JustCare

Tag: Driving

  • Six warning signs of dementia

    Six warning signs of dementia

    Dana Smith reports for the New York Times on six warning signs of dementia, memory loss included. Keep in mind that each of these signs alone should not cause concern. But, taken together, they are cause for visiting the doctor. To read more about signs of dementia on JustCare, click here.

    Financial problems: People with dementia can experience problems handling their finances long before losing their memory. In many cases, they struggle to stay on top of their bills and can’t manage their expenses. Some will spend money excessively or give money away without appreciating what they’re doing.

    Sleep problems: Again, lots of adults have sleep issues. But, people with dementia might have a change to their circadian rhythm and need to sleep at odd hours and be awake in the very early morning when it’s still dark. Some people with dementia will act out their dreams while they sleep, physically moving and talking. It’s not normal sleep walking or sleep talking; it’s more hitting and screaming.

    Changes in personality: People with dementia might withdraw from social activities, stay home more,  and become less agreeable and conscientious before they show other signs of mental decline. For example, hey might struggle to finish projects. They will continue to be disagreeable and less trusting of others as their dementia progresses.

    Challenges driving: Driving  requires the driver to perform multiple mental tasks at once. When driving becomes a challenge, it’s a sign that the driver is suffering from dementia. The driver might not see a stop sign or nearly miss hitting another car or otherwise not follow the rules of driving. If that’s the case, you might want to take action to prevent the person from driving.

    Loss of smell: People with dementia often lose their ability to smell long before they experience other symptoms. Dementia can cause loss of smell.

    In addition, people with dementia might struggle for words, might misplace things, or become confused more easily.

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  • Is it still safe to drive? Have the doctor request a driving test

    Is it still safe to drive? Have the doctor request a driving test

    If you are lucky enough to live to a ripe old age, there may come a time when you should stop driving, both for your own safety and the safety of others. You may no longer have the reflexes, the hearing, the vision, or the overall ability to react quickly to a challenging situation on the road. Is it still safe to drive or time to put away the car keys? With the doctor’s help, get a driving test.

    My dad was still driving, and driving very cautiously, at the age of 91. He was only driving during the day, on local roads with relatively little traffic, at low speed limits. And, he loved the freedom driving offered him to get out and about. So, it was extremely hard for me to decide what to do.

    Different people offered me different advice. Some suggested I simply take away his keys, which I was unprepared to do. My dad showed no signs of being a danger on the road. And, I do not believe it was my place to make the decision for him. His doctor, likewise, was not prepared to say he should not drive.

    I broached the topic with my dad, a highly responsible man. And, he saw no reason to stop driving. He was super careful. He did not feel stressed or anxious about driving. And, being able to drive gave him much valued independence. It allowed him to get to the grocery store, the pharmacy and his water aerobics class, all important destinations for him.

    I respected my father’s position, but I also worried for his safety and the safety of others. I then learned that the registry of motor vehicles (RMV) gave “competency” tests to older people to determine whether they were still fit to drive. That seemed like a good idea to me, but my father was resistant. He did not see the need. And, the RMV would not require it on its own.

    So, I spoke to my dad’s doctor. She offered to send a letter to the registry of motor vehicles requesting he take the competency test. On his doctor’s request, the RMV would schedule it. And, shortly thereafter, the RMV called my dad in.

    His driver’s license was revoked before he had taken the road test. My dad failed the vision and hearing test. On one hand, I felt terrible for my dad. On the other hand, I appreciated that neither he nor I was not the appropriate judge of his driving ability or his safety and the safety of others, so long as he was behind the wheel.

    The National Institute on Aging, NIH, has several tips for helping people decide whether they should continue driving or rely on other forms of transportation.

    [N.B. This post was first published on November 20, 2018.]

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  • Five ways to ensure the people you love are safe and healthy 

    Five ways to ensure the people you love are safe and healthy 

    At least once a year, every caregiver should engage the older people they love in what can be difficult conversations. No child looks forward to being a parent to her mom or dad; no one wants to have to speak with a spouse about exercising more, rethinking a medication regimen or considering stopping driving.  But, that’s often what needs to happen. Here are five ways you can help ensure the people you love are safe and healthy.

    1. Make sure they get an annual flu shot.  This should be easy since often the local pharmacy will administer the shot.  The shot minimizes the risk that older adults will develop flu-related health problems, including pneumonia and worsening chronic conditions. [Editor’s note: Also make sure they get their Covid-19 vaccine and booster shots.]
    1. Check out what drugs they are taking.  And, make a list of them, along with the names and phone numbers of their doctors, both for yourself and for their wallets.  If they keep the list on them, and you have a backup copy, it will help ensure their doctors are best prepared to treat them.
    1. Ask them about painkiller prescriptions they take as well as over the counter drugs, like Tylenol.  Too much acetaminophen can be dangerous. Prescription painkillers, such as Percocet or Vicodin, can be even more dangerous, particularly if mixed with alcohol, tranquilizers or other drugs.
    1. Try to nudge them to exercise. A brisk walk can reduce the likelihood of stroke and help prolong their lives. If they are not inclined to move, ask them what might get them out of the house.  Sometimes, a companion can make all the difference.  Anything they can do to move their bodies is great, including in hospital. Sometimes, showing them some easy exercises can work.  You can find simple balance exercises that the National Institutes on Health recommends here. For information about free and low-cost exercise programs in your community, visit the eldercare locator.
    1. Talk to them about driving if they are still driving. Many people can drive all their lives.  But, both mental and physical reflexes can weaken as you age.  The National Institute on Aging offers great advice on when and how you can help someone you love decide to stop driving.

    And, if you need help motivating them to change an unhealthy behavior, here are six tips that could help.

    Of course, there’s more you can do, including making their homes easier and safer to live in: for example, make sure floor surfaces are smooth to reduce the likelihood of tripping, install ramps and  raise toilet seats. More on that in a separate post.

    (This post was originally published on April 10, 2015.)

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  • Higher risk of car accidents for people on multiple meds

    Higher risk of car accidents for people on multiple meds

    While it’s no surprise that many older adults take a lot of different medications, many of those drugs can potentially increase their risk of getting into an automobile accident.

    A new report from the AAA Foundation for Traffic Safety found that nearly 50% of active older drivers used seven or more medications. An analysis of 3,000 older drivers that also monitored the drugs they were taking found that about 20% of the meds should be avoided because of limited therapeutic benefit and/or potential to cause excess harm. These drugs are on a list known as the Beers Criteria.

    These inappropriate drugs include benzodiazepines such as Xanax (alprazolam) and Valium (diazepam), as well as first-generation antihistamines. These medications can cause blurred vision and confusion and can impact coordination, increasing a driver’s crash risk by as much as 300%, according to AAA.

    Some of the most commonly prescribed medications in this age group can affect driving ability. For example, 73% of respondents said they took a heart medication, and 70% said they took a central nervous system drug, such as a pain medication, stimulant or anti-anxiety drug.

    The AAA Foundation said prior research found that less than 18% of older drivers say they received a warning from their doctor that their medication could impact their driving ability.

    This article was originally published on Medshadow.

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  • Tips for driving safely

    Tips for driving safely

    As you get older, it can become increasingly challenging to drive. A variety of health conditions can affect your ability to drive. If you are concerned about whether you or someone you love is a safe driver, talk to your doctor. Don’t risk hurting yourself or others. Here are tips for driving safely from the National Institutes of Health.

    If your joint and muscles are stiff, you may have difficulty turning your head to see oncoming cars or responding to a situation where you need to turn the steering wheel or brake quickly. In these situations, you are likely better off driving an automatic car with power steering and brakes and big mirrors. And, you should exercise so that you are as strong and flexible as possible.

    If your vision is not what it used to be, you may have trouble seeing people and things in front of you as you drive. You also might struggle to see at night. Visit the eye doctor to ensure your vision is as good as possible. You also might consider stopping driving at night.

    If your hearing is failing, you may not hear horns and sirens and may not be warned when you need to get out of the way. Make sure to have your doctor check your hearing. Also, consider keeping the radio off while you are driving so that you are better able to hear outside noises.

    If you have mild dementia, you may continue to drive. But, you want to stop when your memory weakens and you are unable to remember where you need to go. You may not appreciate the challenges of driving.

    As your reflexes slow down, you may not be able to respond as quickly as needed while you are driving. Try to not to get too close to the car in front of you, brake sooner, and, if possible, stay out of rush-hour traffic. If you need to drive when the roads are busy, try to keep to the right lane.

    If you are taking medicines, be sure to note whether the warning label includes side effects like drowsiness or lightheadedness.  If so, driving can be unsafe, and you should not be driving. Be sure to check the warning labels on your medicines and discuss them with your doctor to see whether you should be driving while taking them.

    To be safe, try not to drive when the weather is bad and at night and avoid highways, if possible. Here are helpful tips on how to help someone you love decide when to stop driving.

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  • How can you help someone you love decide when to stop driving?

    How can you help someone you love decide when to stop driving?

    Getting older does not mean that you cannot continue driving.  But, the last thing you want is for people you love to hurt themselves or others.  As people age, they can lose mental and physical functions that enable them to drive safely.  The National Institute on Aging has several tips for helping people decide whether they should continue driving or rely on other forms of transportation.

    Responsible driving depends upon good reflexes. And, good driving is often about making snap decisions. So, if people you love have trouble seeing, turning their head, climbing stairs, responding quickly, or confuse the brake and the gas pedals, those are signals that driving might put them and others at risk.  Similarly, if driving makes them anxious, stressed or tired, those could be indicators that it’s time for them to stop.

    People who have trouble keeping up with the flow of traffic, seeing when cars are coming at them, making sense of the traffic signs on the road or staying in the proper lane should likely also not be driving.  They will know whether they are having problems if other drivers are honking at them, if they had minor accidents or have been pulled over by a traffic officer.

    For sure, once people you love lose their vision, hearing, reflexes or have had a stroke or another serious condition, you should advise them to take a driving test every three years. If they continue to drive, encourage them to stay home in bad weather and, if possible, take alternate routes on quieter roads that are less stressful.  For more information, click here.