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Hard conversations: taking away the keys from the cognitively impaired

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Telling a patient with a head trauma, Alzheimer’s disease or Parkinson’s disease that it is no longer safe to drive is a conversation that often the family wants the physician to have with the individual. However, this interaction may put the physician in conflict with the patient. Mitchell Rubin, MD, medical director of Virtua’s neurosciences program of excellence, offers a solution: “Virtua’s Driving Assessment Program uses a third party to objectively assess a person’s driving ability. In doing so, the balance and trust of the doctor- patient relationship is maintained.”

The two-part assessment includes on-road testing through a licensed driving school and an in-office exam performed by an occupational therapist and consists of vision, coordination and cognitive testing. In some cases, patients may continue driving with an assistive device, such as handbrakes or with supervision.

“It’s sometimes easier to take away the keys when a patient is obviously impaired, but much more difficult when there is doubt regarding ability, or if the person is just beginning to fail,” adds Dr. Rubin.

The testing provides a clear recommendation that allows the family and the physician to maintain a good relationship with the patient.