HJNO Mar/Apr 2020

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAR / APR 2020 51 Melissa Brunvoll Lambeth House stops suddenly ahead of you. Drivers must react quickly to ensure their own safety, as well as the safety of those around them. Cognitive decline and diseases like Al- zheimer’s can also seriously affect one’s abil- ity to drive safely. According to Aging Care and theAlzheimer’sAssociation, 60 percent of people with dementia will wander at some point during the progression of the disease. Wandering at any length is dangerous, but when you add a vehicle to the mix, “it can significantly increase how far a senior can travel from home, and the level of danger theymay encounter while wandering,”writes Cindy Laverty of Aging Care. Regardless of the health problems they may be facing, driving signifies indepen- dence for most people, and for that rea- son, seniors may become defensive when the subject of taking away their car keys is broached.The NHTSAsuggests that caregiv- ers start out by answering a few questions to help themdecide if a conversation needs to be initiated, such as: • Are they getting lost on routes that should be familiar? • Have you noticed new dents or scratches to the vehicle? • Have they received a ticket for a driving violation? • Have they experienced a near-miss or crash recently? • Have they been advised to limit/stop driv- ing due to a health reason? • Are they overwhelmed by road signs and markings while driving? • Are they taking anymedication that might affect driving safely? • Have they received a ticket for impaired driving? • Have you noticed them speeding or driv- ing too slowly for no reason? • Are they suffering from any illnesses that may affect driving skills? Once these questions are answered, the NHTSArecommends making a plan to take away or limit access to the senior’s keys. That is where you, the healthcare provider, come in. It depends on the individual, but the NHTSA says that when asked, older adults claim they would listenmore to a healthcare professional than a family member. This is not to say that the conversation is any easier for a healthcare professional than it would be for a familymember. It is understandable to want tomaintain a good and trusting re- lationship with your patients; however, their safety, and the safety of other drivers on the road must come first. The NHTSAandAging Care both recom- mend starting the driving conversation ear- lier. If you delay the talk until their driving has already become dangerous, the conver- sation can be “tense and awkward for every- one involved.”Discussing health problems in relation to driving over time may help them better understand the need to stop driving. When starting the conversation, it is also helpful to come armed with resources to help patients maintain their independence after giving up the keys. The NHTSArecom- mends having patients consult with their lo- cal Office onAging for different transporta- tion options in their community. Depending on the situation, patients may also benefit from attending a driving safety program, such AARP’s Driver Safety Program, which is a national program that aims to educate older adults on driving safely, self-assess- ment, and finding transportation. Similarly, the AARP also offers a free on-line seminar called “We Need to Talk” to assist families with having the difficult driving conversation. In certain instances, it may be beneficial to refer patients’family members to this resource to better under- stand the situation. No matter how you slice it, taking away someone’s ability to drive, and the indepen- dence that goes with it, is never going to be pleasant. However, as a trusted healthcare professional, you have the ability to play a pivotal role in ensuring the safety of your patients, as well as the safety of anyone they may encounter on the road. While it may be an uncomfortable conversation to have, your patients’families will be glad you did. n “It is understandable to want to maintain a good and trusting relationship with your patients; however, their safety, and the safety of other drivers on the road must come first.”