ShareThisThe American Medical Association this week released a guideline for physicians to help them navigate the delicate topic of what role they can play in screening and evaluating older patients for driving safety.
The guideline was first put out in 2003 and has not been updated since then to reflect changes in some states. Six states require physicians to report to motor-vehicle divisions the names of patients they feel are no longer safe to drive.
Several physicians reached and at least one Alzheimer's organization said the guideline is a nice gesture but they question how much weight it will carry in the medical community.
Physicians are already stretched thin for time to address treatment issues with patients. And physicians tend to defer to caregivers when an elderly loved one should stop driving,
"Unless it is extreme, I think they like to take a hands-off," said Chuck Pollard, president of the Alzheimer's Support Network in Collier County, Fla. "They are making a judgment this person is impaired and often the patient won't go back and they need to go back for treatment."
On the other hand, when there has been a diagnosis of dementia or Alzheimer's disease, the network will inform family caregivers that they have a responsibility not to let the individual drive anymore, he said. The family runs a liability risk if the individual gets into an accident and hurts others.
The AMA said car accidents are the leading cause of injury-related deaths in adults 65 and older; the fatality rate for drivers 85 and older is nine times higher than the rate for drivers 25 to 69.
Dr. Edwin Dean, who runs a preventive medicine practice in Naples, looked at the AMA's new guidelines online and said doctors are hard pressed for time to read the 200-page document.
At the same time, the guidelines are "certainly a good start" for addressing a difficult subject of elderly patients and whether they should stop driving, he said.
"A lot of patients fall into the gray zone," he said, adding that physicians' time with patients is getting shorter and shorter and they are focused on the medical issues. "It's not on the front burner of issues they want to deal with."
Dr. Ron Garry, a geriatrician, said he and others in his practice deal with the driving issue all the time but he doesn't believe physicians in general will read the AMA guidelines.
"I'm not so sure how many doctors are supportive of the AMA and I'm not sure how many will read it," he said. "In general this (issue of patients and driving) is very uncomfortable for doctors."
That's not something that Margaret Palmer, 62, wants to hear about physicians who deal with a lot of elderly patients when family members don't intervene.
Palmer suffered numerous injuries after she was struck by a car in August 2009, by a 91-year-old driver, Frank Blumeyer. Palmer was jogging southbound and Blumeyer was driving north when he crossed the road and struck her.
"They (elderly drivers) believe their doctors," she said. "They don't want to believe their kids."
(Connect Liz Freeman at www.naplesnews.com/staff/liz_freeman)
