Help for families, caregivers, health care providers

Reporting an unsafe driver

The Iowa DOT's Office of Driver Services' booklet, Driving with Diminished Skills, includes information on how to report an unsafe driver. In Iowa, any individual may ask the Iowa DOT to re-examine the ability of another person to drive safely. Family members often find this difficult, if not impossible, and seek out the help of a physician or peace officer. A re-examination involves both written and road testing, and may also include a requirement for medical information. To learn more about the process, click here or visit the Office of Driver Services' Web site at http://www.iowadot.gov/pdf_files/diminished_driving.pdf.

Resources for medical practitioners

Medical practitioners and health care professionals can also help drivers evaluate their driving skills. Resources to help medical practitioners assess the driving skills of older individuals include the following.

• AMA Physician's Guide to Assessing and Counseling Older Drivers provides information to assist medical practitioners in counseling older drivers. To view, click here or visit NHTSA’s Web site at http://www.nhtsa.dot.gov.
• The AMA Web site provides information on older driver safety. To view these resources, click here or visit the AMA's Web site at http://www.ama-assn.org.
• Driver Licensing Policies and Practices is a Web site produced by the AAA Foundation for Traffic Safety that includes information on state driver licensing policies and practices affecting older and medically-at-risk drivers. The site includes a policies and practices database and a noteworthy initiatives database. To view, click here or visit the Web site at http://lpp.seniordrivers.org/lpp/.
• State Licensing Requirements and Reporting Laws contains licensing agency contact information, license requirements and renewal criteria; reporting procedures; and Medical Advisory Board information listed by state. These materials are provided to physicians as a reference to aid them in discharging their legal responsibilities. To view, click here or visit the AMA's Web site at http://www.ama-assn.org.
• DrivingHealth.com, which is sponsored by TransAnalytics Health & Safety Services provides information on medical fitness to drive, medications that might impair driving, screening and assessment, training and remediation. To view, click here or visit  http://www.drivinghealth.com/about.htm.
• Driver Safety in Older Adults: The Physician’s Role in Assessing Driving Skills of Older Patients is an article written by Germaine L. Odenheimer, M.D. in Volume 61, Number 10 of Geriatrics. The article provides useful information about the vital role physicians play in keeping older road users safe. To view the article, click here or visit http://geriatrics.modernmedicine.com.

Resources for families and caregivers

Families, partners and friends play a large role in older road user safety. Research indicates that discussions between older drivers and families and friends can be effective in helping the older driver with the issues of aging and safe driving. In a survey conducted by The Hartford/MIT AgeLab of 7,200 adults aged 50 and older, more than half followed the suggestions made in conversations about driving. Even when family members, friends and providers are willing to tackle these difficult conversations, research shows they want more information with which to begin the discussion.

Families can be better prepared for the discussion by having:

• A list of signs and "symptoms" indicating driving problems (see warning signs).
• Tips on observing the older driver’s driving abilities.
• Assistance in understanding the meaning of driving from the loved one’s perspective.
• Suggestions on how to begin the driving discussion. 
• Ideas on how best to talk about appropriate driving choices and ways to travel around the community.
• A list of community resources for driving evaluation and remediation.
• Strategies for driving reduction or retirement.
• Checking out local transportation alternatives, which can be accessed under the Find a Ride Web page.

Tips on observing driver behavior

As a family member or caregiver, you may know there is a problem if:

• The older road user is often forgetful or confused.
• Uses bad judgment when driving.
• Fails to follow the rules of the road.
• There is inability to see where they are going.
• Aggressive driving.
• Driving well below the speed limit.
• There is a rash of crashes or new dents or dings on the car.
• Family members may notice crashes.
• Neighbors, friends, police or others indicate there is a problem.

The Iowa DOT''s Office of Driver Services' booklet Driving Retirement includes a helpful transportation plan that will help the older person identify their transportation needs. To access the booklet, click here or visit the Office of Driver Services' Web site at http://www.iowadot.gov/mvd/ods.

Some reasons conversations are not brought up:

• Apprehension about the older person’s response.
• Fear of seeming disrespectful.
• The family may not want to deal with their role in meeting transportation needs.
• The decision to stop driving may isolate the older person if they are the only person in the household.
• The older driver may not want to burden others for rides.
• The discussion is postponed until a crisis has occurred - a poor time for developing a transportation plan.

Resources to assist family members or caregivers include:

• The Iowa Association of Area Agencies on Aging offer a wide range of services designed to address the needs of seniors and caregivers. To access a list of these agencies click here or visit http://www.iowafamilycaregiver.org/search.php.
• LifeLong Links is an Iowa resource to assist residents and their loved ones with making decisions about their future. To find more information, click here or visit  http://www.lifelonglinks.org/family.htm.
• AMA’s How to Help the Older Driver provides tips on determining if your loved one is an unsafe driver and what to do if you are concerned about their driving. To review this information, click here or visit AMA's Web site at http://www.ama-assn.org.
• The American Occupational Therapy Association (AOTA) has valuable information for caregivers and families. To learn more click here or visit AOTA's Web site at  http://www1.aota.org/olderdriver/consumers.html.
• AOTA’s Keeping the Older Driver Safe provides information on how an occupational therapist can help keep an older driver safe. To learn more click here or visit AOTA's Web site at http://www.aota.org/olderdriver.
• NHTSA’s How to Understand & Influence Older Drivers provides information on helping older drivers make informed decisions about their driving behavior and provides suggestions on how to begin a conversation with an older driver. To view a copy of this report, click here to visit NHTSA's Web site  at http://www.nhtsa.dot.gov.
• The National Center for Senior Transportation (NCST) has produced five new tip sheets for caregivers offering suggestions on how to promote safe and positive experiences when transporting older adults. Subjects include: communication, transportation sensitivity, providing physical assistance, providing assistance to agitated passengers, and resources for caregivers. To learn more click here or visit  NCST's Web site at http://seniortransportation.easterseals.com.

Respite care

Caring for the elderly, especially those with diminished skills or abilities, can be a taxing process for any caregiver. Respite care is short-term care that helps a family or caregiver take a break from the daily routine and stress. The following resources can be used to find respite care providers:

• The Iowa Association of Area Agencies on Aging provides a searchable database of services and can help locate respite services in your area. To find these services, click here or visit http://www.iowafamilycaregiver.org/search.php.
• The National Family Caregivers Association provides information and resources for family members and other providers of respite care services. To learn more, click here or visit http://www.nfcacares.org.

Emergency contact information for drivers

The Next of Kin Registry (NOKR) is a FREE tool that stores emergency contacts, next of kin and vital medical information critical to emergency response agencies during a medical emergency or national disaster. The information is secure and can only be accessed by local, state and sometimes federal Agencies which are attempting to locate a next of kin or emergency contact point. Once you register, you receive a decal to place on your identification. For further information on NOKR, click here or visit their Web site at  http://www.nokr.org/.