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Kraig W. Jacobson, M.D.

Allergy, Asthma & Immunology

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When a loved one becomes a road hazard, seek support

Posted by on in Primary Care
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At Risk DriversYou may remember the excitement you felt the day you received your driver's license and were handed your first set of car keys, realizing the amount of independence you'd been given as a new driver. Driving is an enjoyable and necessary activity for people of all ages.

But when someone you love and care for reaches a point in their life when it's apparent that they should no longer be driving, we know that losing that privilege can be deflating and frustrating.

Loved ones often find it difficult to tell a family member that, by continuing to drive, they could potentially harm themselves or others. Physicians and other medical professionals and the Department of Motor Vehicles can play an instrumental role in helping with this process.

Oregon DMV
Oregon DMV has a Medically At-Risk Driver Program, which has screening and reporting components. A new driver, or someone renewing a license or replacing a license, must answer a series of medical questions when applying. If the answer is "yes" to any of the following questions, the DMV will not issue a license, renewal or replacement. The DMV will ask:

  1. Do you have a vision condition or impairment that has not been corrected by glasses, contacts or surgery that affects your ability to drive safely? (And the person is unable to pass a DMV vision screening.)
  2. Do you have any physical or mental conditions or impairments that affect your ability to drive safely?
  3. Do you use alcohol, inhalants or controlled substances to a degree that affects your ability to drive safely?

Oregon law and mandatory reporting
Certain physicians and health care providers in Oregon must report a patient's impairment when it becomes severe and uncontrollable, making it unsafe for the person to operate a motor vehicle.

According to Oregon Administrative Rules, mandatory reporters include a physician or health care provider acting as the person's primary care provider; a physician or health care provider providing specialized or emergency health care services to a person who does not have a primary care provider; or an ophthalmologist or optometrist providing health care services to a person who does not meet DMV vision standards.

Alternatively, health care providers may voluntarily report individuals who have conditions or impairments that interfere with a person's ability to safely drive.

Oregon DMV's reporting rules do not require individuals be reported to Oregon DMV solely for medical diagnosis or based on their age. People with early signs of dementia and early Alzheimer's may still be safe drivers.

Cognitive and functional impairments are required to be reported when they become severe and uncontrollable, affecting a person's ability to operate a motor vehicle, or the impairment is not correctable by medication, therapy or surgery.

Cognitive impairments include:

  • Attention
  • Judgment and problem-solving
  • Reaction time
  • Planning and sequencing
  • Impulsivity
  • Visio-spatial
  • Memory
  • Loss of consciousness or control

Functional impairments include:

  • Peripheral sensation of extremities
  • Strength
  • Flexibility
  • Motor planning and coordination

It's important to note that if a patient has a medical condition or a change in medication that temporarily hinders the ability to drive, that person may be treated, reevaluated and resume driving upon doctor's approval.

Mandatory reporting curbs accident rates
Researchers evaluated the effectiveness of physician's mandatory reporting policy in Ontario, Canada by comparing patient accident rates before and after physician involvement. After patients received formal warning from physicians against driving with common medical conditions — such as syncope (fainting), diabetes, dementia and epilepsy — accident rates fell by 45 percent the following year, when compared with baseline accident rates among patients three years before. The decline in accident rates among patients older than 75 was even higher.

For more information
We encourage you to review the DMV's At-Risk Driver Program frequently asked questions. Also, check out AAA, which has a resource focused on helping seniors stay on the road longer and safer.

Additionally, here in Eugene, we have a wonderful resource in Laura Fischrup, who opened Driving Solutions in February 2005 to assist in serving individuals, their families, physicians, caseworkers and other agencies to meet the driving and transportation needs of people with disabilities or who are older drivers. A certified driver rehabilitation specialist, Laura can assess driving skills, determine what modifications or adaptations are needed and provide training to help clients maintain independence.

If you have a loved one who you feel may be at risk of injuring themselves or others while driving, we encourage you to seek the opinion of his or her primary care physician.

If you have questions, or would like to make an appointment, please feel free to contact us.

An energetic problem solver, Dr. Kraig Jacobson has spent his career treating patients and teaching about the complexities of allergy, asthma and immunology. He has practiced medicine in Eugene since 1979. The bigger the challenge, the more he enjoys his work.