![]() In Ontario, meanwhile, doctors rarely use the SIMARD-MD test, says Shawn Marshall, a doctor who is researching driving habits of seniors for the CanDrive research project. The Ministries of Transportation of BC and Alberta recommend that doctors administer the SIMARD-MD test for seniors they suspect may have cognitive issues that prevent them from driving safely. How doctors decide whether a person’s medical condition should be reported to the Ministry of Transportation varies by province and by individual doctor. Depending on the information in the doctor’s report, transportation authorities may suspend the license immediately (if a person has advanced Alzheimer’s, for example), or they might request further medical or road testing. “If a doctor believes that a patient may harm him/herself and/or others by continuing to drive, they are ethically obligated to report,” writes Kelly Eby, director of communications at the College of Physicians and Surgeons of Alberta. But even in those provinces, doctors’ professional bodies recommend reporting. In Alberta, Nova Scotia and Quebec, doctors aren’t legally mandated to report unsafe or potentially unsafe drivers. In most provinces, when doctors think someone shouldn’t drive or are unsure, they are required to send a report on that person’s medical condition to their provincial Ministry of Transportation. How doctors decide when to refer a senior who may be unfit to drive Importantly, however, when it comes to the risk they pose to others, teenagers and drivers in their 20s are much more likely to kill other people on the road than seniors are.Ĭurrently, there’s wide variability in how doctors evaluate a senior person’s driving fitness, and whether they assess it at all. In 2013, drivers 65+ made up almost 20% of driver fatalities caused by collisions, compared to 13% in the 20-24 age group, even though the age groups had the same rate of driver injury. Although senior drivers don’t have more accidents than younger drivers, they are more likely to die in a crash due to increased susceptibility to injury and medical complications, according to the Centers for Disease Control and Prevention. The decision to remove someone’s license can also prevent deaths. When Frank recommended a male patient not drive last week, for example, “his wife was very relieved,” he says. In other cases, however, family members have been pleading with their loved one not to get behind the wheel, to no avail, and appreciate a decision from an objective authority. “They feel they’re a bother to everyone if they ask for rides,” says Carol Libman, a consultant with CARP Canada, a seniors advocacy organization. It can also have negative repercussions for patients. “Some patients don’t go back to a doctor who has recommended they don’t drive,” says Chris Frank, a geriatrician and palliative care doctor in Kingston, Ontario. When doctors recommend a patient not drive, it can seriously damage a doctor-patient relationship. “I feel like I’m going downhill,” he says. He misses being able to go shopping or to the barber on his own, but the psychological blow of losing his license has hit him the hardest. “You can’t win for losing,” says Saltarski.ĭue to the failed tests, Saltarski no longer has a license. And when he took a second test, the examiner failed him for driving too slow. He failed that test because the examiner said he exceeded the speed limit in a school zone (which Saltarski disputes). For one part of the test, he was asked to name some vegetables he would see in a grocery store.īased on the results from that doctor’s office test, Saltarski was referred to the Ministry of Transportation and was required to do a road test. The first doctor he saw in the province administered a test, called SIMARD MD, aimed at detecting cognitive impairments that can interfere with driving. At age 87, he drove across the country to move closer to his son in Chilliwack, British Columbia. A former bus driver, he’d only had one minor accident in his life. Joe Saltarski, an 89-year-old who lost his license earlier this year, thinks the current way doctors test senior drivers is unfair. And as baby boomers age, doctors will increasingly have to weigh the safety of their patient and others, with their patient’s desire for independence and mobility. But the line between fit and unfit to drive is difficult to define, especially for seniors with multiple cognitive, sensory and/or physical issues. Doctors are expected to report people who have a medical condition that prevents them from being able to drive safely.
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