A study in the July
2004 Canadian Journal of Psychiatry, led by Dr.
Robert Hopkins, estimates there are 34,000 Ontario drivers
who have dementia. With an aging driver population, it
projects that number will rise to nearly 100,000 by 2028.
The researchers say
that drivers in the earliest stage of dementia may not be
dangerous, but as their condition progresses they pose more
and more risk to themselves and other drivers. Drivers with
dementia are two to five times more likely to be involved in
a collision than drivers who do not have the condition.
Collisions at intersections are very common.
Over the years,
road fatalities have dropped significantly in all age groups
except 65 and over. Based on distance driven, older drivers
have more collisions than any other age group.
According to the
Canada Safety Council, dementia is one of several factors
that can affect the abilities of older drivers. When it
comes to collisions, data is lacking on how dementia stacks
up against such factors as: deterioration of eyesight,
particularly at night; movement-limiting disabilities such
as arthritis and rheumatism; and medications, which can
affect driving ability in various ways.
“Seniors who
recognize age-related changes and learn how to compensate
for them can continue to drive safely for a long time,” says
Canada Safety Council president Emile Therien.
“Unfortunately, the onset of dementia is much harder to
recognize than most other changes.”
Therien notes older
drivers tend to be safety conscious. Many choose to drive
shorter distances and avoid night driving, busy highways and
downtown areas. However, dementia affects memory,
concentration and judgement, and these are the very
abilities that enable people to deal with their own
limitations.
He agrees with Dr.
Hopkins’s study that screening procedures are needed to
identify senior drivers who may have dementia, and points
out that such procedures are already being developed.
University of Ottawa researchers, including leading
geriatricians from the Faculty of Medicine announced in
November 2003 a national multi-centre five-year study called
CanDRIVE in which 3,000 to 5,000 drivers over the age of 70
are expected to participate.
Canadian physicians
are legally responsible in seven provinces for reporting
medically unfit drivers to their respective ministries of
transportation. The goal of the University of Ottawa study
will be to develop a method to help physicians identify
seniors whose medical and functional limitations may make
them unfit to drive. Dr. Hopkins’s research team suggested
that such procedures should be added to the Ministry of
Transportation’s vision and road-sign tests.
So the issue is
being addressed — but in the meantime, what should family
members do when an aging parent suffers from dementia? If
they shouldn’t drive, how can Mom and Dad get around?
Family members must
take up the challenge of finding — or providing — the
necessary transportation. In the city, taxis and public
transit are cost effective (and less expensive overall than
keeping a car). Most suburban areas have these services,
although access may be less convenient. Rural areas offer
few if any transportation options; rides from friends and
family are often the only alternative to driving.
Regardless of age,
a driver’s licence means independence. In the interest of
safety, a ministry of transportation may decide to remove a
person’s licence due to a disability such as dementia. With
the possibility this will happen more often, society must be
willing to provide services to enable that individual to
maintain a degree of independence.
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