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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

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Older Drivers

Prof Desmond O’Neill

18th 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


Older people safest group of drivers

Older people in my clinic will have issues


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


Crashes/1,000/year by age


Ten top tips - fitness to drive in older people


1. Be opportunistic in asking patients about driving


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


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


Driving model

  • Complex mix behaviour, personality, cognition

  • Hierarchical model:

    • Strategic

    • Tactical

    • Operational


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


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


Modified Ulysses Contract


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


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

Bertrand Russell


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