Parkinson's &
Driving Decisions

[ Dangling Car Keys ]
When is it time to hang up the keys? You decide...
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Topic 36: parkinson's & driving links
This site contains education and research URL's bookmarked by a Parkinson's patient. Nothing you read in these pages should be considered an endorsement or medical advice.

"Dec. 9, 2002 -- A growing body of scientific research is confirming what common sense implies -- Parkinson's patients can be dangerous behind the wheel. Yet aside from a doctor's suggestion, there is nothing to prevent most licensed patients with this degenerative disease to drive."

Parkinson's Disease Affects Driving -- People with even mild Parkinson's disease can have greatly diminished driving skills, a decline which may not be apparent to their physicians or to the individuals themselves, say Finnish researchers.

Unsafe Behind The Wheel? Driving Safety In Patients With Parkinson's Disease
SAN DIEGO--The ability of patients with Parkinson's disease to drive may be overestimated by both the patients and their neurologist, according to Theresa A. Zesiewicz, MD.

Parkinson's Patients at High Risk for Car Accidents By Richard Robinson Special to DG News SAN DIEGO, CA -- May 8, 2000 -- Parkinson's disease is a significant risk factor for automobile accidents, according to a new study.

When Are Parkinson's Patients a Risk on the Road?

Learning to Live With Parkinson's Disease - Many people believe a Parkinson’s diagnosis means they will have to give up driving, traveling and working. This isn’t necessarily true. Each case of Parkinson’s is different and the disease follows a unique course in every individual. Some Parkinson’s patients do eventually end up relying on others to feed and bathe them, but many others don’t.

Stay Active

Although driving isn’t safe in the advanced stages of Parkinson’s, patients with milder symptoms who can control their impaired motor abilities can continue driving. As for work, Weiner and Shulman say that if a person enjoys what they do and are still able to perform their job, there is no reason they shouldn’t continue working.

Parkinson's Disease
Quality of Life Issues
Barbara Fitzsimmons, RN, MS
Lisette K. Bunting, RN, MScN
Driving Performance... When a patient is seen for the management of PD, no discussion would be complete without addressing driving. Motor manifestations of the disease as well as a decline in cognition may impair the pafient's ability to function safely behind the wheel. Some patients may willingly retire their driver's license, whereas others may view this as giving up valued independence. Evaluation of driving skills by a professional driving instructor may provide a nonthreatening avenue to assess auto safety. Family members should be involved in the evaluation of driving to arrange alternate transportation if the patient's driving is found to be unsafe.

One of the most difficult decisions a Parkinsonian has to make is when to give up driving an automobile.

To Drive or Not to Drive... What should you do when driving becomes a problem?

Driving - Privilege or Right? When is it time to take the keys away... Is it time to take the keys away?

AARP 55 ALIVE is the nation's first and largest classroom driver improvement course specially designed for motorists age 50 and older

Safe Driving For Seniors by Germaine Odenheimer, MD - Most of us have had at least one close call with another car, pedestrian or object while driving, and many of us have had car accidents.  So how do we know when these incidents signal that it is time to worry about one's ability to drive safely?

DOT HS 808 853 April 1999 SAFE MOBILITY FOR OLDER PEOPLE Notebook - A Research Product of the National Highway Traffic Safety Administration Model Driver Screening and Evaluation Program

U.S. Driver Licensing Renewal Procedures For Older Drivers as of May 2002

Licensing Older Drivers--Part I

Licensing Older Drivers--Part II

Licensing Older Drivers--Part III

Driving Fact Sheet 27 - Driving in the elderly - Driving and Parkinsons - Driving less or not at all

"But Driving is My Life-line"

DRIVING - the difference to the quality of my life has been fantastic

OKLAHOMA REGULATIONS: SUBCHAPTER 5. MEDICAL ASPECTS 595:10-5-1. Purpose To operate a motor vehicle, a driver must possess certain physical and mental abilities. The first and primary purpose and intent of the Department of Public Safety is to license new applicants and to renew driver licenses of persons with these abilities but, when necessary, to restrict, deny, cancel, or disqualify the driving privilege of those applicants or licensees who present an unwarranted risk or do not meet the minimum standards.

UK - Minutes of Driver & Vehicle Licensing Agency
Item 4: Advice for driving after transplant surgery
Item 5: Neurosurgery for epilepsy, Parkinson’s and Post-VP shunt insertion

Background Papers on Restricting Driving Privileges...

FELLASLEEP at the wheel... YIKES!!!

To Drive Or Not To Drive That Is The Question

To Drive or Not to Drive

Check out this MGH discussion of driving in the PD Forum

Parkinson's Disease and Driving

Driving safety in Parkinson’s disease

Emerging views of dopamine in modulating sleep/wake states in Parkinson Disease

Study: It is frequently stated that 90% of the sensory information required for driving is "visual." The fact that virtually all countries, including most states in the United States, require some form of vision test as a prerequisite for driver licensure is certainly consistent with this viewpoint.

Visual Disturbances in Parkinson's Disease

Vision and Automobile Driving - Fitness in Parkinson's Disease

Do Visual Attention and Imagery Deficits Affect Driving in Parkinsonism?

Should You Be Out At Night As A Driver

Fears grow over elderly drivers on the road

Should Parkinson's Patients Drive? - Latest Study Adds to Research That Disease Impairs Ability

Study: Parkinson's Disease Can Impair Driving

"Sleep Attacks: Sudden Episodes of Falling Asleep Without Warning, Without Being Drowsy, Or Falling Asleep Without Remembering You Were Drowsy?"

Evaluation of Sleep and Driving Performance in Six Patients with Parkinson's Disease Reporting Sudden Onset of Sleep Under Dopaminergic Medication: A Pilot Study

Daytime Sleepiness, Agonist Therapy, and Driving in Parkinson Disease

Excessive Daytime Sleepiness and Sudden- Onset Sleep in Parkinson Disease - A Survey by the Canadian Movement Disorders Group

Study: Parkinson's Drugs Don't Cause Drowsiness - Patients Often Suffer From Daytime Sleepiness

Daytime Sleepiness and Falling Asleep At The Wheel Are Not Associated With Any Specific Medication Or Class Of Drugs To Treat Parkinson Disease

Parkinson's Drugs Not to Blame

Sleep attacks and driving don't mix

Misperceptions about Unforewarned “Sleep Attacks” When Driving

Sleep attacks do exist as an effect of dopamine agents

Sleep attacks in patients taking dopamine agonists: review

Anti-Parkinson Drug, Requip (Ropinirole), Can Cause Patients To Fall Asleep Without Warning

Antiparkinsonian drugs and "sleep attacks"

Excessive Daytime Sleepiness and 'Sleep Attacks' in Parkinson Disease - Implications for Driver Licensing (Dr. D. Hobson/Dr. N. Swirsky)

Unsafe Behind The Wheel? Driving Safety In Patients With Parkinson's Disease

DriveABLE - Medical Conditions and Driving

"AMA hopes to increase physician awareness of this public health issue and encourage physicians to add driver assessment to their geriatric medical services.”

Medically Fit - Both temporary and chronic ailments can make driving risky. Emergency physician David Smith outlines the medical community's role in evaluating who should - and shouldn't - drive.

Driving and the Physician: A (More) Modest Proposal - Assessing a patient's ability to drive is a contentious problem for physicians. We have no training to assess driving ability and the evaluation frequently puts the doctor in an adversarial role. The extremely interesting and educational articles in this issue make clear both how much is known about driving safety in medically affected and older populations and how much more there is to learn. I think it is perhaps a shock to the physician-parent to learn that the only population at greater risk of motor vehicle accidents than the demented elderly is the male teenager.

The American Academy of Neurology says it is time to crack down on drivers with Alzheimer's disease and is issuing new practice guidelines that tell neurologists how to negotiate the emotional issue of taking away a patient's car keys

An update on dementia and driving Although concerns over the possible impact of decline in functional ability in patients with dementia on driving were raised in 1967 [1], the first authorative paper on the subject came from Friedland in 1988 [2]. This paper, followed rapidly by several similar reports, emphasized the potential hazard posed by drivers with dementia to themselves and others. What have we learned over the intervening decade?

Driving With Dementia — What Is The Physician’s Role?

Counseling the driver with dementia

US: Evaluation of fitness to drive - The physician's role in assessing elderly or demented patients

CANADA: Determining Medical Fitness to Drive: A Guide for Physicians

CANADA: Assessing Medical Fitness to Drive: Personal Strategies (pdf document - you must have Adobe Acrobat Reader to view)

CANADA: Using "Age" as a Fitness-to-Drive Criterion for Older Adults

CANADA: Saskatchewan physicians' attitudes and knowledge regarding assessment of medical fitness to drive

CANADA: Ontario Medical Association - OMA Health Policy Report - Limited Licensure to Drive

UK: If you have a medical condition which has become worse since your licence was issued or you develop a new medical condition , you must write and inform the Drivers Medical Unit of the nature of your condition, as it may affect your fitness to drive. What does DVLA want to know about? You must tell us if you had any of these: (Parkinson's disease)

UK: Fitness to Drive and Medical Conditions

UK: At a glance - A guide for Medical Practitioners - Medical aspects of fitness to drive - Links to the on-line DVLA guidelines on fitness to drive following neurological, cardiovascular or visual disorders

UK: At a glance - A guide for Medical Practitioners - Neurological Disorders

UK: "At A Glance" Booklet - A guide for Medical Practitioners (pdf document - you must have Adobe Acrobat Reader to view)

EUROPE: The AGILE Project: AGed people Integration, mobility, safety and quality of Life Enhancement through driving

SWEDEN: Report calls for doctors to have more say on driving fitness

AUSTRALIA: “Assessing Fitness to Drive – Guidelines and Standards for Health Professional in Australia” Second Edition - "The guidelines will not change the way in which people get or renew their licence. However, they will make it easier for health professionals to advise patients about their driving and routine use of the guidelines will ensure that fitness to drive is assessed in a consistent manner."

AUSTRALIA: Medical Practitioners Compliance with the Motor Vehicle Act, 1959 A Legal Obligation to Report

NEW ZEALAND: Medical Aspects Of Fitness To Drive Guidelines are for medical practitioners, optometrists and occupational therapists so that they can make informed judgements about whether their patients are fit to drive. The new edition includes suggestions and amendments from a range of health professionals, and covers the most common conditions affecting a person’s ability to drive. This includes neurological, cardiovascular, locomotor and many other conditions. (pdf document - you must have Adobe Acrobat Reader to view)

Ask the PDF Expert - Category: Driving

Parkinson's Affects Driving Ability Study finds people with it do worse in simulated tests

Neuroeducation Free Information Sheets - Parkinson's Disease - Driving

To Drive or Not to Drive? That is the Question

QUT Balance and Driving Studies

The Driving Dilemma

Some Tips on Traveling with Parkinson's

To Drive or Not to Drive... What should you do when driving becomes a problem?

Elderly Drivers

Patient Education Forum - Safe Driving For Seniors

Seniors: Behind the Wheel

Seniors: Behind the Wheel - Interview Transcripts

Robert Dakin - Senior driver with Parkinson's disease

The impact of aging on our bodies affects virtually everyone's ability to drive, whether or not we want to admit it. The key is to understand the limitations and adjust

Alternatives for the older driver

When it's time to get off the road

An Epidemic of Black-Outs - Janet Reno

Reno ends truck tour with 3,071 fresh miles on her pickup

When loss of meaningful activities occurs in those with memory disorders

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