Medical Driving Evaluations

Hidden Holiday Surprises:  What to do when driving concerns are identified on a visit home

Posted by Joan Cramer on Dec 23, 2020 10:22:36 AM
Joan Cramer
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The Holidays for many, young and old, are filled with surprises and joyful moments that allow families to appreciate each other. For many the joyful reunion is going to be quite different given the health concerns associated with the COVID-19 pandemic. The annual trip “home” for many has been cancelled. New plans are being made to connect with loved ones using alternate means and technology.

Families are focused on how best to navigate an in-person visit with a special great-grandparent or child who lives in a different state/country. The adult children of many seniors are wanting to get a chance to assess how their elderly parents are managing in their home alone during these changing times.

Geographic distance between adult children and their aging parents has a new definition with the COVID-19 pandemic. Families may be local and still struggle to assist their parents given the need to socially distance from vulnerable individuals. Children living far away are unable to visit resulting in many emotions and adjustments for the entire family.

Adult children will be visiting with their aging parents using an electronic device, such as a computer or the small screen on a cell phone. This communication will depend on how skillful the older adult is with technology use. It is important to remember that these devices have limited viewing potential for both parties. For some hearing loss may make the communication frustrating as well.

Visiting on Zoom presents limitations. Families will not be able to assess the functional changes or see the warning signs from their parent such as difficulty walking, getting up from a chair, carrying a beverage or even getting to the restroom in a controlled manner. The sedentary nature of a Zoom call will limit families from identifying changes in endurance. Families may not be able to see any coordination challenges that may call into question the safe driving ability of their parent.

For some seniors, not being with family at the holidays may result in increased anxiety and loneliness. Management of emotions can influence driving skills and one’s ability to make sound decisions in unexpected situations. Coping with being alone for the holidays may create some depression for our older drivers, which may hinder their judgement when deciding to drive across the state to see family to follow holiday traditions.

Driving with anxiety will influence driving ability since it is a complex task requiring the integration of many skills. If anxiety is an issue, it would be best to explore the option of a special driving evaluation for elderly. Getting an objective assessment of driving as you age will provide peace of mind for all involved parties.

It is a widely known fact that many seniors are strong willed and proud. Their ability to live long lives is due in large part to their determination to be independent. For many, independence to access community resources requires driving.

Pride and frugal practices may prevent older drivers from asking for help to complete simple, yet important, tasks like: picking up medications at the pharmacy, getting to medical appointments safely, or attending social events and/or religious services. Many seniors simply want the freedom to “drive around when they feel like it”, yet their children are left asking who can complete a driving evaluation for my loved one?

Driving as you age is a task that requires increased skills of attention, coordination, visual awareness and timely reactions. Challenges with continued driving are often not recognized by the older driver. Most will not be aware they ran a stop sign. Denial is common when children learn of little fender benders. Challenges with driving are often associated with changes in vision and/or cognitive skills that occur silently. The older driver is not aware of errors made when navigating familiar locations.

With less in person visiting this holiday season, families will not have a chance to inspect the car for unexplained dings or garage doors with obvious signs of parking errors. Therefore, a driving evaluation may be recommended by family members to allow a trained professional to offer guidance pertaining to their parent’s need for continued independence behind the wheel.

The discussion about fitness to drive often creates a great deal of anxiety and tension in families. Adult children may find themselves concerned about their parent’s safety behind the wheel yet unsure of what action to take. Raising the question is difficult but important to ensure their parent is safe to continue driving.

In many states the laws do not require physicians to be a mandated reporter to the Department of Motor Vehicle. When there are concerns about a long-term patient's safety behind the wheel it is common that the discussion for retiring from driving is passed off to family or another health care provider. The responsibility to ensure safety of a parent is now a greater challenge for an adult child, caring for their aging parents. Did you know that occupational therapy driving evaluations offer insight to fitness to drive?

Adult children may find themselves wondering where to turn for help. Driving may present a safety concern following illnesses such as: a stroke, COVID-19, head injury from a fall, major surgery, or in grieving times when a loved one may have passed. The adult child is often searching for resources to guide them as they attempt to protect their parents from being injured in an accident. It is common to learn of older drivers determined to remain independent despite having been the cause of a major accident.

Many older drivers have been heard saying they “don’t want to bother their children” to get to an appointment or a trip to the grocery store. Family members with concerns do have options. There are a variety of driver assessment services available in every state performed by driving rehab specialists.

During your holiday “visits” be mindful to note any concerns. Focus on a positive visit and consider addressing your concerns on the days following the holiday to avoid making the visit a negative experience.

Some suggested things to observe, which may ultimately prompt the family to contact a Driver Rehab Specialist to schedule a driving evaluation include:

  1. Controlled mobility as they walk with a phone
  2. Ask them to show you inside the refrigerator to assess if there is food (check for signs of spoiled food)
  3. Look for changes in grooming habits as this may indicate changes in sleep patterns, increased confusion, limited insight to changes
  4. Note any comments about difficulty seeing the Zoom/phone screen
  5. Note if there are changes in speech and the effort needed to have a conversation (are they short of breath talking?)
  6. Posture, when sitting should be upright, shoulders level and head straight. These features are important for senior drivers
  7. Conversations on the phone/Zoom may reveal that there is more repetition of storytelling
  8. Forgetfulness related to medical issues/appointments
  9. Forgetting the names of family they are engaging with using technology
  10. Limited in person visiting can prevent the identification of swelling in the ankles/feet that may be associated with the failure to manage medication

Simply put the definition of “independence” includes driving for many older adults, and their children are left asking: “When is the right time for a driving evaluation to ensure Mom/Dad can safely operate a vehicle?” In most cases the parents’ physician or medical professionals are not able to observe their patient behind the wheel, so speaking up and voicing concerns is the best way to be an advocate for a senior driver.

If driving concerns are identified during a holiday visit speak up and take action. Ask the physician for a Driving Evaluation. This exchange can be done in person at a scheduled visit (if you are able to attend). It may be best however, to raise your concerns by phone, email or a fax prior to a scheduled office visit. Having an Adaptive Driving School assist in the process is a good way to offer a neutral 3rd party objective assessment that maybe be easier for the senior driver to accept.

A discussion about driving with older drivers can get them upset, which may lead them to become defensive about their ability to operate a vehicle. Your parent’s medical professional should respect the fact that their driving skills oftentimes require further assessment by an occupational therapist trained in driving rehabilitation.

Driving Assessments should be completed by a trained certified driving rehab specialist who is employed by an Adaptive Driving Program. They will provide objective facts about your parent’s safety behind the wheel and can help identify options to assist the family in creating an individualized plan of action to ensure continued safety and independence.

Take the Next Step

We know how hard it can be to face these problems with a loved one and find solutions, which is why we founded The Next Street Driver Rehab Services.

We take a personalized approach to each driver and can bring our evaluation team directly to them in their own home, or they can come to one of our therapy centers in several locations across the state.

Our goal is to work with you and your loved ones to understand and develop their driving skills, and if needed, find the best possible alternative transportation options.

If you’d like to learn more about our services, you can visit our Driver Rehabilitation Homepage, or call us at 860-483-7009.

Topics: Safe driving, elderly, driver rehab, adaptive driving

Driving is Important

We Are Here to Keep You Safe Behind the Wheel

Our Driver Rehabilitation program works with patients whose change in health may affect their ability to safely drive. We have a team of Certified Driving Rehab Specialists that will work with patients on evaluating your driving abilities. We also have a team of professional instructors to help you gain or regain the skills you need to drive. We created this blog to talk about the various diagnoses we experience and how they may affect your experience behind the wheel. 

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