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View Full Version : Family questions if B.C. driving test is fair for mother with mild dementia



Teh One Who Knocks
12-13-2022, 11:45 AM
Glenda Luymes - Vancouver Sun


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A B.C. driving test could discriminate against people with mild dementia who may be safe drivers, says a North Vancouver man whose mother-in-law recently gave up her driver’s licence, and with it, some of her independence, to avoid the assessment.

Damian Dunne said his wife’s 82-year-old mother is “a bit forgetful” and sometimes repeats questions, but her grasp of the rules of the road remains strong. In October, after learning she was in the early stages of Alzheimer’s disease, she received a letter from RoadSafetyBC requiring her to complete an enhanced road assessment to keep her licence.

Some aspects of the test would be challenging for someone without dementia to complete, said Dunne. “I was quite shocked.”

The family’s situation highlights the complexities around road safety and dementia, which affects more than 500,000 Canadians today, according to the Alzheimer Society of Canada, with the number expected to rise to 912,000 by 2030. While road assessments are intended to keep both the driver and public safe by testing a driver’s “functional ability to drive,” dementia is progressive and affects people in different ways.

The Alzheimer Society of B.C. said people who have been diagnosed with the early signs of dementia often find the test notification “jarring.”

“A big part of what we do is help families talk through the complexities of dementia and driving,” said Amelia Gillies, a support and education coordinator.

Dunne said many aspects of the 90-minute road test seemed reasonable and designed to ensure safety, but he questioned a requirement to remember and follow a three-step driving instruction — such as “turn right at the next intersection, then turn left at the traffic light, and then left at the stop light — and a test where the driver is directed to a certain point, then must turn around and follow the exact same route back to the start.

“When I’ve told other people about it, several have said they wouldn’t be able to do that,” Dunne said.

Determined to maintain some independence, his mother-in-law, who lives in Chilliwack, booked her test. But when she got to the testing location, she began crying and surrendered her licence instead of taking the test.

Dunne said he understands the need for safety, but no one has explained to him why following multi-step directions and driving a route in reverse is a requirement. His mother-in-law uses Google Maps and the family can see her location using a GPS tracking app.

“This has taken away her independence to shop, go to church, drive to appointments and visit friends,” he wrote in a letter to Mike Farnworth, B.C.’s public safety minister.

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Gillies said dementia impacts different areas of the brain at different times for different people, so while some people can safely drive for months or a year after being diagnosed with dementia, others might struggle.

“We sometimes say if you’ve met one person with dementia, you’ve met one person with dementia, and that translates to driving too,” she said.

Gillies said some doctors will refer people for a road test immediately, while others do not. As a result, the society hears concerns from people, like Dunne, who are surprised by the test, but also from families who are concerned about a family member who is still driving when it may be unsafe.

Way-finding is one of several issues that might arise for someone driving with dementia, she said. More significantly, dementia can affect visual processing, as the brain struggles to quickly interpret information coming at it and then react appropriately.

The enhanced road assessment is not a pass or fail test. According to the government policy, it consists of tasks designed to “assess driving skills and behaviours in situations of increasing complexity, yet within the abilities of a healthy, experienced driver.”

After referral, drivers are typically given 60 days to take the test, which is free. Their licence is cancelled if the test is not completed.

The test results are considered along with other information, including driving record, to determine whether a driver is “medically fit and functionally able” to safely drive. The driver may keep their licence, have restrictions added to it, or have it cancelled. RoadSafetyBC may schedule a reassessment for a later date, with the interval based on the driver’s medical condition.

In a statement, the Ministry of Public Safety said the assessment program has been in place since 2018. Between 2018 and 2021, an average of 4,680 people have been referred each year.

Of all medical fitness cases involving an assessment, 20 per cent of drivers are found medically unfit to drive, while 30 per cent either surrender their licence of have it cancelled when they don’t respond.

Drivers may request a review of a decision if they feel it is unfair.

Teh One Who Knocks
12-13-2022, 11:45 AM
If you have dementia, mild or not, you have no business getting behind the wheel. This is absolutely stupid.

PorkChopSandwiches
12-13-2022, 04:25 PM
Truth

Godfather
12-14-2022, 01:13 AM
If you have dementia, mild or not, you have no business getting behind the wheel. This is absolutely stupid.

Agreed.

So my wife is a geriatrician. GP's/primary care family doctors send her their older patients for referrals, often because they don't want to be the ones to make the call as to whether they need to be referred for a driving exam, which will probably ruin their relationship with the patient. My wife then sees these clearly confused folks and has to write a letter to the government saying they need a driving test.... and these people get extremely upset. She's been threatened, sworn at, had families call her clinic and harass her. She's empathetic and sweet about it, most cities in North America are bad for transit especially for the elderly and taking away their vehicle is extremely difficult on them... Ultimately, if you can't pass a driving test when you're showing signs of dementia it's a no-brainer you shouldn't be behind the wheel and your doctor has a duty to flag concerns over these folks driving.

lost in melb.
12-14-2022, 02:34 AM
It's tough.

There is an interesting grey area, though. About what constitutes "dementia". Some people can be highly functional and yet not so functional in other ways, or very specific circumstance.

Dunne said he understands the need for safety, but no one has explained to him why following multi-step directions and driving a route in reverse is a requirement. His mother-in-law uses Google Maps and the family can see her location using a GPS tracking app.

Godfather
12-14-2022, 03:35 AM
It's tough.

There is an interesting grey area, though. About what constitutes "dementia". Some people can be highly functional and yet not so functional in other ways, or very specific circumstance.

Dunne said he understands the need for safety, but no one has explained to him why following multi-step directions and driving a route in reverse is a requirement. His mother-in-law uses Google Maps and the family can see her location using a GPS tracking app.

Ya eh. From what I hear around the dinner table, the standardized tests they use to measure dementia are for the 'average' person. So you might've been a high powered, well read lawyer and score well on these tests even though you're in a cognitive decline. Other times my wife says she sees people who present as wildly confused, but apparently drive themselves and their partner around town every day with no issue. Not easy I'm sure...

Safe to say though, when in doubt I'm all in favor of a driving test. I'd even be fine if they became mandatory with increasing frequency as you age.

lost in melb.
12-14-2022, 04:42 AM
Ya eh. From what I hear around the dinner table, the standardized tests they use to measure dementia are for the 'average' person. So you might've been a high powered, well read lawyer and score well on these tests even though you're in a cognitive decline. Other times my wife says she sees people who present as wildly confused, but apparently drive themselves and their partner around town every day with no issue. Not easy I'm sure...

Safe to say though, when in doubt I'm all in favor of a driving test. I'd even be fine if they became mandatory with increasing frequency as you age.

Yep, I think a driving test is the ultimate 'test'. Probably not the preferred method is assesment due to economic rationalisations.