Integrating driver safety with patient encounters

You can integrate driver safety into office visits using one or more of the following suggestions:

  • Ask older patients to complete the ChORUS Driver History Questionnaire. Patients can complete this simple questionnaire when they arrive for their annual wellness check or other appointments as appropriate. The answers to these questions may prompt a conversation with the patient and additional screening.
  • Use screening/assessment tools to determine if an older driver is fit to drive safely. Consider Medscape’s Older Driver Safety Training.
  • Suggest that an individual complete a self-assessment or have a caregiver help. However, before administering any tests, it will be important to explain that safety is the key issue.
  • Start a conversation by exploring reasons for the patient to continue driving, noting that screening and assessment can help find solutions to keep older adults on the road. Screening and assessment can also identify technology, driver rehabilitation, and clinical interventions for someone at risk. This discussion should start early (ages 60-65) before a patient is in crisis. It can be framed around working with the older adult to continue driving as long as they can safely.
  • The ChORUS Older Driver Transportation Planning Tool empowers patients to take steps early to plan for when their capabilities diminish.

Assessing Functional Abilities for Driving offers methods to incorporate into patient visits as the patient ages. An assessment of five key domains helps you determine the level of risk for older patients. These domains include cognition, vision, motor/sensory function, current medical comorbidities, and medications.[1] Impairment in any of these areas can increase the older adult’s risk of being involved in a crash, getting lost, and endangering others.

The assessment results allow you to evaluate if one or more of the following apply.

  • More information is needed in any of these areas.
  • The clinician can correct underlying medical conditions that allow the patient to continue driving safely.
  • A referral to a medical specialist is warranted for further evaluation or treatment.
  • A referral to an occupational therapist or driving rehabilitation specialist can help an older adult continue to drive safely.
  • A recommendation for driving cessation and alternate transportation resources is warranted.

[1] Hill, L.J., Pignolo, R.J., & Tung, E.E. (2019). Assessing and counseling the older driver: A concise review for the generalist clinician. Mayo Clinic Proceedings, 94(8), 1582-1588.