This will be of interest to those concerned about driving safety.
There’s a good article on the topic of driving safety in the July 2008
Parkinson’s Resource Organization newsletter. See:
Editor’s Note: Article is no longer available from source
http://www.parkinsonsresource.
Driving Safety with Parkinson’s and Parkinson’s Dementia
Parkinson’s Resource Organization
July 2008
(article is on pages 1 and 7)
The full article is copied below.
Robin
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http://www.parkinsonsresource.
Driving Safety with Parkinson’s and Parkinson’s Dementia
Parkinson’s Resource Organization
July 2008
Driving is a complex activity that requires quick thinking
and reactions, as well as good perceptual abilities. For
the person with Parkinson’s and/or dementia, driving
becomes a safety issue. While he or she may not recognize
that changes in cognitive and sensory skills impair driving
abilities, you and other family members will need to be firm
in your efforts to prevent the person from driving when the
time comes.
That said, it’s important to consider the person’s feelings
and perceived loss of independence when explaining why he
or she can no longer drive. Helping the person with dementia
make the decision to stop driving — before you have to force
him or her to stop — can help maintain a positive sense of
self-esteem.
How dangerous is it?
Previous studies demonstrate that poor driving performance
increases with increased dementia severity. However, not all
people with Parkinson’s are unsafe drivers at a given point
in time. What’s more, drivers with dementia are not in more
crashes than non-demented elderly drivers, suggesting that
dementia should not be the sole justification for suspending
driving privileges. Instead, an on-the-road driving test, or
other functional test, is the best way to assess driving skills
in dementia.
Some state agencies have special drive tests to determine
how well a person sees, judges distance, and responds to
traffic. Ask the person who administers the test to explain
the results to you and the person with dementia. If your state
does not offer special testing, private assessments (generally
fee-for-service) may be available. Your local DMV, Highway
Patrol or even Senior Centers may be able to provide a list of
these programs.
How do you know when the time has come?
There are also a number of steps you can take to assess the
person’s ability to drive.
1) Look for signs of unsafe driving
Signs of unsafe driving include:
• Forgetting how to locate familiar places,
• Failing to observe traffic signs,
• Making slow or poor decisions in traffic,
• Driving at an inappropriate speed,
• Becoming angry or confused while driving.
Keep a written record of your observations to share with the
person, family members and health care professionals.
2) Learn about your state’s driving regulations
In some states, such as California, the physician must
report a diagnosis of Parkinson’s to the health department,
which then reports it to the department of motor vehicles.
That agency then may revoke the person’s license. Check
with your local DMV for information on driving regulations in your
state.
Tips to limit driving
Once it’s clear the person with dementia can no longer drive safely,
you’ll need to get him or her out from behind the wheel as soon as
possible. If possible, involve the person with dementia in the decision
to stop driving. Explain your concerns about his or her unsafe driving,
giving specific examples, and ask the person to voluntarily stop driving.
Assure the person that a ride will be available if he or she needs to go
somewhere.
Other tips to discourage driving include:
• Transition driving responsibilities to others. Tell the person you can
drive, arrange for someone else to drive, or arrange a taxi service or
special transportation services for older adults.
• Have prescription medicines, groceries or meals delivered.
• Solicit the support of others. Ask your physician to advise the person
with dementia not to drive. Involving your physician in a family
conference on driving is probably more effective than trying by
yourself to persuade the person not to drive. Ask the physician to
write a letter stating that the person with Parkinson’s must not drive.
Or ask the physician to write a prescription that says, “No driving.”
You can then use the letter or prescription to tell your family member
what’s been decided.
• Experiment with ways to distract the person from driving. Mention
that someone else should drive because you’re taking a new route,
because driving conditions are dangerous, or because he or she is
tired and needs to rest. Tell the person he or she deserves a chance
to sit back and enjoy the scenery. You may also want to arrange for
another person to sit in the back seat to distract the person while
someone else drives. If the disease is in an advanced stage, or there
is a history of anger and aggressiveness, it’s best not to drive alone
with the person.
In the later stages, when the person is no longer able to make decisions,
substitute his or her driver’s license with a photo identification card.
Take no chances. Don’t assume that taking away a driver’s license will
discourage driving. The person may not remember that he or she no
longer has a license to drive or even that he or she needs a license.
What if the person won’t stop?
If the person insists on driving, take these steps as a last resort:
• Control access to the car keys. Designate one person who will do all
the driving and give that individual exclusive access to the car keys.
• Disable the car. Remove the distributor cap or the battery or starter
wire. Ask a mechanic to install a “kill wire” that will prevent the car
>from starting unless the switch is thrown. Or give the person a set of
keys that looks like his or her old set, but that don’t work to start the
car.
• Consider selling the car. By selling the car, you may be able to save
enough in insurance premiums, gas and oil, and maintenance costs to
pay for public transportation, including taxicab rides.
In some states, it might be best to alert the department of motor
vehicles. Write a letter directly to the authority and express your
concerns, or request that the person’s license be revoked. The letter
should state that “(the person’s full name) is a hazard on the road,”
and offer the reason (Parkinson’s disease or Dementia). The state may
require a statement form your physician that certifies the person is no
longer able to drive.