Lecture 11 Sensory function and safe driving

Question 1

A _ is an electronic device for text communication over a telephone line designed for use by persons with hearing or speech difficulties.

Answer 1

TDD (telecommunications device for the deaf).

Question 2

Skills related to driving (1 of 2)

Answer 2

1. Lower body strength, range of motion, mobility, and coordination to use foot-operated controls.
2. 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.
3. Ability to hear other traffic and vehicle warning devices.
4. Ability to see other traffic, road conditions, pedestrians, and traffic signs and signals.

Question 3

Skills related to driving (2 of 2)

Answer 3

1. Cognitive skills - ability to think, understand, perceive, and remember.
2. Ability to maintain normal consciousness and bodily control - to respond to stimuli.
3. Ability to maintain a normal social, mental, and emotional state of mind.

Question 4

In order to legally drive in Louisiana, a person must be free from loss of consciousness and seizure activity for at least _

Answer 4

6 months.

Question 5

_ will more readily give up their driving privilege when they feel that they are no longer safe to drive.

Answer 5

Women.

Question 6

Negative consequences of driving retirement include _

Answer 6

Decreased freedom and independence, alterations in socialization, changes in mobility, feelings of helplessness.

Question 7

Positive consequences of driving retirement include _

Answer 7

Safety, increased walking, exploration of other transportation and social resources, financial savings.

Question 8

An over-the-counter medication that is frequently associated with impaired driving is _

Answer 8

Diphenhydramine (Benadryl) - adversely affects speed, mood, attention, vigilance, working memory, and level of activity.

Question 9

The risk for a car collision at an intersection is greatest when _

Answer 9

Making a left turn (requires crossing more lanes of traffic).

Question 10

Age-related changes regarding vision

Answer 10

1. Presbyopia - far-sightedness.
2. Diminished visual acuity - interferes with perception of fast-moving vehicles.
3. Delayed dark and light adaptation - may impact driving through tunnels.
4. Diminished depth perception.
5. Increased sensitivity to glare - interferes with perception of objects.
6. Narrowing of the visual field.
7. Altered color perception.
8. Slower processing of visual information.

Question 11

Decreased ability to discern the colors _ and _ is a normal age-related change.

Answer 11

Blue and green.

Question 12

Older adults retain the ability to discern the colors _ and _ the most.

Answer 12

Red and yellow.

Question 13

Bright sunlight at sunrise/sunset interferes with perception of _ and _ traffic lights.

Answer 13

Red and blue.

Question 14

Cataracts

Answer 14

1. 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.
2. 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.
3. Can be prevented by protecting one’s eyes from sunlight.

Question 15

Age-related macular degeneration (AMD)

Answer 15

1. Pathologic condition of the eye in which the area in the middle of the retina is damaged by deposits of retinal pigment.
2. Impact on driving: Loss of central vision - person will only see the outer areas of the visual field.

Question 16

Glaucoma

Answer 16

1. Pathologic condition of the eye in which an abnormal buildup of aqueous humor increases the pressure within the eye.
2. Impact on driving: Loss of peripheral vision; poor vision in dim lighting; sensitivity to glare.

Question 17

Ototoxic medications include _

Answer 17

1. Aspirin and NSAIDs.
2. Furosemide (Lasix).
3. Antibiotics (especially aminoglycosides or ‘-micin’ drugs).
4. Quinidine.

Question 18

Regardless of the source, a referral for a driving evaluation must be accompanied by _

Answer 18

A doctor’s order.

Question 19

Factors related to candidacy for a driving evaluation include _

Answer 19

1. Has known equipment needs.
2. Has a physical or medical problem that would affect driving (e.g., stroke, spinal cord injury, etc.).
3. Has a stable medical status.
4. Is free from visual/perceptual deficits (this does not mean the person cannot be assessed - needs can be identified).
5. Is free from cognitive deficits.
6. Has been seizure-free for at least 6 months.
7. Does not take medications that would interfere with driving.

Question 20

Mandatory reporting laws for potentially unsafe drivers

Answer 20

In Louisiana, there are no mandatory reporting laws. If a physician chooses to report, however, there is a law that protects them from retaliation.

Question 21

The ideal funding source for driving evaluation and rehabilitation is _

Answer 21

Vocational rehabilitation or veterans services.

Question 22

Informed consent for a driving evaluation must be accompanied by _

Answer 22

A disclosure that the patient’s driving license may be suspended, revoked, or restricted based on the results of the assessment.

Question 23

Assessment of Driving-Related Skills (ADReS)

Answer 23

Elderly driving assessment guide developed by the American Medical Association; includes the following tests:

1. Peripheral visual fields by confrontation testing.
2. Rapid pace walk.
3. Manual test of range of motion.
4. Manual test of motor strength.
5. Trail making test.
6. Clock drawing test.

Question 24

Between 25% and 40% of individuals aged 65 and older and 40% to 66% of individuals aged 75 and older have some degree of _

Answer 24

Hearing loss.

Question 25

Among older adults with hearing loss, _ is the most common cause.

Answer 25

Presbycusis (age-related sensorineural hearing loss).

Question 26

Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S)

Answer 26

1. 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).
2. 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).
3. Audiologic referral is recommended for individuals scoring 10 points or higher.

Question 27

Short attention span and easy distractibility are indicators of _

Answer 27

Hearing loss.

Question 28

Older adults who report difficulty driving at night may have _ or other visual impairments.

Answer 28

Cataracts.