Driving Assessments for High-Risk Older Adults

Authors in a recent Public Health Nursing article suggest a three-pronged approach to testing for safety in older adult drivers, which includes a patient assessment and medication review, a computerized simulation using a touch screen interface, and a road test with a certified road test examiner (doi: 10.1111/phn.12274).

First author Lisa Kirk Wiese, PhD, RN, APHN-BC, CNE, assistant professor at Florida Atlantic University (FAU) Christine E Lynn College of Nursing, (Boca Raton, FL) said: “Drivers with dementia, and even their caregivers, may lack the insight needed to limit and eventually discontinue driving.”  

Memory plays a significant role in driving competence, according to Dr Kirk Wiese. At a basic level, memory provides drivers with the knowledge of how to operate a motor vehicle—turning the key in the ignition, shifting gears, and distinguishing the brake from the gas pedal. Drivers also need to remember their destination so that they don't get lost.
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The on-road test, in a dual-controlled vehicle, was developed solely for the purpose of detecting driving errors made by cognitively impaired drivers. At the conclusion of the testing session, results and recommendations are provided, and, if needed, options for alternative transportation and supportive services are discussed.

Today, almost half of all drivers on the roadways are over the age of 65, and this number is projected to increase to 77% in the next 30 years. Adults over the age of 65 also have the highest crash rate per mile compared to any other age group. Self-rated methods for older drivers at risk are not effective because they may be overconfident and lack insight into their perceived versus actual driving abilities.

María Ordóñez, DNP, ARNP, GNP-BC, assistant professor in FAU’s College of Nursing, commented: “Our driving evaluation program is one of several comprehensive services we provide to individuals with memory disorders and their families. We are committed to helping [older adults] function at their personal best to maximize their quality of life and to respond to their unique needs with caring, expertise, and compassion.” —Amanda Del Signore