I believe that age is a gift. But along with the gift of a long life, comes changes that can affect our ability to drive safely. There may be changes in vision, hearing, cognition, physical abilities and general health. We all age at different rates, so unless there is a sudden onset of a medical condition, you don't have to worry that everything will go at once! What you do need to do, is to become aware of the changes as they occur, and how they may affect your ability to continue driving safely.
Please keep in mind that it is easier to see the changes in someone else than it is to see them in ourselves.
Let's look at them one by one:
Vision - There is more to vision than just having good near and distance vision. This is commonly termed "20/20 vision". This means that the objects you see are in focus. But you can have 20/20 vision and still have decreased depth perception, peripheral vision and/or contrast sensitivity. There may be a condition where both eyes do not work well together, or you may have loss of vision due to illness or injury. Often, these are not just within the eye and optic nerve, but the overall brain's utilization of information coming throught them.
Any of these things make distances and speed of other vehicle more difficult to judge, and objects coming from the sides of our visual field may "surprise" us. If visual scanning is impaired, we may not be aware of all the visual information there is to see. If visual tracking is impaired we may not be able to follow the path of other traffic in order to guage our own placement in the traffic pattern. Decreased visual processing means that we are slow to understand what we are seeing (remember the example of the person at the stop sign I gave last time.)
Hearing - Hearing alerts us to situations in or around us such as honking horns, emergency vehicle or engine sounds. It is also useful to keep us aware of road conditions, such as the sound of the pavement, concrete, gravel or water under our wheels. Changes in hearing may cause us to become distracted by loud music, loud noises or even conversation.
Cognition - Changes in cognition, or the way our brain processes information, can have a devasting effect on our driving behaviors. Symbols, such as traffic signs, may no longer make sense. Or it may just take longer for us to figure out the meaning of viusal or auditory information. Pathfinding, or the ability to follow previously familiar routes may be decreased. How often do you read in the paper or hear on the news of the elderly person who got lost on the way home? Decreased working memory may make it more difficult to remember what was on the informational road sign we just passed. If it was a detour, where do we go?
Physical Abilities - Often, physical disabilities related to age will make it difficult to get into or out of the car. Or it is difficult to hold onto the steering wheel or to turn the key in the ignition or to operate the different secondary controls such as the windshield wipers, lights, horn, heater/air conditioner or the radio. Decrease in flexibility may make it more difficult to turn your head to look over your shoulder when making a turn or lane change or when backing out of a parking place.
General Health - By this I mean "overall health". Do you have headaches. Are you easily stressed? What kind of medications do you take? Even something as simple as aspirin works because it changes the way your brain processes information. Do you take a sleeping pill that makes you feel hungover or groggy in the morning? Does a pain pill make you dizzy or sleepy? Do you take multiple medications?
Even with all that I have said about age-related changes, I still believe that age is a gift. As my dad said for many years, "It sure beats the alternative." We just don't want the alternative to happen suddenly in a crash because we did not pay attention to the changes as they occur in our own bodies. You often CAN continue to drive safely with the help of a driving professional who can help you to develop strategies as the changes occur.
Drive safely and keep the rubber side down.
Karen
Karen Richardson, OTR/CDRS
Registered Occupational Therapist, Certified Driving Rehabilitation SpecialistFind all the topics I've contributed here at Lumigrate at http://www.lumigrate.com/forums/integrative-medicine-parts-m... [1] We encourage questions and comments, just use the Contact Us here at Lumigrate.com!
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Comments
Thank You Karen Richardson! There is a growing concern for so many people with aging parents and neighbors/friends as well as medical providers related to this critical issue. I really like the way you constructed this piece, as it gives the overview well and in a streamlined way, which is right up our alley here at Lumigrate.com. (Yes, driving/road pun intended.) See? We can even make driving information a bit FUN as well.
Our other main concept is 'progressive'. Since Karen took the baton from me at a progressive driving program about 10 years ago, I went on to be haunted and almost hunted by doctors who had patients they were concerned about related to driving ability. So I've continued to do a lot of assessments of functional activity in my therapy area and because of two years of experience knowing how to translate how someone does particular activities and exercises, I can at least weed out the clear 'yes' or 'no' folks and then send the questionable ones to the driving specialists. There is much someone can do remotely to advise and offer testing, and in some communities there are driving specialists with hospital-based programs, off on their own in private practice, or sometimes the driving programs for young drivers have qualified people if they have some mentoring from a driving specialist who has experience with medically impaired people and driving. There's growing awareness and concern related to the effects of medication that people are on increasingly.
I worked closely with a driving specialist OTR at the regional medical center in my community of Grand Junction, CO, where we were fortunate to still have a hospital-supported driving program. In 2011, they opted to close that program and lay off there long-term employee, who purchased some of the equipment and set things up to go off on her own in our community. These are just the times we are in, and there is a huge void in the funding for these types of services. If families see the value AND have the money they can pull together from one or more sources/people, then it's my strongest suggestion that they utilize it on advise about driving because the legal and then financial repercussions of having someone driving past when they are capable are staggering. And most importantly, we wouldn't want our loved ones to be injured themselves, naturally.
Since driving is not considered a 'necessity' as the country's governments get and have monies for public transportation, it ends up being this HUGE issue over and over again. It's one of those examples in my opinion, of 'how can a country that was SO capable not see the error of its ways on this?' Enough said about that, but I did want to bring it up. Part of the responsibility that comes as consumers is to be active in giving feedback in our political system, and that now includes our medical system and these types of issues.
Back when I was working for MasterDrive for two years around the turn of the millenium, I was in close contact with the Colorado Dept of Motor Vehicle administrators and others, and want to pass along and answer a question right here that so many have: They would LOVE to be testing all senior drivers but don't even have the budget for getting all the first time drivers tested in the way they would prefer.
Most people who have been to a DMV office for any period of time will report being surprised and concerned at someone who renewed a license. Just this week I heard 'she couldn't even figure out how to put her face to the eye testing device and do that, how's she on the road operating a vehicle?' Keeping this in mind is my overall suggestion, and know that the process that is forced by economics to the what is "supposed to work" is for a medically impaired driver to be repeatedly observed or have infractions they get enough tickets for they lose their license. Unfortunately, that leaves much room for problems that are costly in bodily and property damage and affects lives and well-being of the people involved and our overall society.
Within my own family, someone's ability for safe driving diminshed and we had a disagreement about what was going on, so I got to experience first hand being inside one of the difficult family situations I only previously had been a consultant for. Since there wasn't support of my opinion with my family, I decided to see what happened with 'the process'. My family member wasn't someone who just drove to church -- there was a monthly full day drive trip to another state to a second home for several years past when I thought driving should end for this person. Once the license expired, it was replaced with an ID, and fortunately nothing occurred that injured anyone else. Once there was nothing to lose by telling the stories, it was frightening and astounding how someone could have "gotten by with it". We were ALL very fortunate for that, and I want to include that in my information here so you know "I've been there too". And again, please be proactive, as we all see the OTHER cases, which are in the news.
Essentially, it's a long legal process which is stressful, naturally. It costs $30-50,000 to go to court on something major if it's serious and complicated.
It is unfortunate that the family doctor ever has to be 'the bad guy', but when it comes to their responsibility to report to DMV any driver they know to have a condition that makes them unsafe for operating a motor vehicle, there is a side-effect of the patients not wanting to go to the doctor for fear of that happening! My family member that I mentioned, above, reported to me after this was all a non-issue that the medical advise I was suggesting they seek out was avoided for this reason. A refusal to go to the doctor to find out why a person is choking, weakened, and becoming unsafe in their activities of daily living occurred because of the fear of losing driving privileges if the suspected neurological condition was diagnosed and treated.
SO, I hope this increases the realization that a driving specialist become part of the 'team', also known as The Lumigrate You Model" here on our home page. Karen is certainly qualified to do that for individuals who have questions, or physicians or other medical providers who have concerns but don't know what to do.
When I saw this piece posted by Karen, I went to my 'resource room' and pulled out my Physician's Guide to assessing and Counseling Older Drivers, which has a letter dated June 6, 2003 from the CEO of the AMA at the time, Michael Maves, MD, MBA announcing it to be the first product of a cooperative agreement between the AMA and NHTSA (American Medical Asociation / National Highway Transportation Safety Administration). This is a topic for future discussions in this forum, and maybe it's my turn to start the topic and let Karen come along and pick up the 'comment' ball.
In summary, physicians have a responsibility to report and in my experience are generally unaware of this and don't know the process at all and are VERY eager for an OT to help them with that.
I want to hop off here with saying that we have to be careful of 'agism'. I have the priviledge of having an amazingly healthy, robust 80+ year old woman in my realm of reality and I'd put her behind the wheel ANY DAY and ride along without any more cause for concern than you have overall from being on the roads That is why I prefer the term 'medically impaired driver', because it's not the AGE, it's what's going on inside the body which occurs increasingly with age, but can occur at ANY age.
THANK YOU KAREN... NOW we're getting somewhere!
Live and Learn. Learn and Live Better! is my motto. I'm Mardy Ross, and I founded Lumigrate in 2008 after a career as an occupational therapist with a background in health education and environmental research program administration. Today I function as the desk clerk for short questions people have, as well as 'concierge' services offered for those who want a thorough exploration of their health history and direction to resources likely to progress their health according to their goals. Contact Us comes to me, so please do if you have questions or comments. Lumigrate is "Lighting the Path to Health and Well-Being" for increasing numbers of people. Follow us on social networking sites such as: Twitter: http://twitter.com/lumigrate [3] and Facebook. (There is my personal page and several Lumigrate pages. For those interested in "groovy" local education and networking for those uniquely talented LumiGRATE experts located in my own back yard, "LumiGRATE Groove of the Grand Valley" is a Facebook page to join. (Many who have joined are beyond our area but like to see the Groovy information! We not only have FUN, we are learning about other providers we can be referring patients to and 'wearing a groove' to each other's doors -- or websites/home offices!) By covering some of the things we do, including case examples, it reinforces the concepts at Lumigrate.com as well as making YOU feel that you're part of a community. Which you ARE at Lumigrate!