• Stopping at green lights instead of red lights
• Not understanding signage
• Getting confused at freeway entrances and merges
• Driving the wrong way on a one-way street
There is no right way to resolve the driving difficulty issue. The responses of individual family members may vary. Those involved with the care of the driver need to remain focused on the self-respect of their loved one and the safety of others on the roadways. Understandably, one doesn’ t want to prematurely end driving, but waiting too long can jeopardize safety and result in serious injury or death.
What to Do
1. Begin discussions and planning early; anticipate with the patient that there may be a time when they can no longer drive. When possible, involve the driver in these conversations. Open and early communication can help avoid a crisis later. Many carepartners permit their loved ones to drive longer than they know they should, causing carepartner anxiety and fear of putting others at risk.
2. When it is time to give up the keys, explain everything to your loved one and do not become critical of them.“ Medicalizing” the problem can help. For example, let your loved one know that PSP results in symptoms that interfere with safe driving. You are there to support the person and tell them you understand their feelings.
3. Never leave the keys out where they can be found. 4. Assure your loved one that they can depend on you to meet their transportation needs.
Determining Driving Safety
It is sometimes hard to know the degree to which illness impacts safe driving. If the impaired driver resists driving cessation, talk to the neurologist or family doctor. Based on the office visit and the patient’ s history of crashes, the physician may believe that they can strongly recommend the patient stop driving. However, sometimes it is hard to know from the office visit whether the patient is still safe to drive, since driving is an overlearned skill( like riding a bike). Each state differs in its procedures, but you or the neurologist may choose to contact your Division of Motor Vehicles and supply the DMV with a Driver Medical Evaluation form. In some states, the driver will then be notified of the need for a formal driving assessment. Another good option is to check to see if driving safety can be assessed through a nearby rehabilitation hospital or another hospital offering this service. Your physician can order such an evaluation. These formal assessments are valuable since the emotionally-charged decision about driving is turned over to skilled professionals who can render an objective opinion. These assessments, often done by an occupational therapist, measure key cognitive functions linked to driving safety, as well as visual and physical functions related to driving. The most comprehensive programs also include an on-road test, most often conducted in the car of a certified driving instructor. If patients do well with this assessment, they and the family can be reassured. Often, follow-up testing is necessary. The guidelines of the American Academy of Neurology suggest six-month follow-up for anyone with a progressive neurological condition.
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For information on physical and cognitive impairments and driving, contact your local DMV and ask for the Regional Driver Safety Office. Explain the situation and ask about resources.