Should Someone With Parkinson’s Drive

Driving With Parkinsons Disease: Exploring Lived Experience

Jeffrey D. Holmes

1School of Occupational Therapy, The University of Western Ontario, London, Canada

2School of Health Studies, The University of Western Ontario, London, Canada

3Health and Rehabilitation Sciences, The University of Western Ontario, London, Canada

Abstract

1. Introduction

Given the implications that driving has for independence, autonomy, and social participation, exploring and understanding the lived experiences of people living with PD is critical to the development of targeted interventions and preemptive driving retirement approaches. Therefore, the purpose of the current secondary data analysis is to explore the lived experiences of people with PD surrounding their fitness to drive.

2. Materials and Methods

2.1. Setting and Context

2.2. Primary Data Set

2.2.1. Participant Recruitment

For the parent study, a convenience sample of participants was recruited via posters displayed within local movement disorder clinics in a midsized Canadian city and from information sessions that were delivered at local PD support groups and regional PD conferences. Individuals were eligible for participation if they were living with idiopathic PD and understood English. Participants were excluded if they experienced cognitive or communication difficulties that impacted their ability to participate in an oral interview or group discussions.

2.2.2. Data Collection

2.3. Secondary Data Analysis

3. Results

3.1. Meaning and Significance of Driving

3.2. Driving Cessation

Cholinesterase Inhibitors Widely Used To Treat Dementia

Cholinesterase inhibitors, widely used to treat dementia, may cause worsened parkinsonism, primarily increased tremor . Large double-blind trials of rivastigmine, a cholinesterase-inhibiting drug, in both dementia with Lewy bodies and Parkinson disease dementia have demonstrated that rivastigmine is well tolerated without significant worsening of motor function overall, although tremor may increase . The other cholinesterase inhibitors have been less well studied but appear to have similar benefits and side effects.

Tips For A Better Sex Life With Parkinsons Disease

• Communicate: Be open with your partner about your feelings and discuss your physical needs. If the topic of sex causes upset or arguments, it might be worth seeing a sex therapist.
• Consider changing your medication: If your medication is having an impact on your sex life, talk to your doctor about an alternative treatment. Your sex life is important, so it should be given as much attention and care as your general health and wellbeing.
• Be open with your doctor: Don’t be afraid to talk about sex with your doctor that’s what your healthcare team is there for, and they will have dealt with these types of concerns before.
• Deal with fatigue and depression: Depression and fatigue can negatively impact your sex life, so look at ways of treating these symptoms. A combination of therapy and antidepressant medications may help, so talk to your doctor.

Recommended Reading: Parkinson’s Disease And Cough Medicine

Look For The Silver Lining

I know people in the Parkinson’s community who moved to a city where a car was not needed. Relying on buses and trains may take more of your time and patience but it is an option worth considering. You might also think about what you have to gain: you can say goodbye to high gas prices, car insurance, maintenance fees and the stress of traffic delays, parking and road rage. Consider the impact driving has on your finances and mental health, and think of all you will save.

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.”

NeurologyBritish Medical Journal

Don’t Miss: Can Parkinson’s Start In The Legs

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.

Notify your national driver and vehicle licensing body that you have Parkinsons: they will advise you of the steps you need to take to retain your driving licence. This may involve contacting your doctor to confirm your fitness to drive, a medical examination or a driving test. Some countries may issue a licence for a fixed term, usually renewable provided your ability hasnt deteriorated sufficiently to make you unfit to drive.

Inform your insurance company: you should tell the company of any health change that may affect your driving. In most countries it is an offence to make a false statement or withhold information for the purposes of obtaining a certificate of motor insurance. Anyone who drives when considered unfit will invalidate their insurance cover.

How Parkinsons Disease Symptoms Affect Driving Skills

Parkinsonâs disease symptoms vary from patient to patient. They can range from mild to severe. But even in mild cases, common symptoms such as shaking in the arms, hands, or legs, impaired balance, and slowed physical and mental responses can affect driving skills.

Episodes of tremor, for example, often begin in a hand or a foot and can affect the ability to operate a carâs controls. Rigidity can result in jerky motions while steering. Slow movement can interfere with braking in heavy traffic or ability to quickly react to road hazards. Postural instability often results in a stooped posture in which the head is bowed and shoulders are drooped, further reducing driversâ awareness of their surroundings.

For many people with early Parkinsonâs disease, medications can reduce symptoms. But medications may have side effects, such as drowsiness, that can affect driving as well. It can be difficult for doctors to devise a medication plan that reduces the primary symptoms of Parkinsonâs disease and allows some patients to drive without causing side effects that make driving a car even more dangerous.

Also Check: Treatment Of Dyskinesia In Parkinson’s Disease

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 a driving test is needed it normally begins at your home address, with a VicRoads assessor. You will be asked to drive to places where you would normally go, and are tested on your ability to drive safely on your local roads. You are allowed up to three attempts at this driving test.

If you fail the driving test three times, you may be required to have your driving abilities formally assessed by an occupational therapist experienced in driving assessments.

More information is available from VicRoads. You can phone VicRoads on 13 11 71 or visit their website www.vicroads.vic.gov.au.

Are There Any Changes I Could Make To Help Me Stay In Control

Yes, there are many changes you can make to help you stay in control and remain independent. Adapting your daily routine is one important way that you can help yourself. Choose a time in the day when your medication is working well to embark on any strenuous activities, and always pace yourself, taking rests if you need to.

There are also many types of specialist equipment to help with activities such as washing, dressing and eating for example. Occupational therapists are trained to help people to maintain their independence and adapt to any limitations they experience. They can advise on special equipment and modifications to your environment or daily routine.

Many people also devise their own strategies for coping with some difficulties – see Coping strategies videos for a range of ideas. For other helpful hints on everyday living see Helpful hints.

See also Living well.

Also Check: Early Parkinson’s Symptoms In Young Adults

How Does A Person Know When They Should Reconsider Driving

A good indicator of when it may be time to consider driving retirement is when there are notable difficulties and/or changes in any of the symptoms we mentioned above. Since many times it is difficult for someone to notice a decline in function in themselves, it is usually a family member, close friend, or physician who will notice significant changes in function. It is the physician who will recommend driving retirement or make a referral to a specialist who can perform a comprehensive driving evaluation. Since driving requires a combination of visual skills, motor skills and cognitive skills, it is important to monitor how all of these areas change when someone is diagnosed with a neurodegenerative disease like PD. If someone notices a significant change in function that might affect the ability to drive safely, this should be talked about with a doctor.

Another very important indicator of whether a person should be driving, is how well the person is currently driving. For example, have there been recent accidents or traffic tickets, small scrapes on the car, potentially dangerous actions observed by passengers in the car, or getting lost while driving, etc? Again, in such cases a doctor may recommend driving retirement or a comprehensive driving evaluation.

Treatment For Parkinsons Disease And Sex Issues

Treatment for erectile dysfunction in men might include medications like Viagra, as well as physical or psychological therapy. In some cases, surgical implants may also be used. Womens sexual health in Parkinsons is slightly more complex due to their hormonal makeup.

Treatment options for women are somewhat restricted, but they include adding lubrication and seeing a therapist. Many women find timing sex during their ON periods to be helpful.

In terms of reproductive health, there is no evidence to suggest that Parkinson’s disease causes problems with pregnancy although there have been no studies into the safety of PD medication during pregnancy.

Parkinsons disease and sex can be challenging, but there are plenty of treatments and solutions that can work for both men and women. Its important to communicate with your partner and talk through any feelings you might be experiencing, especially if youre struggling with body image or confidence issues. Navigating sex during Parkinsons disease can be difficult for partners, too, so remember to keep the dialogue open in your relationship.

APA ReferenceSmith, E. . Parkinsons Disease and Sex Issues: Libido, Sex Drive, HealthyPlace. Retrieved on 2021, August 26 from https://www.healthyplace.com/parkinsons-disease/effects/parkinsons-disease-and-sex-issues-libido-sex-drive

Don’t Miss: Voice Exercises For Parkinson’s Patients

Any Medication That Blocks Dopamine In The Body Can Cause Parkinsons Symptoms

You may have heard of Parkinsons disease , a movement disorder. Someone with it may have characteristic signs, such as a pill-rolling tremor in the fingers or a hunched forward posture. You may recognize someone with this disease from the faltering, tiny steps they take when they walk or by their rigidly emotionless face.

The cause of Parkinsons disease is mostly unknown. Some people develop Parkinsons-like symptoms after treatment with certain medications. This is called drug-induced parkinsonism or secondary parkinsonism. Certain medications can also worsen symptoms in someone who already has Parkinsons disease.

Any medication that blocks dopamine in the body can cause Parkinsons symptoms. Dopamine is a brain chemical that helps control movement. Common dopamine-blocking drugs are antipsychotics. They are used to treat certain mental illnesses or severe nausea. Less commonly, certain types of calcium channel blockers cause drug-induced parkinsonism. These drugs may be used to treat chest pain and high blood pressure, or irregular heart rate.

What Is The Best Walker For Parkinsons Patients

If you are looking for the best Walker for Parkinsons Patients, I recommend you to go for Drive Medical Folding Walker. The best thing about Drive Medical Folding Walker is that its extremely lightweight due to its aluminum frame. Also, it comes with a foldable design, which makes it easier to carry it while traveling.

Don’t Miss: Transcranial Magnetic Stimulation Parkinson’s

Advice On Serious Myasthenia

• Driving is permitted only if the symptoms of myasthenia are controlled with medical therapy.
• The specialist will report to the patient in this regard, warning him of the side effects of the medication, so that he maximizes the precaution when driving.
• Some drugs such as quinine, hydantoin, streptomycin, diazepam, and phenothiazines can worsen myasthenia or favor a spontaneous episode.
• We should avoid these drugs and, in case they are necessary, warn out patient of the possible interference with driving.
• Drivers with myasthenia gravis should be recommended to drive at daytime, when they are not tired yet.
• If they suffer diplopia or eyelid fall while driving, they should park the car and ask for assistance. Forcing driving in this situation can cause an accident.

Guidance For People Who Are Clinically Extremely Vulnerable

Some people are at very high risk of severe illness and hospital admission from coronavirus because of an underlying health condition.

If youre in this group, you will have received a letter from the NHS or from your GP telling you this. You may have been advised to shield in the past. Often, Parkinsons alone is not enough to make you clinically extremely vulnerable.

If youre affected, check the guidance where you live, which may include some additional measures:

Read Also: Is Thumb Twitching A Sign Of Parkinson’s

Drive Medical Nitro Euro Style Walker

If you wish to have a walker that has all standard features plus a stylish look and comes with a reasonable price on Amazon, Drive medical nitro euro style walker is the one you should seriously consider.

The walker serves as a great aid for people with mobility problems like Parkinsons disease. Using it provides increased safety, flexibility, and great walking comfort. It is crafted with a high-quality aluminum frame with a built-in brake cable for extra safety and protection. The overall frame of the walker is very stable and safe. It can handle a weight of up to 350 pounds.

A feature you may not see in other walkers is its big front wheels that help you smoothly go through very rough surfaces like stone roads and lawns. Also, the walker is very handy. It can be folded and you can take it in the trunk of your car and enjoy outdoor gatherings with your family and friends.

Living With A Husband Who Has Parkinsons Disease

Dennis was diagnosed with Parkinsons 15 years ago and underwent Deep Brain Stimulation at OHSU in 2013. Last week, we heard his story, from the patient perspective. Here, his wife Mary Ellen provides a look into the caregivers frame of mind.

Originally published on Summit For Parkinsons, a group of Montanans giving back to the Parkinsons community.

You May Like: Best Books On Parkinson’s Disease

Adjusting To Life Without Driving

When older adults are adamant about not giving up their licenses, sometimes family members have to take action themselves by disabling the car or taking it away, Kennedy says.

When driving is no longer possible, you can reduce your need for transportation by taking advantage of delivery services for groceries, meals, and medications and even try at-home service providers, such as a hairdresser. You can also explore other options for transportation, including:

• Family and friends. Ask loved ones about setting aside time to drive you to the places you need to go.
• Eldercare providers. Look into senior health or eldercare services that provide transportation.
• Mass transit. If your city offers it, reacquaint yourself with the public bus or train system, which may be a fast and inexpensive form of transportation.
• Paratransit. Many communities offer paratransit, in which a driver will pick you up at home and take you where you need to go.

Making the transition from being an independent driver to being a passenger can be difficult. However, creating a network of alternative transportation arrangements to get you where you need to be can go a long way toward helping you adjust.

How Can I Help Myself

To accommodate life with Parkinsons you may need either to change the type of car you drive or to make adaptations to your existing vehicle. Investigate all available options and follow up those that are practical and will help overcome any difficulties, bearing in mind that symptoms are likely to progress. Examples include:

• cars that are easier to drive and have been designed to suit people with disabilities
• cars that provide more space so that you can manoeuvre yourself in and out more easily
• power steering
• an automatic gearbox
• other automatic functions, e.g. electric windows and windscreen wipers that are activated when it rains
• swivel seats or sitting on a sheet of plastic to make it easier to get in and out of your car seat
• door handles that are simple to open
• hand controls or aids to make steering, braking or acceleration.

Always take a mobile phone with you when you drive, so you can call for assistance if you get into difficulties or have an accident.

You May Like: Signs Of Parkinson Disease Early Symptoms