Contributor: Ronan Factora, MD
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Some of the most difficult physician-patient discussions focus on the issue of driving.
Driving is a part of daily life in the United States — a need that lets you to go to work, visit friends and family and manage daily activities, such as grocery shopping, going to church and transporting children and grandchildren
But unless you live in a metropolitan area with well-developed public transportation, living without a car can be difficult and inconvenient.
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Over time, many people develop limits in their ability to continue to drive independently.
- Vision problems interfere with a person’s ability to see the road and avoid objects and other vehicles.
- Hearing problems hinder the ability to modify driving at the sound of car horns or police/fire department sirens.
- Arthritis, Parkinson’s disease and the effects of stroke can impair a person’s ability to perform the mechanics of driving.
- Cognitive impairment or dementia can interfere with a person’s ability to remember directions to familiar locations or the rules of the road.
Concerns about driving ability noticed by an older adult or by their family members should not be ignored.
Family members who refuse to allow an individual to drive them or their children are red flags. Other clues that there is a driving problems include unexplained dents and scratches on the car, new traffic citations for accidents and the driver running through red lights and stop signs.
Often, older adults with driving limitations will, on their own, limit their driving to familiar locations, good weather and daytime, and avoid highways and heavy-traffic areas. The problem arises when an older adult does not recognize that there is a problem at all.
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Get the right advice
Just like any other medical problem, a loss or impairment in your loved one’s ability to drive should be broached with their physician. Underlying causes, particularly vision and hearing problems, mobility limitations and cognitive impairment, should be investigated.
Though the findings of a physician’s office evaluation may be associated with higher risk of getting into an accident, the gold standard for evaluating safety and the ability to drive independently is an occupational therapy driving evaluation.
An evaluation with a physician may identify deficits, but the therapist also may identify situations where limited, low-risk driving will still be reasonable — and so the complete cessation of driving may not be necessary.
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Try to keep them driving
As much as possible, attempts should be made to allow your loved one to drive with the minimum restrictions necessary for safety. Loss of driving ability has been associated with depression and worsening physical impairments in older adults.
It should also be pointed out, though, that if an older adult is told to stop driving completely, the recommendation should be followed.
In circumstances where an older adult continues to drive despite recommendations against it, the person’s physician may ask the state department of motor vehicles to suspend the driver’s license. Those who continue to drive without a valid driver’s license are at risk for fines or jail time.
Additionally, some auto insurance companies may refuse to cover liability for damages to an older adult’s vehicle or the other vehicle — including injury to the other driver — involved in an accident if the driver who was cited was driving against the recommendations of their physician.
The recommendation to stop driving is not easy for physicians to make, but greater success in preserving safety can be achieved through involvement of an occupational therapist and with support from the patient’s family.
This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.