The ability to drive a car is something most of us take for granted. We love the freedom and independence it affords us, and we can’t imagine ever having to give that up.
Fortunately, many people living with Parkinson’s continue to drive safely for many years after their diagnosis. However, because no person experiences Parkinson’s in the same way, the following question should be revisited on a regular basis when evaluating driving with Parkinson’s:
How can I ensure my safety and the safety of others on the road?
How can Parkinson’s affect my driving?
Driving is a complex task. It requires physical strength, mobility, good reflexes and reaction time, depth perception, good eyesight and hearing and the ability to multi-task and keep track of many visual and spatial inputs at once.
Some of the symptoms of Parkinson’s can make executing all of those tasks a challenge. A few symptoms that are the most troublesome when it comes to driving include:
- Tremor in legs, arms and hands
- Decline in vision and spatial processing
- Compromised balance
- Freezing that can make it difficult to get moving again once you’ve been still
- Slower reaction time and diminished reflexes
- Side effects from taking medications such as sleepiness, blurred vision and confusion
- Mild to severe cognitive impairment
Many of the medications you may be taking can dramatically mitigate your symptoms; however, it’s important to remain vigilant when considering how safe you’re able to be on the road.
If you’re still driving, here are a few actions you can take to optimize your safety and the safety of others:
- Reduce distractions such as talking, eating, listening to the radio or anything else that requires concentration
- Avoid night driving if your vision is worse in the dark
- Avoid driving during “off times” when your medication isn’t as effective
- Use a GPS system and plan ahead of time if you’ll be driving in unfamiliar areas
- Avoid driving when you’re tired
If you get to a point when you’re starting to wonder if you should still be driving, there are several things you can do.
- Ask your care partner or another friend to ride in the car with you and then give you an honest assessment of your driving ability.
- Talk to your doctor about changes you’re experiencing and ask their opinion. Depending on where you live, your doctor may refer you to a Certified Driving Rehabilitation Specialist (CDRS) who can give you a comprehensive driving assessment.
We recently spoke with Christy Dittmar, an occupational therapist (OT) and CDRS from CNS Adaptive Driving Solutions in Fort Collins, CO. While the referral process is different in every state, she gave us a general idea of how the process works.
Get a Baseline
Dittmar recommends that you get a baseline assessment early in the process, before you start to decline, because the more your doctor and occupational therapist (DRS) know, the longer they may be able to keep you driving safely with Parkinson’s.
Some of the warning signs that indicate you may need to schedule a safety assessment include:
- You drive considerably slower than the rest of traffic
- You have trouble switching lanes
- You stop or slow down for no clear reason
- You drift in and out of your lane
- You forget to use your traffic signals
- You get lost on familiar roads and routes and forget where you’re going
- You get almost too tired to drive
- You miss cyclists, pedestrians and others who are sharing the road
- You are getting tickets for various infractions
- You get into fender benders, or almost get into them, often
If you’ve done any of the above, the next step is to learn more about how your state handles drivers with disabilities.
Learn the Protocol for Your State
Colorado is not a medically mandated state. It’s a self-reporting state, which means it’s up to you to assess whether or not you are fit to drive. With that said, Dittmar says that approximately 75% of the driving assessments she does are direct referrals from doctors.
Once Dittmar has completed a driving assessment, she sends the report to the driver’s doctor and it gets linked back to the driver’s DMV profile. The recommendations then become connected to a license.
These recommendations must be measurable. For example, some of the restrictions that could be placed on a driver include:
- Can only drive in daylight
- Can only drive within a certain radius of their home
- Can only drive below certain speeds
In some states, the report gets sent to the medical board. Contact the DMV in your state to learn more about how it’s done where you live.
Dittmar says that her assessments typically take between three and three and a half hours, which can be broken up into two sessions if that coincides better with “on times.”
The first part of the assessment is clinical. During this part, Dittmar tests for physical movement, reaction time, visual processing and cognitive function. The second part of the assessment includes an hour or more on the road to see how the driver responds in a variety of situations.
The final part of the assessment is the review. During the review, Dittmar goes through everything she observed and offers recommendations. These recommendations then go to the driver’s physician who makes the final determination of their fitness to drive.
Accept the Results
There are typically three recommendations that doctors give.
- You can continue to drive without restrictions.
- You can continue to drive with certain limitations.
- You should no longer drive.
Being told it’s time to retire from driving can be really tough. The important thing to remember is that you can still keep your freedom and independence. You can…
- Trade in your car for an eBike
- Take a bus or train (Check in with your local transportation office to find out about discounts)
- Take advantage of services like Lyft and Uber (If you’re not sure how to use them, ask a care partner for help in setting up your account and doing a dry run with you)
- Look into shuttles or vans for people with disabilities
- See if your church or local religious organization offers free transportation
- Ask a friend to drive you (You’d be surprised how many people love being asked for help)
We know it’s easy to list off a bunch of solutions you can try when it’s no longer safe for you to drive; however, we don’t want to minimize how big a transition like this can be. Many people experience anxiety and loss when their driving windows are limited, or gone completely. If that has been your experience, reach out to your care partners or the people in your support group (and if you don’t have one, now might be a great time to join one) and share your experience with them. Opening up to others who have shared experiences can be a great way to move through many of the changes that come with living well with Parkinson’s.
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Really excellent article, but all your suggestions assume we live in urban areas where there is public transportation, UBER, and it is safe to walk on the roads. Those of us who live outside of cities don’t have this – try walking with a cane on the shoulder when there are no sidewalks and people are driving 50+. The senior bus has spotty service and I still have to walk a long distance to get picked up. Nobody has yet come up with good alternatives for us.
Hi Fran – Thank you for reaching out. The public transportation in rural areas is a big issue and an ongoing problem that has yet to be solved. And with the proportion of older persons in many of these areas continuing to increase, the problem is not going to go away. This article has a few resources that might be worth checking out: https://www.aarp.org/content/dam/aarp/livable-communities/act/transportation/public-transit-in-rural-communities-aarp.pdf. In particular, http://www.unitedweride.gov may have more information that addresses your specific situation. I’m sorry there aren’t better alternatives for you at this point. We’ll continue to keep our eye out for developments in this much-needed area of public transportation.
One additional recommendation that I often share with my clients- try out some alternative methods of transportation BEFORE it is time to make the often emotional & difficult decision to stop driving. For instance, go with a friend out to lunch, and ride the bus together to get there. Or try a ride sharing service if you are heading somewhere that parking is difficult, you’ll love the convenience of being dropped off at the door! This can be a low-stress and enjoyable way to gain confidence while proactively exploring new transportation methods.
Great advice, Kayla! Thanks for lending your voice to the discussion!
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