Lecture 11 Sensory function and safe driving Flashcards
A _ is an electronic device for text communication over a telephone line designed for use by persons with hearing or speech difficulties.
TDD (telecommunications device for the deaf).
Skills related to driving (1 of 2)
- Lower body strength, range of motion, mobility, and coordination to use foot-operated controls.
- Upper body strength, range of motion, mobility, and coordination to use hand-operated controls and to turn head and body to the left, right, and rear to observe for other traffic and pedestrians.
- Ability to hear other traffic and vehicle warning devices.
- Ability to see other traffic, road conditions, pedestrians, and traffic signs and signals.
Skills related to driving (2 of 2)
- Cognitive skills - ability to think, understand, perceive, and remember.
- Ability to maintain normal consciousness and bodily control - to respond to stimuli.
- Ability to maintain a normal social, mental, and emotional state of mind.
In order to legally drive in Louisiana, a person must be free from loss of consciousness and seizure activity for at least _
6 months.
_ will more readily give up their driving privilege when they feel that they are no longer safe to drive.
Women.
Negative consequences of driving retirement include _
Decreased freedom and independence, alterations in socialization, changes in mobility, feelings of helplessness.
Positive consequences of driving retirement include _
Safety, increased walking, exploration of other transportation and social resources, financial savings.
An over-the-counter medication that is frequently associated with impaired driving is _
Diphenhydramine (Benadryl) - adversely affects speed, mood, attention, vigilance, working memory, and level of activity.
The risk for a car collision at an intersection is greatest when _
Making a left turn (requires crossing more lanes of traffic).
Age-related changes regarding vision
- Presbyopia - far-sightedness.
- Diminished visual acuity - interferes with perception of fast-moving vehicles.
- Delayed dark and light adaptation - may impact driving through tunnels.
- Diminished depth perception.
- Increased sensitivity to glare - interferes with perception of objects.
- Narrowing of the visual field.
- Altered color perception.
- Slower processing of visual information.
Decreased ability to discern the colors _ and _ is a normal age-related change.
Blue and green.
Older adults retain the ability to discern the colors _ and _ the most.
Red and yellow.
Bright sunlight at sunrise/sunset interferes with perception of _ and _ traffic lights.
Red and blue.
Cataracts
- Pathologic condition of the eye in which the normally transparent lens of the eye becomes cloudy, transmission of light to the retina is diminished, and vision is impaired.
- Impact on driving: Problems with night driving; increased sensitivity to glare; decreased contrast sensitivity; halos and blurred objects; diminished color perception; double vision may be present.
- Can be prevented by protecting one’s eyes from sunlight.
Age-related macular degeneration (AMD)
- Pathologic condition of the eye in which the area in the middle of the retina is damaged by deposits of retinal pigment.
- Impact on driving: Loss of central vision - person will only see the outer areas of the visual field.
Glaucoma
- Pathologic condition of the eye in which an abnormal buildup of aqueous humor increases the pressure within the eye.
- Impact on driving: Loss of peripheral vision; poor vision in dim lighting; sensitivity to glare.
Ototoxic medications include _
- Aspirin and NSAIDs.
- Furosemide (Lasix).
- Antibiotics (especially aminoglycosides or ‘-micin’ drugs).
- Quinidine.
Regardless of the source, a referral for a driving evaluation must be accompanied by _
A doctor’s order.
Factors related to candidacy for a driving evaluation include _
- Has known equipment needs.
- Has a physical or medical problem that would affect driving (e.g., stroke, spinal cord injury, etc.).
- Has a stable medical status.
- Is free from visual/perceptual deficits (this does not mean the person cannot be assessed - needs can be identified).
- Is free from cognitive deficits.
- Has been seizure-free for at least 6 months.
- Does not take medications that would interfere with driving.
Mandatory reporting laws for potentially unsafe drivers
In Louisiana, there are no mandatory reporting laws. If a physician chooses to report, however, there is a law that protects them from retaliation.
The ideal funding source for driving evaluation and rehabilitation is _
Vocational rehabilitation or veterans services.
Informed consent for a driving evaluation must be accompanied by _
A disclosure that the patient’s driving license may be suspended, revoked, or restricted based on the results of the assessment.
Assessment of Driving-Related Skills (ADReS)
Elderly driving assessment guide developed by the American Medical Association; includes the following tests:
- Peripheral visual fields by confrontation testing.
- Rapid pace walk.
- Manual test of range of motion.
- Manual test of motor strength.
- Trail making test.
- Clock drawing test.
Between 25% and 40% of individuals aged 65 and older and 40% to 66% of individuals aged 75 and older have some degree of _
Hearing loss.
Among older adults with hearing loss, _ is the most common cause.
Presbycusis (age-related sensorineural hearing loss).
Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S)
- 10-item questionnaire developed to assess how an individual perceives the social and emotional effects of hearing loss (i.e., does not assess actual hearing capacity).
- The higher the HHIE-S score, the greater the handicapping effect of a hearing impairment. Possible scores range from 0 (no handicap) to 40 (maximum handicap).
- Audiologic referral is recommended for individuals scoring 10 points or higher.
Short attention span and easy distractibility are indicators of _
Hearing loss.
Older adults who report difficulty driving at night may have _ or other visual impairments.
Cataracts.
