will likely need to stop. People with dementia often do not know they are having driving problems. Family and friends need to monitor, and signs include new dents or confusing the brake and gas. That is a clinician's conversation. This page does not diagnose him. If a clinician has already named a dementia, read Play 07 before you treat the keys as a pride problem.
The ride plan that has to exist first
Do not win the keys and lose the rest of his week. NIA points families to the Eldercare Locator at 800-677-1116. In this metro, Aging Ahead covers adults 60 and older in St. Louis, St. Charles, Franklin and Jefferson counties. In the city, the St. Louis Area Agency on Aging is at (314) 612-5918. United Way 211 is 24/7. Write the actual week: grocery, pharmacy, church, the doctor on Ballas. Put names next to the slots. A son in Kirkwood cannot be every cell. Non-medical hours can cover some of those rides. If you want that from a company in this metro, Call (314) 405-0887 and ask New Plan Care about transportation and companionship, not about taking a license. New Plan Care is a client of OwnersFirm, which publishes this site, and pays for that mention.
Should I hide the keys tonight?
This desk is not going to tell you to take his property. It is going to tell you to build the ride plan, call the doctor, and, if you file, file the form the statute describes, once, with what you saw. A hidden set of keys is a family fight that can go badly in a house where he still lives alone. The state's process exists so that fight is not the only tool you have.
What to do tonight
- Write what you actually saw: dents, near misses, wrong-way stories, night driving, getting lost on a familiar road. Dates if you have them.
- List every trip he made this week and who could cover it without him driving.
- In the morning, call the doctor's office and describe the driving, not your theory of why.
- Do not file a false report. Do not file twice in twelve months. If you file, use the written declaration the Department of Revenue prescribes.
When to ask the care team or the doctor
Whether he is safe to drive is a clinical question and a licensing question. Eyes, ears, medicines that make him drowsy, a stroke, a change in thinking: those belong with the physician. Ask the care team whether they will talk with him about driving, and whether they will use Form 1528. A home care company does not decide this. Neither does this desk.
Next: Play 07, if a clinician has already named a dementia, or Play 02, if the real gap is rides in the house.
Sources: Missouri Revisor, RSMo 302.291 and 302.311; Missouri Department of Revenue, Physician Reporting of Unsafe Drivers and Form 1528; National Institute on Aging, Safe Driving for Older Adults and Driving Safety and Alzheimer's Disease. Opened September 10, 2026.