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When do you tell your grandparents enough is enough and take the keys?
It's not my responsibility. Not only am I unqualified to make a proper assessment on my Grandparents driving ability but I pay a very large yearly sum in taxes, registration, and licensing fees to ensure that there is a government entity that should be large enough, capable enough, and is qualified enough to assess it's licensed drivers and make the determination who and who should not drive on public streets.
Implement mandatory computer simulated driving tests every time your license is renewed. The SoS should be able to make the determination in under 15 minutes whether or not a person is capable of driving. You could set up a simulated car running assessment software in each SoS office for under $50,000. The drop in accidents alone would justify the cost.
The test doesn't even have to be that hard, the people you are trying to weed out are the ones that mistake the gas for the brake at the grocery store and drive through crowded public markets dragging bodies behind them because they forgot where they are. You could even have different programs for different types of licenses.
Driving on public streets is not a God given right. It is a responsibility that requires a certain amount of skill.