Excerpt: 'The Driving Dilemma'

Recent near misses or close calls while driving. Sometimes a near miss isn't our fault, but sometimes it is a symptom of declining driving performance. It's important to know which is the case in order to evaluate the risk for the driver.

Having friends or relatives say they don't want to ride with the driver, or having them say they don't want their children driving with that person.

Since people are often reluctant to speak up about their concerns for a person's driving, such expressions should be taken seriously as a sign that something is wrong. If concerns are raised, get the details and follow the guidelines presented later in this book for initiating a conversation and taking action.

Accumulation of vehicle dents and dings. Backing into things or scraping walls or other objects may indicate vision, mobility, or navigational problems. Minor fender benders also signal that driving fi tness is slipping.

Feeling uncomfortable, stressed, or exhausted when driving. Stress and exhaustion are signs that a driver may not be feeling fully competent behind the wheel and, thus, can be a signal that driving skills are diminishing.

Having other drivers honk, gesture, or seem annoyed at you when driving.

Unless you live in a city that is famous for rude drivers, honking, yelling, or other "impolite" actions are probably a clue that a person's driving is either erratic or outside the norm, both of which can be a sign of trouble.

Diffi culty judging gaps in traffi c at intersections and on highway entrance and exit ramps.

Age-related changes in the eyes may impair depth perception.

Failing to notice vehicles or pedestrians on the sides of the road when looking straight ahead.

Being surprised by the sudden presence of pedestrians or cars could indicate a diminished fi eld of view, which is vital to safe driving.

Not seeing lights, signs, signals, or pedestrians soon enough to respond to them smoothly.

Getting lost more often than in the past, especially in familiar areas.

This could signal memory problems or other cognitive defi cits. Trouble paying attention to traffi c signals, road signs, and pavement markings.

This could be a sign of a problem with the cognitive ability to divide attention and to respond to multiple cues simultaneously.

Slow response to unexpected situations. This could signal impaired thought processes related to recognizing stimuli and attaching meaning to them or a delay in physical reactions.

Becoming easily distracted or having diffi culty concentrating while driving.

New or worsening medical conditions. Chapter 2 explores medical conditions and driving in detail. The worsening of a condition may require adaptations.

Taking medications with side effects that can impair driving safety. Many medications carry warnings about operating machinery or driving while taking them. In Chapter 3, many common medications and their effects on driving safety are discussed.

Not using the safety belt. Forgetting to take advantage of the safety belt could signal problems with memory. If it isn't that the driver forgets to use the safety belt, but that he or she can't operate it because of physical limitations, there are seat belt extenders that can lengthen the receptacle and strings or ribbons that can make it easier to pull the belt over the shoulder and torso.

Diffi culty negotiating sharp turns and intersections. These may refl ect problems with seeing or moving, both of which impair safety.

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