Decisions About Driving

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

Caregivers should continually reassess the driving abilities of the care recipient with Alzheimer's and related dementia. As impairment increases, the caregiver should balance loss of independence and dignity against the risk to self and others.

At the Crossroads: A Guide to Alzheimer's Disease, Dementia & Driving is an excellent publication available from The Hartford Financial Services Group as a pdf AttheCrossroadsHartfordMASS.pdf.This publication offers such things as tips for balancing independence and safety, warning signs for drivers with dementia, and an agreement with the family about driving.

Have a conversation about your concerns.

It is never easy to consider giving up driving. Plan the conversation and decide who is the best person to communicate the concerns and when/where to hold the conversation (not in the car while they are driving!). Liberty Mutual Insurance provides Tips for Talking with Your Loved One which is quoted below:

"If you think that an older family member could be dangerous behind the wheel, it?s important to deal with the issue sooner rather than later. Here are some tips to prepare for this sensitive conversation."

"Before You Talk:

• Take a ride with your loved one and observe their driving. Watch their awareness of their driving environment. Do they have slow reaction times? Are there dents, scrapes, close calls, tickets or warnings?
• Look into alternate transportation solutions and be prepared to discuss options.

During Your Talk:

• Consider beginning the conversation with a question about how they feel when driving.
• Listen to what your family member is saying and truly hear their concerns.
• Highlight your concern for their safety and the safety of others.
• Use a respectful tone.
• Don't get drawn into an argument; be kind and patient.
• Frame the conversation in a positive light as preserving mobility and independence when supplementing driving or when driving is no longer safe
• Suggest an evaluation from a drivers' rehabilitation specialist or professional driving teacher.
• If necessary, enlist the help of your loved one's physician.
• Most importantly, have realistic expectations. It?s likely that the matter will not be resolved with the first discussion."

Co-developed by Katherine Freund, founder of the Independent Transportation Network and Executive Director of ITNAmerica.(2/16/08).

You may need help 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

For transportation options for persons who give up driving, call the Senior Helpline at 1-800-96ELDER.

The State of Florida has in place a process by which the general public may report medically impaired drivers who may pose a threat to public safety. Florida Statutes section 322.126(2), (3), provides that "Any physician, person, or agency having knowledge of any licensed driver's or applicant's mental or physical disability to drive...is authorized to report such knowledge to the Florida Department of Highway Safety and Motor Vehicles..." These reports shall be confidential and no civil or criminal action may be brought against any physician, person, or agency who provides the information.

When a report is sent in to the Florida Department of Highway Safety and Motor Vehicles, it is carefully screened by medical disability specialists and forwarded to investigators who work for the department. The investigators make contact with the driver and submit reports on their findings to the medical review section in Tallahassee. Investigators can interview family members, neighbors, or the driver's physician as part of the investigation. Drivers may be requested to submit a medical report from their physician and/or be required to report to a driver license office for re-testing. If the investigator does not find any substance or validity to the complaint, no further action is taken. The form is available on the web site at http://www.flhsmv.gov/forms/72190.pdf or you may report an unsafe driver by calling 1-850-617-3814 or writing:

Division of Driver Licenses
Attn: Medical Review Section
Neil Kirkman Building
Room 227-MS 86
Tallahassee, FL 32399-0500