Are you as safe a driver as you think?

Daniel Montgomery, 72, uttered some choice words when he learned that his ability to drive was being questioned by his concerned daughters Kate and Mary.

The self-proclaimed “healthy man” had lost his way home twice and had started making errors while paying his bills. Kate and Mary knew their concern was real when Dan, as he is affectionately known in the community, knocked over Mary’s mailbox while he was visiting for Sunday lunch. “The mailbox could have easily been a child”, Mary said, “who regularly plays in the driveway or someone else in the neighborhood.”

The daughters took it upon themselves to voice their concerns to Dan’s physician of 32 years who immediately ordered a series of tests to try and uncover the cause to this change in behaviour.

MRI’s had shown mild cerebral atrophy while he exhibited other medical conditions including hypertension and sleep apnea. Based on the test results, Dan’s physician knew that Dan was a medically-at-risk driver, however he was reluctant to tell him to stop driving at the risk of damaging their long-standing relationship and in the absence of actual evidence that spoke to real-world driving ability.

In an effort to avoid being the ‘bad guy” Dan’s physician sent him for a DriveABLE assessment, an evidenced-based cognitive evaluation that provides a predictive score of how a patient performs when driving in the real world. Dan, unfortunately, scored as High Risk but his physician could use the report as objective evidence when advising him to retire from driving. Dan listened to the retirement advice and to his daughters’ relief, has embraced the life of alternative public transport and the help of family. When Dan knew he was posing a risk to other road users and the community, the decision was simple. He “never wanted anyone to get hurt” and while “hanging up the keys was difficult” he knew that “the safety and wellness of the community was more important”.

What is DriveABLEThe DriveABLE Cognitive Assessment Tool or DCAT, as it is more commonly referred to, was established through an 8-year research project and has been used across North America for 18 years. It is a standardized evaluation that has 6 computer-based tasks looking at the cognitive skills critical for safe driving and gives a calculated score that provides insight into real-world driving risk.

The computer-based test takes approximately 45 minutes to administer and involves the activities of touching a screen or button. The tasks are easy to perform but measure complex skills and no prior computer experience is needed. The evaluation is designed to give each candidate the best opportunity to demonstrate their abilities. It is administered with a trained evaluator and it offers the candidate the chance to practice each task before being scored. The scoring is normed to ensure that the candidate is compared to a healthy normal individual of the same age and sex. Why use DriveABLEDan’s story is not unique and while cognitive impairment can affect anyone and their ability to drive, Baby Boomers are at the highest risk. Of the 87 million drivers in North America, 40% are Baby Boomers and according to the Alzheimer’s Association 1-in-9 people at age 65 are at risk of cognitive impairment and this risk increases with age. There is a clear wave of about 10 million Baby Boomers that will need to consider the question of driving retirement in the next 10 years and DriveABLE has the science-backed technology to help provide a fair and accurate answer.

There is often a misconception that only conditions like Alzheimer’s and dementia render a driver medically-at-risk. Driving is a complex activity that requires cognitive abilities like alertness, attention, concentration, coordination, memory, multi-tasking ability, perceptual abilities, reaction time, thought processing, judgment and insight. 

There are many medical conditions that can compromise one or more of these abilities which could put a person, as well as the community, at risk when they drive. The DCAT assesses these abilities in a proactive manner to ensure the risk is identified before an incident happens. It also protects people from being unfairly discriminated against because of others’ perceptions of their condition and the potential risk they believe it has on the individual’s driving.

Medical conditions that may affect driving:

• Alzheimer's disease 

• neurological disease 

• kidney disease 

• pulmonary disease 

• heart disease 

• neurological disease 

• head injury 

• stroke 

• diabetes 

• psychiatric illness 

• medications 

• traumatic brain injury 

Signs of declining competence to drive:

• missing traffic signs 

• unaware of driving errors 

• close calls 

• driving too slowly 

• unaware of other vehicles 

• problems with other day-to-day activities 

• getting lost and confused 

• confusing the brake and gas pedals

Where to get information on DriveABLEFor more information about the DriveABLE assessment in your area contact Harbor Speech Pathology @ 253-851-00075202 Olympic Drive NW Suite 100 ,Gig Harbor Washington 98335 Article Submitted by Mary Coupland