Monday, December 6, 2010

When to STOP DRIVING?????????

 10 Signs That It's Time To Give Up the Keys

Deciding when an older adult is no longer
fit to drive is a challenging issue with no
clear answer. When it comes to dementia,
the decision can be especially tricky. A
recent study in the journal Neurology
found that as many as 76 percent of people
with mild dementia are still able to pass an
on-road test and drive appropriately. Yet
virtually all dementia sufferers will have
to stop driving eventually, as the disease
worsens and memory, spatial orientation,
and cognitive function decrease over time.
Earlier this year, the American Academy
of Neurology released new guidelines to help
determine when people with Alzheimer's
disease or other forms of dementia should
stop driving.

Caregivers are frequently the first line of
defense when it comes to reporting unsafe
driving in a person with dementia, and doctors
should listen to what they have to say, according
to the American Academy of Neurology’s report.
“Caregivers are often proven correct when they
report dangerous driving,” says Peter Rabins,
M.D., M.P.H., director of the division of
geriatric psychiatry at Johns Hopkins and a
Health After 50 board member. “They are more
likely than the patient to give a realistic assess-
ment of the patient’s driving abilities.”
But the most reliable measure of a dementia
sufferer’s driving ability is a driving test. If a
doctor has doubts about a patient’s fitness to
drive, he or she may refer the patient for an
on-road driving test, according to Dr. Rabins.
Some states actually mandate behind-the-wheel
road tests by the Department of Motor Vehicles
for older drivers to renew their licenses, while
other states allow occupational therapists trained
to assess driving ability to evaluate patients.
States also differ in physician requirements for
reporting a driver who is too impaired by
dementia to drive.

Often, enforcing a decision that a person with
dementia is unfit to drive comes down to the
patient’s family or caregiver. Dementia patients
may forget they were told not to drive or not agree
with the assessment that they are unfit to drive.
It’s a very difficult topic to approach, but beginning
discussions about driving with the person early on,
reducing the need to drive, and arranging alternative
transportation can help make for a smoother transition
to life after driving.
How can you tell if a driver with dementia may no
longer have the skills needed behind the wheel? If
someone shows one or more of the signs below, it’s
time to have a serious conversation with the driver
and his or her doctor:
• Stops in traffic for no reason or ignores traffic signs
• Fails to signal or signals inappropriately
• Drifts into other lanes of traffic or drives on the wrong
   side of the street

• Becomes lost on a familiar route
• Parks inappropriately
• Has difficulty seeing pedestrians or other vehicles
• Has difficulty making turns or changing lanes
• Gets drowsy or falls asleep while driving
• Lacks good judgment
• Has minor accidents or near misses

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