Stage One, section 7: Driving Assessment

If your care receiver is still driving, it may be time to look at this issue and consider a driving assessment.

Among the conditions that could cause concern about a person's ability to continue driving are problems with eyesight and coordination, Alzheimer's and related dementia, Parkinson's, and stroke. Medications and alcohol may also affect driving, and drug interactions can multiply impairment.

Here are some indicators of impaired driving from various causes:

• getting lost in familiar places
• failing to observe and obey traffic signs and speed limits
• poor or slow decision making in traffic
• trouble navigating turns or judging distance
• not anticipating actions of other drivers
• drifting across lanes
• getting confused at exits
• stopping before intersections
• parking inappropriately
• hitting or driving over curbs
• anger, confusion or frustration while driving
• scrapes on car, garage, or mailbox
• car accidents or near misses
• needing instructions from passengers

In Pinellas County, Florida, there is a formal resource that involve assessing a person's driving skills:

The Bayfront Medical Center Driver Evaluation Program utilizes an occupational therapist who offers an evaluation to individuals needing to determine if they are safe on the road and what adaptive equipment can be used to allow them to return to driving again. It is a two part evaluation. Part one is a clinical assessment of eye-hand-foot coordination, reaction time, visual scanning ability, and other cognitive and motor functions. The second part, if needed, is a road test of driver safety, awareness of laws, and training needed.

There is a charge for the assessment. For more information call 727-553-7132. Staff will arrange for required documents, including the required prescription from their health care provider. They must have a current driver's license, 20/40 corrected vision in one eye, and be seizure-free for 6 months.
Contact:
The Driver Evaluation Program
Occupational Therapy Department
Bayfront Medical Center
St. Petersburg, FL 33701
727-553-7132

The Report a Driver Form for reporting medically impaired drivers who may pose a threat to public safety in Florida can be found on the Department of Highway Safety and Motor Vehicles web site at http://www.flhsmv.gov//forms/72190.html. You may prefer to call 1-850-617-3814 (not a toll-free number) or write Division of Driver Licenses, Attn: Medical Review Section, Neil Kirkman Building, MS 86, Tallahassee, Fl 32399-0500. Any person is authorized to report an unsafe driver confidentially, with protection from civil and criminal actions. Complaints are investigated, and retesting at a driver license office may be required.

Please remember that ever since January 1, 2004, all drivers 80 years and older who are renewing their driver licenses are required to pass a vision test. Driver's License offices provide these tests, preferably by appointment, at no cost. Another choice is to be tested by a family doctor or eye specialist, who has to complete a form. For a copy of the form see Mature Driver Vision Test form on the Florida Department of Highway Safety and Motor Vehicles web site, http://www.flhsmv.gov//forms/vision.html.

Having to give up a driver's license represents a great loss of freedom and mobility and can be difficult emotionally, as it is symbolic of loss of control over one's life. As is true of other losses, it causes grieving. It can also lead to increased isolation and secondary losses such as loss of friends and activities. As one older person described it, "It's the hardest thing to have to give up your license, because then you're grounded."

Referral to community resources for transportation may be helpful. Please be aware that these services may have eligibility guidelines, mileage limits, and call-ahead policies. To the person having to give up the license, using transportation programs cannot erase the pain of having lost the freedom to drive anywhere anytime. Counseling to get over the loss may be needed.

More Helpful Resources

• To access the services or programs described in this Handbook, call the Senior Helpline at 800-96ELDER (800-963-5337).

• The American Stroke Association has a fact sheet called "Let's Talk About Driving After Stroke" that is available online at: http://www.strokeassociation.org/presenter.jhtml?identifier=3017279. Warning signs of unsafe driving after stroke are provided, and stroke survivors are encouraged to talk with their doctors and occupational therapists and to get tested through a driver's assessment program. Call the American Stroke Association's toll-free number, 1-888-4STROKE (1-888-478-7653). Also ask for information packets for caregivers and for stroke survivors (several different packets are available) and a free year's subscription to Stroke Connection Magazine.

• If your care receiver needs a disabled parking placard, whether driving alone or being transported by family or friends, see Florida's Disabled Parking Program article on this website.

• You may not be able to leave your job or other activities to transport your care receiver as often as he or she would like to be transported. Your care receiver may need to use other transportation services. Call the Senior Helpline at 800-96ELDER (800-963-5337) for information on resources.

• Long distance caregivers may want to use the Eldercare Locator, a free service of the U. S. Administration on Aging, to find resources for driver evaluation, counseling, and transportation. The Eldercare Locator's toll-free information line, 1-800-677-1116, refers callers to elder helplines throughout the United States. The Eldercare Locator web site is found at www.eldercare.gov. Residents of any Florida county may call Florida's Elder Helpline number, 1-800-96ELDER (1-800-963-5337) for direct connection to a local elder helpline.

• The AAA Foundation for Traffic Safety created the Senior Drivers web site, found at www.seniordrivers.org. Find exercises and refresher tips, in a choice of web page or video format, to help older drivers stay in shape for driving.

• The USAA Insurance Company Educational Foundation web site, found at www.usaaedfoundation.org, offers self tests and driving tips, transportation options after giving up driving, and a booklet called "Driving Safely While Aging Gracefully." Click on Order Publications or on Safety to view.

• The National Accessible Travelers' Database lists accessible providers by city for traveling with persons with physical and cognitive (mental) impairments. Find this database under Shortcuts on Easter Seal's Project Action web site, www.projectaction.easterseals.com. You may also call Project Action at toll-free 800-659-6428 or 202-347-7385 (TDD).

• The Florida Senior Safety Resource Center, developed by the University of Florida and found online at www.floridaseniorsafetyresourcecenter.phhp.ufl.edu, provides driving knowledge test, transportation options by Florida county, and links to national driving resources.