Older Road Users: Myths and Realities, A Guide for Medical and Legal Professionals

Author: Morris Odell ISBN 10: 1933264705 ISBN 13: 978-1933264707 Copyright Date Ed:  July 1, 2009 Pages: 320 pages Binding Information: Hardcover Size: 6 ✕ 9 Inches (US) This book, one of the first of its kind, brings you state-of-the-art scientific information on the role of aging in driving behavior and motor vehicle accidents. As our population ages, there will be an increase in the number of older drivers on the road. Those born during the post World War II baby boom are now reaching age 65 and are the first generation where driving has been a constant part of their lives. In countries such as Australia, the United States, and Canada - where driving is often a necessity - evaluation of driving ability and implications of potential accidents have become a concern. This book teaches you about older drivers, their driving behaviors and actual risks versus perceived risks. While this study was conducted in Australia with predominantly Australian data, the findings are highly applicable to the United States and Canada. This book gives you the most up-to-date information possible. It also explores the most common medical conditions that affect driving behavior in older people including neurological, cardiovascular, and other physical conditions; metabolic conditions such as diabetes and hypoglycemia; dementia; psychological issues; visual impairment; and the influence of multiple prescription drugs and alcohol. Extensive chapters are devoted to diabetes, dementia, visual impairment, and prescription drug and alcohol use, as these appear to be the most common causes of impairment of older drivers. A model management program for older drivers with diabetes is presented, with suggestions on how it might be used with other medical conditions. You will also learn about the epidemiology of accidents involving older drivers including fatalities. This book also covers accidents involving older pedestrians and motor vehicles. It gives you an overview of common types of accidents involving older road users of all types and makes recommendations for managing and decreasing these accidents. Of important concern is the evaluation of fitness of older drivers. This book teaches you about the different ways that older drivers are evaluated including the pros and cons associated with each. It also discusses mandatory age related driver testing. It also presents suggestions on implementation of driver evaluation programs as well as training for older drivers from an occupational therapy perspective. This book also teaches you ways to help people manage the transition from driving to no longer being allowed to drive. It covers issues such as alternative modes of transportation, community and family support, and therapy for psychological issues associated with this transition. This book is a must for your library if you work with older drivers in any capacity. This book is also available as an eBook. Click here to purchase and download: Topics Include: Accidents involving older drivers Accident risks of older drivers Licensing procedures Evaluation of fitness to drive Medical review of older drivers Vision and the older driver Dementia and cognitive problems Respiratory and sleep disorders Neurological conditions Effects of prescription drugs and alcohol Diabetes and metabolic disorders Older pedestrians Occupational therapy assessment and training of older drivers Transition from driving to no longer driving Table of Contents Chapter 1. Older Driver Crashes Jim Langford 1.1 Introduction 1.2 Current Older Driver Crash Levels A. Contribution to the Road Toll B. Contribution to Hospital Admissions C. Contribution to All Deaths D. Conclusions 1.3 Do Older Drivers Have a Characteristic Crash Pattern? A. Some Overseas Studies B. Some Australian Studies C. Conclusions 1.4 Are Older Drivers Likely to be Overly Responsible for Their Crashes? A. The Difficulties in Attributing Crash Responsibility B. Findings from the Research C. Conclusions 1.5 Do Older Drivers Have a Heightened Crash Involvement? A. Older Drivers’ High Crash Rates per Distance Driven B. Frailty Bias C. Limitations in the Exposure Measurements—Low Mileage Bias D. Conclusions 1.6 Are Older Drivers a Heightened Crash Risk to Other Road Users? A. Findings from the Research B. Conclusions 1.7 Summary and Conclusions Chapter 2. Managing Older Driver Crash Risk Judith Charlton, Ph.D., Sjaanie Koppel, Ph.D., Jim Langford, and Justine Irving 2.1 Introduction 2.2 What Are the Current Older Driver Licensing Practices? A. Australian Licensing Procedures B. International Licensing Procedures C. Summary 2.3 Is There Evidence for Universal Licence Testing, Based on Age, as an Effective Strategy for Managing Older Driver Risk? A. Summary 2.4 Alternative Approaches to Licensing A. Outline of the Proposed Australasian Model B. Assessment of Functional Ability C. Levels of Assessment of the Model Procedure D. Use of Valid and Reliable Testing Instruments E. Community Referral F. Range of Outcome Options for Older Drivers G. Establishment of a Case Officer Position H. Assessment Undertaken by Government and Non-government Agencies 2.5 Use of Conditional Licences 2.6 Balancing Safety and Mobility 2.7 Self-regulation as a Means of Reducing Risk A. Findings from Research on Self-regulatory Practices 2.8 Summary and Conclusions Chapter 3. Vision and the Ageing Driver Joanne M. Wood, Ph.D. 3.1 Introduction 3.2 Normal Age-Related Vision Changes 3.3 Visual Function, Ageing and Driving A. Visual Acuity B. Visual Fields C. Contrast Sensitivity D. Dynamic Visual Acuity E. Monocular Vision F. Useful Field of View 3.4 Ocular Diseases in Older Populations A. Cataracts B. Glaucoma C. Age-Related Maculopathy D. Diabetic Retinopathy E. Stroke 3.5 Implications for Licensing 3.6 Conclusions Chapter 4. Older Road Users—Effects of Dementia and Cognitive Changes Peteris Darzins, BMBS, Ph.D. and Michel Bédard, Ph.D. 4.1 Introduction 4.2 Dementia and Other "Brain Failure Syndromes" 4.3 Pathology of the Dementing Processes A. Alzheimer Dementia—Pathology B. Vascular Dementia—Pathology 4.4 Dementia with Lewy Bodies—Pathology 4.5 Fronto-Temporal Dementia—Pathology 4.6 Clinical Features of the Dementing Illnesses A. Alzheimer Dementia—Clinical Features 4.7 Vascular Dementia—Clinical Features 4.8 Mixed Dementia—Clinical Features 4.9 Dementia with Lewy Bodies—Clinical Features 4.10 Fronto-Temporal Dementia—Clinical Features 4.11 Other Dementing Illnesses 4.12 The Driving Task 4.13 Driving and Cognition A. Stages of Alzheimer Dementia B. Driving and Stage of Dementia Syndromes Other than Alzheimer Dementia 4.14 Incidence of Crashes in People with Dementia 4.15 Crash Patterns of Older Drivers 4.16 Driving Patterns of People with Cognitive Impairment 4.17 Differentiating "Safe" from "Unsafe" Drivers with Dementia 4.18 Management of Driving by People with Dementia 4.19 Conclusion Chapter 5. Respiratory and Sleep Disorders in the Older Driver Matthew T. Naughton, F.R.A.C.P. 5.1 Introduction 5.2 Respiratory Illnesses A. Cigarette Smoking B. Chronic Obstructive Pulmonary Disease C. Pulmonary Fibrosis D. Cough Syncope E. Lung Cancer F. Deep Venous Thrombosis and Pulmonary Emboli G. Pneumothorax H. Post Thoracotomy I. Asthma 5.3 Sleep Disorders A. Sleep Deprivation B. Sleep Apnoea 5.4 Summary Chapter 6. Driving and the Elderly: Neurological Conditions Mark Cook, M.D. 6.1 Introduction 6.2 Stroke 6.3 Dementia 6.4 Parkinson’s Disease (PD) 6.5 Head Injury 6.6 Drugs 6.7 Epilepsy 6.8 Conclusions Chapter 7. Road Safety Effects of Prescription Drugs in the Older Driver Olaf H. Drummer, Ph.D. 7.1 Introduction 7.2 Terminology Used in Epidemiological Studies 7.3 Baseline Culpability 7.4 Alcohol 7.5 Drugs Other than Alcohol A. Benzodiazepines B. Anti-Depressants and Other Mood Altering Drugs C. Anti-Diabetic Drugs D. Anti-Coagulants E. Opiates F. Other Drugs 7.6 Conclusions Chapter 8. Diabetes and the Older Road User Trisha Dunning, Ph.D. 8.1 Diabetes 8.2 Incidence of Traffic Crashes in Older People with Diabetes 8.3 Effects on Driving Ability Related to Diabetes 8.4 Functional Impairment and Disability A. Physical B. Depression and Cognitive Functioning C. Hyperglycaemia <brD. Hypoglycaemia 8.5 Self-Care Knowledge and Behaviours 8.6 Improving Driving Safety in Older People with Diabetes 8.7 Summary Chapter 9. Walking for Older Road Users: A Safe Alternative to the Car? Jennie Oxley, Ph.D. 9.1 Introduction 9.2 Walking: Benefits and Drawbacks 9.3 Crash Types 9.4 Why the Over-Involvement of Older Adults in Pedestrian Crashes? A. Vulnerability B. Pedestrian Behaviour C. Vehicle Design D. The Road and Traffic Environment 9.5 Achieving Safe Pedestrian Environments 9.6 Safer Road Users 9.7 Safer Vehicles 9.8 Safer Roads A. Moderating Vehicle Speeds B. Separation of Vehicles and Pedestrians C. Simplification 9.9 Summary and Conclusions Chapter 10. Medical Review of Older Road Users Morris Odell, M.B., B.S. 10.1 Introduction 10.2 Licensing Guidelines 10.3 The Role of Health Professionals 10.4 Medical Assessment of Fitness to Drive 10.5 Principles of Medical Driver Assessment A. History B. Examination C. Investigations D. Specialist Assessment 10.6 Driving Restrictions and Licence Conditions 10.7 Conclusion Chapter 11. Assessing Older Drivers with Health-Related Problems: An Occupational Therapy Approach Carolyn Unsworth, Ph.D. 11.1 Introduction 11.2 Who Are OT Driver Assessors and What Do They Do? 11.3 Occupational Therapy Driver Assessment Processes and Reporting: Systems in Australia (Victoria), the U.S., U.K. and Sweden 241 11.4 Profile of Older Drivers Evaluated by Occupational Therapists 11.5 The Skills Needed to Be a Safe Driver, and the Impact of Age on These Skills 11.6 Off-Road Driver Assessment for Older Adults A. Driving Simulators 11.7 On-Road Driver Assessment for Older Adults 11.8 Rehabilitation and Strategies to Maintain Driving Independence 11.9 Future Directions in Driver Assessment and Rehabilitation Research 11.10 Summary and Conclusion Chapter 12. Older Drivers Killed on the Road—Analysis of Data from Coroner’s Files Morris Odell, M.B., B.S., and Olaf H. Drummer, Ph.D. 12.1 Background 12.2 Method 12.3 Results A. Alcohol and Drugs B. Medical Diseases C. Culpability Analysis 12.4 Discussion Chapter 13. The End of Driving Nadia Mullen, Ph.D. and Michel Bédard, Ph.D. 13.1 The End of Driving 13.2 Depressive Symptoms 13.3 Impact on Daily Activities 13.4 Impact on Others 13.5 Positive Effects 13.6 Moderating Factors 13.7 Managing Transport Needs 13.8 Preparation 13.9 Conclusion