The other discussions on driving were so long (many pages) that I thought I would pass on an article I read today concerning scientists at the University of Iowa and their findings concening when a person with early Alzheimers should stop driving. His team developed an intricate behind the wheel exam. They fitted a Ford Taurus with the ability to record almost every action a driver might take much like a black box on an airplane and video cameras showed oncoming traffic too.
The results were reported in the Journal of Neurology were striking. Averaged out, the Alzheimers drivers committed 42 safety mistakes, compared with 33 for the other drivers.
These researchers also checked if a battery of neuropsychological tests given before the driving test accurately predicted who would drive worse and they reported some did.
I am encouraged that the doctors in this field are beginning to be aware of the need to find something definitive to ascertain the Alzheimer persons ability to drive or inability to drive safely . Perhaps some tests can be devised that can be used as a standard for our transportation and medical people to use in allowing these people to still drive independently.
THis was just a short article in the paper but perhaps we will begin to see more definitive and technical articles relating to driving experiements with Alzheimers patients.
Considering my husband's horrendous history with "the driving issue", I probably should not be commenting on this post. It will just raise my blood pressure. But I can't help myself, so here it is. I read that entire article. In my opinion and experience with this monstrosity of a problem, no test exists, nor will it ever exist, that can "DEFINITIVELY ascertain the Alzheimer person's ability to drive or inability to drive safely." The nature of the disease excludes it. The disease is erratic, unpredictable, and constantly changing.
They give a test just like that here in Florida. It is administered by an occupational therapist trained in the issues involved in driving. First, they give an hour long visual perception test. Since visual memory has always been, and still is, Sid's strength, he passed it. Not with flying colors, but he passed. Next, they took him out in a specially equipped car in the city and on the highway. Beause of his absolute determination to stay focused and pass the test, he held it together and passed. The actual "mechanics" of his driving are fine. (This was over a year AFTER the neuropsychologist who did an extensive battery of cognitive, memory, reasoning, and judgment tests said he should either not drive at all, or limit it to our neighborhood in the day time.) The OT ignored that advice and said that Sid was cleared to drive with no restrictions. I almost had a seizure.
What the OT DID NOT SEE, and could not possibly test while Sid was so determined and focused, was what happened during normal driving - that my husband was forgetting to put on his directionals, forgetting to turn his head when changing lanes, relying only on his mirrors, which didn't account for the "blind spot", that he constantly lost focus on the highway, and kept swerving into other lanes, that he misjudged times because of his slow processing, thinking the light didn't change to green until at least 5 seconds AFTER it turned green, that he, who always had a 110% sense of direction, was getting confused in neighborhoods where he had to make a lot of turns. That he raged, screamed, and denied ALL OF IT. That when he was told to put his seat belt on while driving in our neighborhood to the pool, he refused, saying that we weren't going that far. When admonished that he almost got into 2 accidents because he didn't look to see if there was another car in the lane to which he was switcing, his answer was - It wouldn't have been a bad accident. I could go on and on and on and on, but the bottom line is that the caregiver's instincts are more correct than any test. If you question whether there is a problem, there is a problem. The AD brain cannot be trusted. At any time, without warning, it can go into a "brain coo-coo", and you don't want that happening while they are driving.
These tests are administeread by people who are judging a person's ability to drive. They are not trained to look for cognitive and visual impairment, which are other things altogether. Joan is right, they get passed when they shouldn't. We have all experienced our LO's appearing perfectly normal only to turn into someone else when we get home. It's not a valid test. CG's know when something is wrong, but such tests, and too often, others in authority, counselors, doctors, instructors will not see what we see and say it's OK. Friends & family help LO's drive when we have taken away the keys, It's like anything to make things harder. Joan, dear, go have a chocolate--oh, have two!
In early stage and I first took dh to a Famous Big city clinic for a second opinion my dh was assigned an elderly Neurologist specializing in headaches (which he doesn't have). I asked the neuro about driving and he said he always hesitated about advising patients about driving.
My pcp said he couldn't believe that Doctor was still there. He said the Dr. was one of his instructers in Med School and must be 80.
I have to agree with you Joan. In 2007, my wife drove to Orlando, for a heart catherization. She insisted on driving, and like an idiot, I caved in because she seemed OK. On the way, I kept reminding her that there were cars in the left lane, and she cut in front of them without looking. By the time we arrived near the hospital, I was a wreck and she yelled and screamed the whole way. I could not convince her to let me drive, and her rage got worse each time. Well, when we got in sight of the hospital, the final intersection, she made a left turn straight into an oncoming van..Result, no injuries but $5,000 damages to our car (a 2006 Camry with 4,000 mi.) The car was repaired. Two months later, I was working in our neighborhood, and my wife showed up with a neighbor, saying that she had driven into our house. When I got home, the car was three feet into the garage wall, the car was still running, and still in drive. Total damages to the car $6,000 and house $2500. OK...while the car was being repaired for the second time, the paint booth at the dealershsip caught fire....yep that was my car in there....... At the time, we did not have a alz diagnosis, and her constant rages really indicated something was off, but I blamed menopause, radiation, etc etc. You may say "why did I let her drive?" Well, my wife excells at rage, and when I insist on something, she threatens, screams, yells, and I cannot restrain her.....she does what she wants to do. Now I not really a wimp, but the last time I insisted on something almost landed me in jail. Our laws on domestic abuse favor women (as they should), but when she yells, kicks and screams and punches and neighbors call police, they look at a 106 lb woman vs a 165 lb man, and guess who is guilty??? My wife often threatened to punch herself, and call the police and say that I did it.....so I back off and let her punch me....and let her drive. Lesson learnt. OK, my wife no longer is able to figure out driving, and I still am facing the issue of taking the keys away. But each time I do, the countertops get smashed with a hammer, doors get slammed off hinges, glasses and dishes get broken. Luckily, she does not feel safe driving anymore, and walks to the store. She has only driven once in the past six months, and I can tell that she now feels unable to drive. Additionally, I did get a spare key made that will not start the car. I am trying to substitue it, but she hides the keys, and I think they are with the pajama bottoms......But there is hope. She recognizes the fact that driving is too difficult for her, and she is losing her desire... Just keep in mind that I am the faithful married spouse, who has been evicted and fired as caregiver, and is sitting on the sidelines now watching her moves...I have so little control over anything, and how I yearn for the alz spouse like they have in the videos......... I sure wish they would show the rages, screaming and other behavior......not the sugar coated version of this disease...
Before this gets way off topic of the driving issue, I am starting a new topic about caregiving spouses living apart. If phranque wishes to elaborate, he can do so under that topic. He is definitely not the only one who has gone this route. Please post further answers and questions to the living apart issue under the new topic. Thank you.
Regarding the driving issue, I need some suggestions. I have been able to keep my husband from driving now for about 7 months. I have the keys with me at all times and he thinks I love to drive so he lets me. However, his drivers licence comes up for renewal in November. Any suggestions on how to handle this? If I let it lapse, I'm afraid he will want to drive again. BTW, I think he is in stage 5 now and he scared me to death when he was driving. He would change lanes where there were cars and he has the biggest road rage. He also has no judgement on how fast cars are going.
Diane-- Check with you Secretary of State about getting a State ID in place of his license. Present the idea as: Since I like to drive and you don't need to, instead of renewing your licnse let's get a State ID and then we can get the insurance on the car reduced too. If he really is not in tune with the license issue, maybe you could just chage him over to the ID and not say much about it. In Michigan they look very much alike.
Carosi-- Thanks for the State ID suggestion, we are also in Michigan. My wife's license is up for renewal next year and since she renewed by mail last time I think she will need to go to SOS and take a written test. I know she won't want to do that since she no longer comprehends what she reads, so I'll suggest a state ID. I've been very fortunate (so far) with this situation. We go everywhere together and she always lets me drive. She still calls it "my car" and wants to keep track of the keys which is OK since I'm more inclined to misplace them then she is. She has become more of a side-seat driver, telling me when I'm one mile over the speed limit and reminding me to stop at red lights but I can put up with that. ~danielp
I didn't renew my husband's license, instead a couple months later went to the DMV for a ID card. It looks exactly like a license, & since his license had expired it was free.
When you go, see about a Handicap Parking hanger. They're good in whatever vehicle she/he rides in and cuts the walking and keeping track of them issues down. You'll need a Dr.s statement of need, but well worth it to get one.
I agree with carosi regarding the handicapped plaque. I have one which we use if I can't find a regular parking spot within a reasonable distance of our destination. DW can still walk some, but tends to shuffle. She is particularly unsteady on icy pavements, so this is where the handicapped plaque has been a great help. Her doctor had no problem filling out the appropriate forms.
I like the idea of a state ID so I will follow up. I just recently started thinking about handicap parking but I didn't know if AD was considered an ailment for that. My husband leans over and shuffles his feet - kind of like a parkinson's walk. I can look into that as well. Is it their physician who determines need or the neurologist? I would think that as long as they can walk, they should. It gives them exercise.
You should be able to get the necessary paper work from your PCP. With my wife, I decide where to park depending upon how she is doing. Some days I park well away from where we are going to give her some exercise. Other days I take the handicapped spot if she is having a bad day or difficulty walking. It also depends upon the weather. During snow or icy conditions, or rain, I park in closer. In good weather I park farther away.
I qualified for Handicapped Parking for a long time after they first started it and didn't use it. "Others needed it worse." When I finally learned to drive and got my first car, I got the plates which would let you park in the spots--still didn't use them. Finally started to use them sometimes after we married in 1974. They definitely came in handy during my pregnancy and when our daughter was little. Saturday mornings, while DH napped after working 3rd shift, Daughter and I'd go to the store. Park in a Handicap spot. We'd get out of our truck, I'd put my hand on top of her whole head and she "helped me walk in being like a walking railing". Kept her from taking off on me. We'd get a cart and after hoisting her (one armed while the other held on to the cart) into the seat, we'd shop. After checkout, we'd get to the truck and I'd brace myself as she climbed out of tghe seat and down me like a tree trunk, then she'd hold the cart still while I un loaded out purchases into the truck. Then we'd get in and go. Sure was particularly glad for tholse spots when she was little. Now they matter for both of us because we're both slow, and shakey on our feet.
I have one for me. At this point I'm using it for him more than for me, but I'm so grateful I have it. It expires this year, but I think I still qualify because of my numb leg. Need to talk to the doctor about it on my next visit.
If not, we will get one for him, because my understanding is that he qualifies for one.
I had always assumed that handicap spots were just for handicapped drivers, not passengers. Right now I think we can both use the walking exercise but I'll keep that in mind for when Alz starts to affect DW's mobility. Thanks for the tip. ~danielp
Just remember the person for whom the tag is set up must be present when it's used. Also, has to be properly displayed. Parking in a spot without a tag can get you a ticket. Unless a chronic happening, generally an explanation and a bit of paperwork will get you out of it. Having it ride around the store in your purse, while the car's in the lot, doesn't work very well.