The ALS Association

ALS Ice Bucket Challenge Progress

Driving Safety Evaluation

By Cynthia Knoche

That first Driver’s License.  Obtained after months of study and behind-the-wheel tests performing skills necessary to drive safely, provided long sought after independence.  Fast forward many years and we often take for granted the multiple skills required to initially obtain that license. Rare thought is given to re-assessing those skills required to drive safely.

Safe Driving

Advancing age, illness, and medications can impair one’s ability to drive.  For those diagnosed with ALS, loss of motor function resulting in weakness and decreased reaction times eventually take its toll.  Even minor cognitive changes, such as having to “think twice” about a process or taking extra time to evaluate a familiar situation can lead to decreased ability to drive safely.

Progressive loss of muscle control can occur so slowly the person doesn’t recognize the change.  Comments from family members or other drivers’ may be the first indication that a person’s driving performance is deteriorating.  Broaching the subject of safe driving can be challenging for family members; the loss of independence afforded by driving is one of the most significant events a person can face.  Here are some tips for approaching this sensitive subject with a loved one:

  • Initiate a conversation outside of the car or actual driving situation
  • In a respectful manner, voice your concern about your loved one’s driving skills
  • Discuss specific symptoms that may impair driving; such as near misses, slow response time, sleepiness or weakness.
  • Expect loved ones to avoid a conversation or discount symptoms

Those facing progressive loss of motor function or cognitive challenges can take proactive action by regularly asking their physician or occupational therapist to evaluate the potential impact of symptoms on their driving skills.  An occupational therapists can provide basic screening for driving safety, which include assessing abilities related to cognition, strength, stamina and flexibility. In addition, physicians may refer patients to a Driving Rehabilitation Specialists in their own community.

Francesa Monchino, O.T.R./L., M.ED, M.O.T., regularly provides driver screening evaluations, through clinics such as the Duke University ALS Certified Treatment Center of Excellence. Comprehensive evaluations can also include detailed measurement of braking time, neck movement, endurance and cognitive abilities.  Screenings or evaluations can result in recommended changes to allow continued safe driving, referrals for community mobility access, or recommendations to discontinue driving in the face of overt safety challenges.

A neutral authority figure outside of the family, such as a physician can initiate the discussion related to increased risk associated with driving and highlight the value of a transition plan for safe community mobility.  Occupational therapist Melissa Werz, O.T.R./L., O.T.D., shares that many driving evaluations result in a proactive plan to access safe alternate transportation methods.  A plan may include hand controls, a steering wheel knob or using alternate sources for transportation such as family and friends or community transportation.  Many communities provide alternate transportation services through an office of disability, special needs, or Agency on Aging.

While technology continues to provide equipment to maintain quality of life in many arenas, it is clear that addressing the challenging issue of driving safely will require team effort.  Additional information related to driving evaluations and alternate transportation options can be found from these resources:

National Aging & Disability Transportation Center

National Association of Agencies on Aging

Association for Driver Rehabilitation Specialists
Find a Certified Driving Rehabilitation Specialist

ALS Association Nationwide Chapter Locator

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