Health Care and Human Services

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Health Care and Human Services

Medical professionals are in a unique position to discuss driving with their patients because driving is often affected by a medical or mental health condition. Similarly, staff from social service agencies are important partners in ensuring continued safety as they interact with individuals seeking services. Unfortunately, many medical professionals and social services staff are reluctant to engage in difficult conversations about driving with their patients/customers. According to the American Medical Association Code of Medical Ethics Opinion 8.2 (Impaired Drivers & Their Physicians), "Physicians have unique opportunities to assess the impact of physical and mental conditions on patients' ability to drive safely and have a responsibility to do so in light of their professional obligation to protect public health and safety."

Research completed by The Hartford Center for Mature Market Excellence found that the majority of older Americans would be most likely to listen to a spouse or child when it comes to concerns about safe driving, with 11% identifying a doctor/healthcare professional as the person they’d be most likely to listen to. However, spouses and children may lack the information needed regarding how a particular medical condition or medication may affect driving. Given this, a better approach to addressing continued safe driving may be to include family, whenever possible, in conversations pertaining to safe driving or necessary restrictions resulting from medical issues.

In the event that a driver needs a comprehensive evaluation to determine fitness to drive, providers can refer drivers to a Driver Rehabilitation Specialist (DRS). These specialists are trained to identify physical and cognitive challenges that impact drivers. Depending on the results of their evaluation, these specialists can either work with the driver on modifications that can be implemented to improve safety or recommend retirement from driving due to safety concerns that cannot be remedied with additional training or vehicle modifications. DRS services, while important, are only covered by insurance under certain circumstances. Individual DRS providers can help determine if the services are covered and what out of pocket costs are associated with the evaluation. Both The Association for Driver Rehabilitation Specialists and The American Occupational Therapy Association offer directories of Driver Rehabilitation Specialists.

The resources below provide both in-depth and quick reference information to better understand the role medical and human services professionals play in ensuring the continued safe driving of older Americans.

Medscape

Medscape.com offers CME/CE's in several modules on the topic of older drivers. In order to locate available courses, search "older driver", "NHTSA", "driver safety", or other similar terms in the search bar and select the CME & Education tab.

Clinician’s Guide to Assessing and Counseling Older Drivers

This comprehensive guide walks clinicians through the assessment and counseling of older drivers to ensure safe driving. Topics covered include general information on older drivers, screening and assessment, interventions, Driver Rehabilitation Specialists, ethical and legal issues, and specific medical conditions that have an impact on driving, among other things.

NHTSA Fact Sheets for Medical Professionals

These fact sheets offer a quick reference for specific medical conditions and include information on how these conditions may impact driving as well as the role of the clinician in ensuring continued safe driving for individuals with these conditions.

UCSD - TREDS

The Training, Research And Education For Driving Safety out of UC San Diego has resources available for health professionals. These resources include short training videos and pocket guides that can help increase knowledge of how aging, medical conditions, and medications can impact driving as well as information on screening.

DMV Medical Review Unit

Professionals who have a concern about an individual’s ability to continue driving safely should be aware of the Medical Review process in North Carolina. A referral for medical review is an important tool to utilize when a driver’s medical condition is impacting their ability to drive safely, but they are unwilling to restrict their driving as needed. It is important to note, however, that a referral for medical review may not be necessary if the individual agrees to limitations on driving based on their individual medical circumstances.

Sources:

American Medical Association Code of Ethics

The Hartford Center for Mature Excellence & MIT Age Lab. We need to talk: Family conversations with older drivers.