Older drivers
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Older Drivers. Prof Desmond O ’ Neill 18 th April 2013. National Office for Traffic Medicine RCPI/RSA. Risk in perspective. Driving at 0100 Sundayx 142 16 year oldx 42 Light carx 20 Rural roadsx 9 ADHDx 4 Sleep Apnoeax 2 Visionx 1-2. Marshall, 2008.

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Older drivers

Older Drivers

Prof Desmond O’Neill

18th April 2013

National Office for Traffic Medicine

RCPI/RSA


Risk in perspective

Risk in perspective

  • Driving at 0100 Sundayx 142

  • 16 year oldx 42

  • Light carx 20

  • Rural roadsx 9

  • ADHDx 4

  • Sleep Apnoeax 2

  • Visionx 1-2

Marshall, 2008


Older drivers

Older people safest group of drivers

Older people in my clinic will have issues


Older drivers

…a reduction of approximately 45% in the annual rate of crashes per 1000 patients


Crashes 1 000 year by age

Crashes/1,000/year by age


Ten top tips fitness to drive in older people

Ten top tips - fitness to drive in older people


1 be opportunistic in asking patients about driving

1. Be opportunistic in asking patients about driving


2 do not assume that frail patients don t drive

2. Do not assume that frail patients don’t drive


3 consider how you can make driving safer for older patients

3. Consider how you can make driving safer for older patients

  • General fitness

  • Rehabilitation

  • Medications

  • Cataracts

  • Car Adaptations


4 when assessing prioritise the most significant conditions

4. When assessing, prioritise the most significant conditions


Driving model

Driving model

  • Complex mix behaviour, personality, cognition

  • Hierarchical model:

    • Strategic

    • Tactical

    • Operational


5 use the adelaide driving self efficacy scale

5. Use the Adelaide driving self-efficacy scale

  • Prudence

  • www.flinders.edu.au/medicine/fms/sites/rehabilitation-aged-&-extended-care/documents/Adelaide_Driving_Self-Efficacy_Scale11.pdf


6 get a witness history where possible

6. Get a witness history where possible


7 make use of specialist support

7. Make use of specialist support

  • Occupational Therapy

  • Neuropsych

  • Specialist driving assessor

  • Social worker


8 advise regular on road testing for patients with early dementia

8. Advise regular on-road testing for patients with early dementia


Older drivers

Modified Ulysses Contract


9 encourage anyone who witnesses dangerous driving to report it to the police

9. Encourage anyone who witnesses dangerous driving to report it to the police


10 remember that patients who aren t fit to drive probably can t use public transport either

10. Remember that patients who aren’t fit to drive probably can’t use public transport either


Older drivers

  • The demand for certainty is one which is natural to man, but is nevertheless an intellectual vice

Bertrand Russell


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