Family Conversations With Older Drivers
This short web page highlights changes that occur with age that make driving more risky for older drivers, changes in driving behavior many people naturally make to continue to drive safely as they age, best practices for bringing up the issue if you think someone is no longer safe to drive, and some tips for situations in which the older adult refuses to make any changes to their driving habits.
Complex Parkinson’s Disease And Palliative Care
Complex Parkinson’s 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 Parkinson’s disease, under the supervision of a doctor with a specialist interest in Parkinson’s disease.
As Parkinson’s disease progresses, you’ll 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 there’s no cure for an illness, palliative care tries to alleviate symptoms, and is also aimed at making the end of a person’s 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 you’d like to be treated and what care you wish to receive.
If A Person Does Have To Stop Driving Because Of Their Pd What Strategies Can Help Them Maintain Their Independence
The COVID-19 crisis is teaching all of us about using alternative strategies that do not require driving to maintain independence for example, online ordering of groceries and medications, telehealth visits with our physicians, and new ways of connecting to our family and friends using technology. We undoubtedly will continue to use these resources even after the COVID-19 crisis ends and all these new strategies can help increase the independence of those who do not drive.
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Tips For Families And Caregivers
If a loved one has been diagnosed with Parkinsonâs disease — with or without associated cognitive impairment — certain day-to-day behavior can indicate an inability to drive safely. Watch carefully for the following signs:
- Poor coordination
- Difficulty judging distance and space
- Disorientation in familiar places
- Inability to handle multiple tasks
- Inattention to personal care
- Getting tickets for traffic violations
- Getting into near-miss situations, fender benders, or other accidents
Any of these warning signs could indicate that itâs time for your loved one to stop driving. Itâs important to discuss any concerns you have with your loved one and their doctor.
How Do I Know If I Can Drive Safely
- Ask a trusted friend or family member for honest input about your driving skills.
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Driving Evaluations In Parkinsons Disease Patients: A Physicians Role
In the medical literature, there are four main methods used for the evaluation of driving ability in PD patients, including questionnaires, off-road tests , driving simulator, and driving skill tests . Different types of questionnaires were developed to assist physicians in their evaluation . However, there is poor correlation between patient questionnaires and disease severity scales in determining medical fitness to drive . This discrepancy necessitates physicians to consider additional tests that evaluate driving-related skills and abilities, including vision, cognition, motor/somatosensory function, and neuropsychological testing . While a combination of motor, visual, and cognitive assessments is often considered an adequate tool that determines functional ability of elderly drivers, it does not evaluate driving skills and does not predict the possibility of accidents in this population . Due to a lack of standardized parameters and protocols for the different off-road testing methods, off-road tests alone cannot reliably predict actual driving performance or the likelihood that a PD patient is or will be at risk for a driving-related accident. Further, positive off-road testing results are not sufficient for designating someone an unsafe driver or recommending them for driving cessation . Therefore, comprehensive driving evaluations often include on-road testing, which is considered to be the reference standard and the ultimate form of driving assessments .
Parkinsons Disease And Driving
Driving is an essential part of many of our activities of daily living. It is how most of us get to work, school and various appointments its how we travel to and from household and social activities. For many, receiving their drivers license marked a rite of passage to becoming an adult. Driving gives us independence and freedom.
Driving is a complex task that requires you to be aware at all times and be able to respond quickly to the constantly changing circumstances. Anything that impacts or affects your ability to drive must be taken into serious consideration. This includes Parkinsons disease, which has physical, mental and emotional symptoms.
Research shows that even healthy people outlive their ability to drive by several years and most often this is due to changes in vision as we age. Most drivers however, do not plan to retire from driving as they age. Many people realize when their driving skills are diminishing, often resulting in decreased confidence on the road. In some cases, the fear of isolation or loss of independence overrides their judgment concerning their driving abilities, resulting in denial of having any problems. This is especially true for those with Parkinsons. People with Parkinsons may be additionally fearful that the need to stop driving indicates a progression in their disease.
For more information and to view checklists, visit
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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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Legal Obligations Insurance And Tax
Your legal obligations will depend on the laws of the country in which you live. In many countries, your doctor will be obliged to carry out a regular ‘fit to drive’ check.
The most common heath-related driving laws in European countries are outlined below but you should always check on current legislation with your doctor or a suitably qualified member of your healthcare team.
Seniors And Driving: A Guide
Comprehensive webpage covering causes of driving difficulties with age, warning signs of an unsafe elderly driver, professional assessments of driving safety, how the DMV can help ensure an older adult drives safely, how to have ‘the talk’ about giving up the keys, ways tohelp a senior transition from driving, transportation options for seniors who no longer drive, and top ridesharing options for seniors.
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Judie Found That Her Disabled Person’s Railcard Did Not Just Cut The Cost Of Travel But Helped
Well you can buy a railcard, disabled persons railcard and you get, I think its half price each. My friend takes me down to London. Weve been to the Parkinsons Carol Service two, two Christmases now and various other events that theyve had on in London. And its wonderful to go by train. If you go in your wheelchair and make the rail company aware that youre going and what times youre going they are absolutely brilliant. The first time I tried it was two years ago when we went to the Carol Service. And we got on at Northampton and we were going to Euston and the guard was there to meet us. They knew which carriage we were going in and we were, planned to be back for about twenty past ten at night and, no half past ten. And we got to the station at twenty past ten and this gentleman jumped out from behind a post and he said, You must be my two ladies for Northampton. Ill take you up. And he took us up, made us a cup of coffee, and he said, Ill come and fetch you when the train comes into the platform and put you in the carriage. And, British Rail are criticised but they are good if you, if you tell them. If you dont tell them you cant expect the help. But they were very good.
Psychological Issue: Depression And Sex
With diagnosis and decreased physical capacity, a persons sense of self is disrupted with Parkinsons. Parkinsons itself can cause changes in the brains chemicals that impact ones mood and well-being. Depression can affect up to 40 percent of those with Parkinsons. This is important to realize since sexual disorders may be due to the depression that can come with Parkinsons diagnosis more than by the actual disease itself. The antidepressant medications that may be administered can also result in sexual dysfunction.
Other emotional issues for those who have Parkinsons, which may result in sexual difficulties, include: anger, stress, grief, and mental fatigue. An individual grappling with Parkinsons may experience reduced self-esteem, which can inhibit ones sexuality. Such is made even more difficult by the body image problems that can arise, due to issues like changes in skin texture or the body smell that results from consuming Parkinsons drugs.
The partner of a person with Parkinsons can also have trouble coping with the situation. Issues that may arise include:
- Fatigue and resentment in taking on more responsibility.
- Dealing with their own feelings related to a partners diagnosis, like fear, anxiety, and depression.
- Loss of attraction and sexual interest due to the symptoms of PD, e.g., involuntary movements or changes in appearance, like the lack of facial expression.
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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
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.
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Eat Plenty Of Protein But Not With Levodopa Medications
If youre taking a levodopa medication, your doctor may tell you to avoid protein when taking your meds. Both animal and plant protein can interfere with the absorption of levodopa medications.
But you should still eat plenty of protein. Just be strategic with the timing. Dont take levodopa medications with meals, Dr. Gostkowski says. Its best to take it on an empty stomach either 30 minutes before your meal or an hour after eating.
If you get nauseous from the medication, eat a small amount of starchy food with it, such as crackers. Make sure whatever you eat with your medicine doesnt have protein. Its a misunderstanding that people with Parkinsons should avoid protein, Dr. Gostkowski says. You definitely need protein in your diet. Just dont eat it when youre taking your levodopa medication.
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.
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Do I Have To Inform My Car Insurance Of My Diagnosis
You must inform your car insurance of your Parkinsons disease diagnosis. Let them know what information your doctor gave you to help them determine the best coverage for your specific situation. Failure to inform your insurance company of your diagnosis could invalidate your insurance policy.You also need to inform your insurer if any adaptations are made to your vehicle. Contact your car insurance provider to find out how to proceed. You can also shop around for insurance to compare coverage and prices.
Ruth Had Looked Forward To Going Away But Had Had To Disappoint Both Herself And Her Husband By
Last year we had got a wee towing caravan and, it worked out okay last year whenever we went away, I, I was fine. This year we were gonna go away a fortnight ago and we were going right till, up until the morning we were, we had planned to go and I just felt really terrible that morning. And I knew there would be no point in me going away because I knew I would have to come home again because I just felt bad, really bad, really down, very painful, very stressed. And I just thought, no its not, its not worth it. I just, I didnt want to go anywhere, so my husband and I ended up really kind of falling out because he had taken time off his work for us to go away and he had, you know, got everything ready and just at the last minute I just said, Look I really cant go. And he was saying, Oh, just come youll be fine. But I, I know myself that I wouldnt be if I went. I know theres no point in going when I feel like that, because I would just have to come back.
For advice on all aspects of driving the government has a very helpful website GOV.UK – see the disabled people section ‘Disability, equipment and transport’ which has information about public and community transport, adapting vehicles and options for buying or hiring cars, vehicle tax for disabled drivers and transport rights and details of the Blue Badge scheme. Also information about train and bus travel, bus passes and shopmobility.
Last reviewed May 2017.
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