“Drive carefully! Remember, it’s not only a car that can be recalled by it’s maker.”
“Why is it that you always say go faster when we are driving but slow down when we are walking?” ponders my husband, frequently, out loud…..
Although, I did not get my drivers license until my mid-twenties and in fact purchased my first car without one ……
Once, I hit the roads of Houston…I never looked back…nothing like the freedom of driving in an open road pushing the speed …. and even now with my illness my greatest joy is driving; makes me feel normal! I can control how fast I can go unlike my walking…which seems to have a mind of its own!
In this country, driving is not only a rite of passage into adulthood but also a sign of independence and freedom….
So, its no wonder we react so violently and negatively to anyone threatening to take this right and privilege away….we feel as if our own independence and livelihood are being challenged.
As, a young healthy physician, who could do whatever and when ever, I did not quite grasp the impact of asking my patients to give up their licenses voluntarily or even worst forced to surrender….
My naïveté cost me a few patients in the beginning…even though they were completely unsafe to drive and it was my duty and professional responsibility to look out for their well being….
I soon realized that it was best to put responsibility back on their hands by challenging them to prove to themselves and the state of Texas they were competent and save drivers…. they could take a course with occupational therapist or retake their driving test administered by the DPS -Department of Public Safety….this way the family felt better if DPS said ok or not ok and so did patients….
Further, we spoke of “retiring” from driving as you would from a job, etc. This, I believe made it easier psychologically in as far it became another “milestone” in life for an individual to pass through.
Certainly, the consequences of giving up the freedom of being behind the wheel cannot be totally dismissed from both a psychological and practical view.
This is true at any age …. whether you have been driving for 10 or 50 years….
I recall when I was first diagnosed with my PD and battling cancer…
I was unable to drive for nearly a year due to medicines side effects and weakness….it was like being a prisoner although my friends were excellent at taking me places. But loosing my independence made me feel like a real invalid having to depend on others for basic things picking up my daughter from school and going to the store for house hold supplies even going to the doctor…the fear and panic intensified as my driver’s license renewal approached and I was still very weak. Fortunately, I was able to keep going because I and my doctor’s knew this was a temporary condition…
However, the decision to give up or maintain a license is not always clear cut…there are a number of factors to consider…
The Parkinson’s Disease Foundation (PDF) put it best in an excellent article they published on the subject, a year or so ago, about the 4C’s to consider and discuss with your physician regarding driving safety.
These are as follow:
Concern about safety- if you or your family is worried about your driving skills.
Condition– are you end stage, unable to turn head and neck, unable to quickly apply breaks, or falling asleep at lights or extremely tired and fatigued and sleepy through out the day.
Crashes-if you had a fender bender or accident caused by you or caused other people to have accident or multiple fender benders and near crashes.
Co-morbidities– if you have severe dementia or cognitive impairments, or other medical problems making driving unsafe like weakness, or sleep disorders.
Then it is time to talk with your physician if he or she have not already done so. (for more information on the subject, visit PDF website under driving recommendations and 4C’S-www.pdf.org).
The majority of PD patients can operate a vehicle safely until it is inevitable with the passing of time and advancing of disease that many patients reach an impasse in which driving is no longer safe….
However, you must know that not only are you liable for any injuries to others on the road if you are not safe but so is your physician if he/she fails to inform you or advise you on the risk of impaired driving performance.
Furthermore, some states like Pennsylvania are implementing mandatory reporting of impaired ability to operate a car or motorized vehicle. Your permission will be asked but keep in mind that if you refuse and doctor feels you are a threat , the physicians responsibility to protect you and others supersedes any HIPAA rules and supports breach of patient confidentiality.
Stay inform and know your rights…
The American Medical Association (AMA) offers a state -by -state summary in a section of its website (www.ama-assn.org) which is also devoted to counseling patients about driving. They also provide a patient self screening tool which may be helpful for Parkinson’s patients to recognize their deficiencies and increase the willingness of the person with PD to formally consider driving assessments. Further, it also provides individuals a test battery called the Assessment of Driving Related Skills which can help the doctor obtain some objective information but in the end the best measure of safety driving is what I recommended my patients – a formal assessment of driving skills with a simulator or in a controlled testing scenario.
Finally, they have a downloadable handout called “Getting by Without Driving.”
The National Parkinson Foundation maintains a similar list.
Together, patients, family, care givers and health professionals MUST work in unison to find solutions for those that have depended on a car for activities of daily living like grocery shopping, going to the post office, going to work etc.
It will certainly entail a substantial adjustment on everyone’s part especially for the patient which might include new living arrangements.
However, given the consequences of driving impaired although extremely difficult and heart wrenching for some, relinquishing your license is NOT an OPTION if PERFORMANCE is IMPAIRED!
Dr. M. De Leon is a movement disorder specialist on sabbatical, PPAC member and research advocate for PDF (Parkinson’s Disease Foundation); Texas State Assistant Director for PAN (Parkinson’s Action Network). You can learn more about her work at www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at www.pdf.org or at www.wemove.org; www.aan.org, www.defeatparkinsons.blogspot.com
may also contact me at