Doctors can help determine whether someone should drive

By Prue Salasky | 247-4784
February 28, 2009
Reprinted with permission by the Daily Press

Almost without exception, the keys to the car are the keys to independent living here in Hampton Roads. So what can you do if you think that a friend or family member is no longer capable of driving safely?

There are several different routes, which all lead eventually through the physician’s office. Driver rehabilitation specialists make recommendations to physicians and the Department of Motor Vehicles, but they do not restore or take away licenses on their own.

• Based on a medical check-up, a physician can write a prescription for a driving evaluation by a certified specialist. When there’s any question of impairment, a physician must give medical clearance to drive.

• You can call a certified driver rehab specialist directly to ask for an evaluation, but they will then solicit authorization from a doctor, who must do the follow-up.

• You can alert the DMV to your concern, which will then send a letter to the driver requesting medical clearance from a physician and the recommendation of a driver rehab specialist. Such alerts to the DMV are kept anonymous if they’re from medical personnel (doctors, nurses, etc.) or family members; anyone else must give their name.

Should you be tested in a simulator or have a behind-the-wheel test?

For the simulator:

• For Matthew Pagels, simulators serve the needs of the vast majority of his “physically intact” clients. He likes the more controlled environment, and the ability to pre-evaluate safety, such as for those suffering from attention disorders. The more sophisticated interactive simulators can provide a more predictably complex environment and therefore more standardized results, he says. “In some sense it’s more complex, the situations programmed in can be a little more challenging.” He finds it to be a consistent predictor of safe driving and a comprehensive test for decision-making and reaction time. He points out that on a road test the driver may not be challenged to make a quick decision, depending on conditions.

• Someone who does not have an existing driver’s license or has had a license suspended can undergo evaluation in a simulator.

• Simulator tests are less expensive to administer.

Against the simulator:

• Ten percent of Pagels’ clients have an adverse reaction to the video effect of a simulator and become carsick.

• A simulator is not set up for those using adaptive equipment, so anyone using a modified vehicle must be evaluated driving their own.

• One of Karl Hoffman’s main objections to the simulator is that it does not convey the true driving experience, and that the elderly in particular may not be comfortable with it. “They’d rather be driving their own Crown Victoria. They accept feedback more readily in their own cars. It’s difficult to accept ‘you can’t drive again.'” Even more so if it’s from a simulator test. Nor can simulators provide any training necessary.

• Both Pagels and Hoffman note that there’s no sense of movement in a simulator. “You don’t feel the centrifugal force,” says Pagels. His concern is whether someone with, for example, a weakened left side, but who doesn’t require adaptive controls, would be able to maintain position. They must take a road test for this reason.

• A simulator only requires 140-degree vision. On the road, drivers are scanning a 360-degree field. Anyone with vision limitations should also take a road test, Pagels believes.

If you’re not sure if someone needs a professional evaluation, which typically costs between $295 and $350 and is not covered by insurance, Pagels recommends ordering “AAA Roadwise Review” ($4.95 plus tax) from the Automobile Association of America as an intermediate step. The CD-ROM provides a series of screening tests.

Also read: Should You Be Driving

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