Drivers with dementia on the rise

In many ways, people's driver's licences are part of their identity.

“That's us,” Birgit Pianosi, chair of the gerentology program at Huntington University, said. “That's our ID. In Canada, a driver's licence is who you are. If you don't have a driver's licence, you don't have anything.”

When older adults are forced to give up their driver's licences because they're no longer able to handle driving due to a cognitive issue as dementia, or because of a physical disability, it can be very difficult for them, she said.

Pianosi is involved with a North East Dementia Coalition Network research project aimed at finding ways to raise awareness of the issue of drivers with dementia. The project was funded by the Ontario Trillium Foundation.

The dementia coalition, aimed at sharing best practices about the condition, is made up of representatives from a number of organizations in the region which have an interest in dementia.

Just because somebody has dementia, it doesn't necessarily mean they need to give up their driver's licence, Pianosi said.

Those who are newly diagnosed with dementia might still have the cognitive ability to drive, as they're still “quite functional,” she said.

“It depends on diagnosis,” Heather Hawrelluk, psychogeriatric resource consultant with the North Bay Regional Health Centre, who is also involved in the project, said.

“If their ability to track a route has been impaired for whatever reason, or their reaction time is very slow, or if their depth perception has been affected, that will obviously impact driving safety.”

There does comes a time when it's appropriate for them to give up driving, Kelley Fish, who was hired to co-ordinate the study for the dementia coalition, said.
She advises older drivers' family members to watch out for dings and scratches on cars, near-miss accidents and avoiding driving on their own, after dark or during rush hour.

“We're working on putting together a pamphlet for older adults on how they can assess their driving, so that their awareness is raised that it might not be safe to drive, or they might need to restrict their driving.”

The number of drivers with dementia in Ontario will expand from about 45,000 today to nearly 100,000 in 2028, according to a Queen’s University study.

Ontario transportation minister Bob Chiarelli told the Toronto Star in February that as the population ages, and there's more drivers with dementia on the roads, the province plans to tighten the rules for these drivers.

This might include more rigorous on-road testing for elderly drivers, and the introduction of graduated licensing for some older adults, who, like novice drivers, would not be allowed to drive on 400-series highways, for example.

Such rules are already in place in many other jurisdictions.

Pianosi said she thinks this is a good idea. Many seniors already restrict their own driving, she said, by avoiding more difficult driving situations.

Family doctors, who are supposed to report those who no longer have the physical or mental capacity to drive, need more training on how they should go about this task, Chiarelli said. He said the province plans to introduce such training.

Pianosi conducted a previous study in 2004 which showed that family doctors don't seem to be assessing their patients' ability to drive.

Part of the problem is that physicians aren't taught to make these kinds of judgments in medical school, she said.

They also don't feel comfortable reporting their patients to the Ministry of Transportation because they feel it's a breech of physician-patient confidentiality, Pianosi said.

Many people in northeastern Ontario also don't have a family doctor in the first place, which makes the process much more difficult, she said.

“When you go to walk-in clinics, those people won't be assessed for their dirivng ability,” Pianosi said. “That's just not on the radar.”

The researchers said they plan to conduct education sessions with family doctors to raise their awareness of the issue.

The researchers also plan to educate police, as many times, police officers are the first point of contact with older adults who should no longer be driving.
The researchers will also be giving a presentation at an older adults' symposium being put on by Sudbury Rainbow Crime Stoppers next month.

Even if they do end up having to give up their driver's licences, there are still ways to get around, Pianosi said.

For example, they might be able to take taxis or public transit or receive rides with charitable groups that offer transportation for older adults.

Pianosi said she's also read about a project where younger family members who don't have a car are paired with older family members who still have a car, but are unable to drive themselves.

“The grandchild would get the car from the grandmother, and drive her around, but also has access to the vehicle when they need it.”

Pianosi said she's happy to be involved in the project, because it's very “hands-on.”

“We're going to create something that's useful to the community, not something that's going to be put on a shelf somewhere,” she said. “It's going to benefit everybody. "I think that's the nice thing.”

Posted by Arron Pickard