Older drivers are evaluated and those with slow reflexes can receive training

March 30, 1994|By Dolly Merritt | Dolly Merritt,Special to The Sun

For many seniors, a driver's license means independence. As a result, older drivers continue to drive in spite of failing reflexes that can result from a number of health-related causes.

To help drivers and their families cope with such problems, Horizon Health & Rehabilitation Inc., in Ellicott City, offers a driver's evaluation program, called the Return to Driving Program.

The privately run program is one of three similar driving &r evaluation programs in the state that assess elderly drivers' abilities to process information and to react. The others are at Good Samaritan Hospital of Maryland Inc. and at Sinai Hospital, both in Baltimore.

Horizon Health Clinical Director Craig B. Grether said about 200 to 300 people, mostly seniors, have been tested since the program began there in 1989. The evaluation costs $250 and is covered by some insurance companies if a person is having health-related problems.

Dr. Grether said that seniors take part in the voluntary program in order to assure themselves and family members that they still have the mental and physical skills necessary to drive safely.

FTC In addition to receiving doctors' referrals, Horizon Health gets requests for driver's evaluations from social workers, home health therapists, the health and wellness coordinator from the county's Office on Aging and from individuals themselves or their relatives who are worried about a loved one's ability to drive safely.

"More than half have had strokes," Dr. Grether said of the patients. "Others are having early signs of dementia, and we will often get a referral from a physician for a driver's evaluation if a person is having minor accidents or is doing things like crossing over the yellow line when driving."

Patients who enter the voluntary testing program are given a computerized test, the first of three evaluations. The computerized test lasts about 20 minutes and measures a person's visual reaction.

A second evaluation, also about 20 minutes, consists of a paper and pencil test. This measures a person's ability for sustained concentration through various exercises, such as connecting a series of numbered circles and letters within a specified time.

If people fail the first two tests, Dr. Grether said, they can take part in training and exercises intended to speed up their reaction time.

"We work with them to filter out distractions and we re-test them. Maybe six months later they will pass the test," he said.

The program provides a valuable service to seniors concerned about keeping their automotive independence, said Jennifer Giroux-Hankewycz, a certified occupational therapy assistant who helps patients strengthen their weak areas.

"Everyone wants to drive; that is one of the major goals," said Ms. Giroux-Hankewycz.

For example, she has been working with Earl Kolbewey, a 75-year-old Ellicott City resident who suffered a stroke in September.

Recently, she used the computer as a tool to improve Mr. Kolbewey's visual reaction time. He used a joystick to move a dot from one part of the computer screen to another in response to cues on the screen.

The third stage of the testing involves taking a client out, in the client's own car, to drive under the supervision of a certified rehabilitation driving instructor.

Wilbur E. Harrison, a 65-year-old Catonsville resident who suffered a stroke in October, went through the driver's &r evaluation program at Horizon Health in December. Having had both physical and occupational therapy, he successfully completed the computer and paper-pencil tests.

The third step was driving his own car, with an instructor, on the highways and around his neighborhood.

"I gave him a guided tour of Catonsville," said Mr. Harrison.

He compared the driver's evaluation test to the state's driving test.

"They are similar," he said. "Both are interested in your reaction time and your mental ability to cope in order to be a safe driver. Parking, slowing down and being able to know what is happening are some of the elements of driving that are observed."

Prior to taking any of the tests, patients are asked to sign a consent form saying the results will be forwarded to the person's physician, who will send the results to the Medical Advisory Board at the Department of Motor Vehicles.

That board reviews driving records and can seek an interview with the patient if there appears to be a medical problem that would interfere with safe driving, or even require another state driving test, Ms. Giroux-Hankewycz said.

But the patient decides prior to testing whether to let the results be sent to the physician and later to the state, according to Ms. Giroux-Hankewycz. If the patient refuses to sign the consent form prior to taking the tests, the tests will still take place and the results will remain confidential, she said.

Dr. Grether said it is rare for a patient to refuse to sign the consent form. Most agree in order to reassure friends and family that they can, indeed, drive safely, he said.

Those who don't pass the test are offered help through Horizon's occupational therapy program, which is intended to increase their reaction time. After taking part in therapy, most patients are able to pass the tests, he said.

Failing the test can be a personal disappointment. But older people often are more willing to accept such news from a medical professional.

In addition, said Dr. Grether, "the families are concerned for their loved one's safety and they are very much relieved when they get the results."

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