I recently read a depressing article on agingcare.com, entitled, “Why Doctors Don’t Like to Discuss Driving with Older Patients“. It is depressing to me and to those of us at Support For Home In-Home Care because we have seen it over and over again, sometimes with disastrous results.
The fact is, for all of us who live long enough, there has come or will come a time when we simply should not be driving any longer. In my case, I can tell you right now, it will be because of declining vision. For others, it can be arthritis that makes it impossible to react quickly enough to critical conditions to be safe. For some, it will be declining cognitive skills, including dementia.
The bottom line is that as precious as the privilege of driving is to us – and it is a privilege, not a right – this is a fact that we need to discuss in the family and prepare for, not bury our heads in the sand. That latter option is a good way to get run over! Families bear the first level of responsibility – and I mean all the adults. My wife and I already know when I will stop driving. Every family should have objective criteria agreed upon, well in advance. That is one of the areas for which we developed the free Advance Living Directive tool that you will find in multiple articles in this blog site and on our Website.
So, according to the article, are doctors so reluctant to deal with this issue?
But there is no official clinical test that a doctor can use to determine if a patient has driving issues, and state laws vary when it comes to how much legal responsibility a health care professional has to report an unsafe driver. These rules and regulations matter because doctors can feel uneasy about reporting to state licensing authorities, says Betz. For example, in Colorado, physicians don’t have to report an unsafe driver, but they are encouraged to, and are offered protection against professional liability if they do.
I “feel uneasy”, so I will just let some folks on the sidewalk get run over over have a grandchild riding with grandpa be paralyzed, so that I do not have to feel uncomfortable. It’s not a problem to tell my patient they have cancer or are dying of heart disease, but telling them they cannot drive? Oh my goodness, no.
So, doctors, nurses and clinical social workers were interviewed, to dig more deeply. Why were they so reluctant? [Brackets added by me]
The interviewees identified several major roadblocks to engaging in dialogues about driving with older patients:  not having enough time during a typical appointment slot,  not being able to accurately evaluate a patient’s driving fitness (Doctors have to rely mainly on hearsay from patients and families because there’s no way for them observe a patient on the road.),  not being trained in the best way to approach driving discussions with patients, and  not having enough information to offer transportation alternatives for adults who should no longer be driving.
So, item 1… Perhaps a longer appointment slot could be arranged? Seems like a fairly simple and appropriate thing to do, to me.
For item 2, no, we are not asking doctors to be driving test providers. However, measurement of mobility, reaction time, vision, cognitive impairment, including memory, judgment, … these are all, it seems to me, within the purview of the medical profession – or did something change while I was out driving?
For number 3, the same excuse exists for most areas of medicine, at some point in a potential doctor’s career. Do you think some training might be available? If not, our number is 916 482-8484, and we are available to provide training at quite reasonable fees.
Number 4 strikes me as the most ludicrous of all. I do not know if there is a bus or specialized transportation program or Uber or … that you can use for transportation, so I would rather you just continued to drive until our next visit, in the hospital, after your accident.
I hope that I am not being too subtle here. If so, let me know. Driving is an extremely dangerous activity – for all parties, inside and outside the car being driven. To shirk responsibility on this issue, very much one tied to health care, is simply unacceptable to me.
Best wishes. Bert