Assessing Your Ability To Drive
The medical report provides an assessment of your fitness to drive. To complete the report, your doctor will refer to a set of medical standards that describe the specific requirements for various conditions, including Parkinsons. These standards can be viewed on line at www.austroads.com.au. VicRoads assesses each medical report on a case-by-case basis and then determines if a driving test is necessary.
If an on-road driving assessment is recommended, you will be assessed by a specialised occupational therapist who has an extra qualification as a driving assessor. The OT Driving Assessor will evaluate your ability to continue to drive safely, legally, and independently. They can also provide advice about how your Parkinsons may impact on your driving and make recommendations for how to manage and monitor any issues identified.
Some possible recommendations may include periodic reviews, driving at certain times , driving locally or modifications to the vehicle . In more rare instances, if there are significant safety concerns, they can recommend a license suspension or cancellation.
More information is available from VicRoads. You can phone VicRoads on 13 11 71 or visit their website www.vicroads.vic.gov.au.
What Are Visuospatial Abilities
Also referred to as visual-spatial and visuo-spatial, visuospatial abilities consist of the ability to understand what we see around us and interpret spatial relationships. In other words, this includes both the images we see , as well as our perception of the size and location of our surroundings .
Systematic Review Of Assessment Tools For Determining Fitness To Drive In Parkinsons Disease Patients
The aim of this study was to perform a systematic review of the four main driving assessment methods and provide the evidence on individual methods for assessing driving ability in PD patients. To address the question of how much evidence we have regarding driving competency in PD, we performed a systematic review by searching MEDLINE, life science journals, Google scholar, and online books using the following key words: driving OR driving safety OR driving ability OR road test OR driving questionnaires OR sleepiness scale OR driving simulator OR naturalistic driving OR car sensor OR reaction time OR driver OR transportation OR automobile OR car OR vehicle OR collision injury OR car accident. Selected articles were required to have the term Parkinsons disease AND any one of the above key words within the title and/or abstract.
Table 3 Summary of studies involving driving assessment tools in patients with Parkinsons disease
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Should Parkinson’s Patients Drive
“The are no rules, laws, or regulations that concern driving for people with Parkinson’s disease,” says neurologist Abraham Lieberman, MD, medical director of the National Parkinson’s Foundation and a professor of neurology of the University of Miami School of Medicine. “The issue of driving and Parkinson’s disease is one that has been looked into, but never in a way as seriously as with epilepsy. And I’m not sure that it will anytime soon.”
But the latest study on the issue, published in the Dec. 10 Neurology, suggests that perhaps it should. Researchers found a direct link in the likelihood of driving accidents with the disease’s progression. Nearly all of the 39 Parkinson’s patients who were tested in a driving simulator were involved in collisions. And while most of them admitted the disease made it harder to operate a car, half continued their pre-diagnosis driving habits with no reduction in time behind the wheel.
“What was surprising, based on our and previous studies, is that the patients didn’t have a good feeling or understanding on how bad their driving really was,” says lead researcher Theresa A. Zesiewicz, MD, of the Parkinson’s Disease and Movement Disorders Center at the University of South Florida College of Medicine. “But I wasn’t surprised by the results.”
Show Sources
NeurologyBritish Medical Journal
Where To Find A Specialist
Ask your hospitals occupational therapy department if they offer assessments, or if there is a driving remediation instructor affiliated with the hospital. You can also call the Association of Driver Rehabilitation Specialists at 1- 866-672-9466 or go to their website at www.aded.net. Health Insurance does not typically cover a driving assessment.
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How Do You Qualify For Attendance Allowance If You Have Parkinsons
To qualify for Attendance Allowance, you need to meet the essential criteria for the benefit which include the following:
- be under State Pension Age
- require help with washing themselves, getting dressed, or need to be monitored to remain safe during the day or night
- be faced with a physical or mental illness, disability, or terminal illness that increases the requirement of being supervised or being taken care of by someone else
- be in England at the time of making the claim and must have lived in England for at least 2 of the previous 3 years
In addition to this, the claimant should be able to satisfy one of the disability tests. These include:
- The claimant requires regular support from another person with their bodily functions. This includes but is not limited to being able to wash themselves and other hygiene needs, getting in and out of bed, getting dressed and undressed, going to the toilet, taking medication, eating, drinking and communicating with others.
- The claimant requires continuous supervision at different intervals to make sure that they are safe, not causing danger or harm to themselves or others
- The claimant requires care from another person to help with their bodily functions. This can either be at least twice each night or for 20 minutes or more
Complex Parkinsons Disease And Palliative Care
Complex Parkinsons disease is defined as the stage when treatment is unable to consistently control symptoms, or the person has developed uncontrollable jerky movements .
These problems can still be helped by adjustment or addition of some of the medications used to treat Parkinsons disease, under the supervision of a doctor with a specialist interest in Parkinsons disease.
As Parkinsons disease progresses, youll be invited to discuss the care you want with your healthcare team as you near the end of your life. This is known as palliative care.
When theres no cure for an illness, palliative care tries to alleviate symptoms, and is also aimed at making the end of a persons life as comfortable as possible.
This is done by attempting to relieve pain and other distressing symptoms, while providing psychological, social and spiritual support for you and your family.
Palliative care can be provided at home or in a hospice, residential home or hospital.
You may want to consider talking to your family and care team in advance about where youd like to be treated and what care you wish to receive.
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When To Give Up Driving And Who Decides
The decision to give up driving is much less well-defined than the decision to get a license. States and individual Departments of Motor Vehicles vary in terms of how they handle license renewal for older drivers. Most people do not want to be told they cant drive anymore. And no one wants to be the bad guy who tells a person that they are not driving safely. But if there are concerns, it is important to start these conversations early. The decision to stop driving can evolve over time, rather than being made suddenly.
A driving test can help you and your family make a decision about giving up driving while avoiding the tension that comes from involving loved ones. If and when the decision is made to stop driving, there are programs available to help you get where you need to go:
- Call the ElderCare Locator at 1-800-677-1116 and ask for your local Office on Aging, or go to their website at www.eldercare.gov and search under the topic Transportation.
- Senior centers, religious organizations, and other local service groups often offer transportation services for older adults in the community.
You may also work out a schedule to get rides with family and friends or consider taxis or ride-sharing services like Lyft and Uber.
How Do You Qualify For Carers Allowance If You Take Care Of Someone With Parkinsons
If you take care of someone with Parkinsons, you may be able to claim Carers Allowance if you can fulfil the below conditions:
- spend a minimum of 35 hours per week caring for someone
- are above 16 years of age
- are not in full-time education
- earn less than or equal to £128 per week
Additionally, the person that you are caring for must be on either of the following benefits:
- Attendance Allowance
- Disability Living Allowance
- Personal Independence Payment
While the Carers Allowance is below the threshold for income tax deduction however, when combined with other sources of income of an individual and crossing the personal allowance limit of £12,750, the amount you receive as a carers allowance is taxable.
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Applying For An Accessible Parking Permit
You can apply as a driver, a passenger or as both.
The application process can be completed online and requires an assessment by a medical practitioner. For those without internet or mobile phone access, a paper-based version of the application can be obtained from your local council.
To learn more about your eligibility and to start the application process, visit the Accessible Parking website.
Can You Claim Benefits If You Have Parkinsons
Since there are an estimated 145,000 people in the UK affected by Parkinsons, it would be of much help to readers to learn whether someone suffering from the condition can claim benefits. This is why we aim to discuss through the content of this article, the benefits that someone with Parkinsons can claim and their eligibility criteria.
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Can I Get A Disabled Parking Permit
If you have trouble walking short distances, you may be eligible for a parking permit for people with disabilities.
Talk to an SAAQ authorized health care professional. They will assess your situation and fill out the disabled parking permit application form if necessary. You will then need to send the form to the SAAQ
The idea that you may one day have to stop driving can be difficult to accept, but being involved in an accident can have a serious impact on you and others.
You and your loved ones can monitor your driving and regularly assess whether you should stop.
Some signs that may be alarming:
- Driving too slow
- Stopping in traffic for no apparent reason
- Non-compliance with road signs
- Getting lost during a familiar route
- Difficulty turning or changing lanes
- Difficulty reading traffic signs or seeing traffic lights in time to react
- Increased car insurance rate due to traffic violations or at-fault accidents
- Problems responding to unexpected driving situations
- Slow reaction to traffic lights
- Several consecutive unsuccessful attempts to park the car
- Tickets for traffic violations
How Does Parkinsons Disease Affect Your Ability To Drive
Driving involves a combination of visual, cognitive and motor skills that may be affected by Parkinsons disease.
Some symptoms, such as tremors, slow movements, rigidity, freezing or cognitive disorders may affect your ability to drive.
Your reaction time in response to complex road conditions can increase significantly, which can increase the risk of accidents.
Some antiparkinsonian medications can also have adverse effects that can affecton driving, such as drowsiness or insomnia.
You can continue driving during the early stages of Parkinsons disease. Enjoy it while you can still do it independently and safely. However, there are certain precautions you should take before driving:
- Plan your route before you leave
- Get behind the wheel when medication is most effective
- Avoid driving during off periods
- Avoid driving at night
- Only drive when you are well rested
- Remove distractions while driving, such as listening to the radio, eating or drinking, using a cell phone, even if it is hands-free, or talking to a passenger
- Maintain good posture in order to be comfortable and have good visibility while driving
- Stay fit and physically active to maintain good mobility, the fast reaction time needed to drive and your energy levels
- Avoid highways that require you to drive fast
- Limit your driving to short distances
- Avoid driving in bad weather conditions
- Do not drive if you are drowsy
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Driving And Parkinsons Disease
For some people with Parkinsons disease , there may come a time when it is no longer safe for them to drive. This is a very sensitive and fraught issue since for many people, driving is equated with independence, and people with PD may assume that relinquishing driving means a further narrowing and limiting of their world. However, with the right tools, a person can continue to be an active and engaged member of society without driving. Gabrielle Blenden, MSOT, OTR/L and Peggy Barco, OTD,OTR/L, CDRS, SCDCM, FAOTA are occupational therapists at Washington University School of Medicine Program in Occupational Therapy in St. Louis, Missouri, where they work at the Driving and Community Mobility Laboratory. They study the role of neurologic disease on driving and perform comprehensive driving evaluations to determine if a persons driving abilities are intact.
Together with the APDA Greater St. Louis Chapter, they designed a Driving Retirement Workshop a four-session program for people with PD and their families to help plan for maintained independence in the face of driving cessation.
Recently, I was able to ask Ms. Blenden and Dr. Barco about their work.
Considerations For Driving With Parkinson’s Disease
In this hour-long webinar occupational therapist, Kathryn McKall, outlines the impact on driving due to changes specific to Parkinson’s Disease with respect to vision, cognition, hearing, sensory & motor function, and medications. She provides driving self-assessment questions, suggestions for remaining a safe driver with PD, adaptive equipment and modern tech to make driving easier and safer, the care partner’s role in evaluating driving and supporting cessation of driving, and tips to prepare for when you are no longer driving.
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How To Ease The Transition
Frank discussions with family members and doctors are often enough to convince people with Parkinsonâs disease to modify their driving. Some people may need additional input from a support group, lawyer, or financial planner to ease the transition.
Some people with Parkinson’s disease can continue driving under strict guidelines, although the long-term goal will still be to eventually stop driving. Guidelines for limited driving may include:
- Drive only on familiar roads
- Limit drives to short trips
- Avoid rush-hour traffic and heavily traveled roads
- Restrict drives to daylight hours during good weather
Itâs important for family and friends to find ways to help their loved one reduce their need to drive. These include arranging for groceries, meals, and prescriptions to be delivered to the home, or for barbers or hairdressers to come to the home.
Itâs also important to help your loved one become accustomed to using alternate methods of transportation, such as:
- Rides from family and friends
- Public buses, trains, and subways
Your local Area Agency on Aging can help you find transportation services for a loved one. Eldercare Locator, a service of the U.S. Administration on Aging, can also assist. Its phone number is 800-677-1116,
If your loved one refuses to voluntarily limit or stop driving, despite a demonstrated need to do so, you may need to take more aggressive steps, such as:
Make sure your loved one’s doctor is aware of your concerns. They should be able to help.
Tips For Traveling With Parkinsons Disease
- Always try to travel with a companion.
- Place the names of your doctor, insurance company, emergency contact, and medications in your wallet or purse.
- Carry identification stating that you have Parkinsons disease.
- Use a fanny pack or backpack so that you have both hands free to balance as you walk, especially if walking any distance.
- Pack snacks and carry a water bottle to take medications.
- Wear comfortable, loose-fitting clothing and good walking shoes.
- When making hotel reservations, request a room on the ground floor or near an elevator. Ask if they have rooms that are handicapped-accessible these usually include grab bars in the shower and bathroom and have wider spaces between furniture for wheelchair access.
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Parkinson’s Drugs And Excessive Sleepiness
Some Parkinsons drugs can make you very sleepy. Sometimes this happens suddenly and without warning. This may be more likely in people with advanced Parkinsons who are taking multiple medications or are increasing their medication, particularly dopamine agonists.
Although this is concerning, the DVLA has stated that the risk of falling asleep suddenly is low and that taking Parkinsons drugs should not automatically mean you have to stop driving. However, if you experience any sudden or excessive daytime sleepiness, you should not drive and tell your GP, specialist, or Parkinsons nurse.
My Parkinson’s Story: Driving
This 9-minute video alternates between an interview with a man and his wife and several specialists. The man and his wife share how he gave up his driver’s license due to Parkinson’s symptoms and how he is adjusting. The specialists share how Parkinson’s symptoms affect a person’s ability to drive, and how driving and cognitive assessments can determine a person’s fitness to drive.
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What Symptoms Of Pd May Interfere With The Ability To Drive Safely
Driving is a complex task that requires vision, appropriate motor skills, and higher levels of cognitive function to carry out safely. The most obvious symptoms that can impact driving ability for people with PD are typically motor difficulties such as resting tremors, rigid movements and difficulty maintaining stable posture, which may make it difficult to operate a vehicle safely. What is less obvious, and often more concerning, is that certain non-motor difficulties that can accompany PD may also interfere with driving. These include decreased contrast sensitivity which limits a persons ability to see things in the dark, decreased proprioception, which impairs a persons ability to know where their body is in space , decreased visual spatial skills, which may affect the ability to know how the car is positioned on the road, and difficulties with cognitive function which can impact memory, processing speed, attention, and problem solving. In our own day-to-day evaluations with drivers who have PD, we often find that it is the cognitive impairment that most impacts driving. Drowsiness that accompanies later stages of PD and medication side effects can also impact the ability to drive safely. Non-motor symptoms are less evident than motor symptoms and have been shown to be a more serious risk to driving safety in some people with PD.