Functional Problems IADL’s and Senior Driving.
Why are we talking about this?
Many of your present older GCM or senior agency clients and their families experience difficulties with driving.
If you know about driving as a functional problem how will this knowledge positively impact the work that you do, as a geriatric care manager or aging professional
1. Know what to expect
2. Help families plan ahead
3. Know specific resources that can provide
4. Help you expand their repertoire of
responses to driving problems
5. Further position you as a GCM or aging professional expert
6. Help families expand their repertoire of
responses aging parental driving decline.
The GCM or aging professional can help families with issues around problems with an older driver
As I said in yesterday’s blog, older drivers are a bigger and more dangerous issue.
Many older drivers have been driving longer than their physician has been practicing. It is a rite of passage in out American culture (like a bar mitzvah)
But there is no rite of passage to take it away.
The older population has relied on being able to drive themselves through most of their lives. This is reflected in the growing rates of person’s age 65 and older who are licensed drivers.
When we take away an older person’s license it creates many problems that the GCM or aging professional needs to solve in their care plan.
There is little public transportation in many areas, especially rural areas. A significant segment of this population is aging in places where alternative modes of transportation, such as buses and walking, are not available. Many older drivers still do not know about Senior Transportation available through the older Americans Act
What the GCM or senior professional faces is there is no midlife transition model for adult children to anticipate taking parents license away
Adult children see their “Internal Parent” (parent when they were young- not present dangerous driving parent – so are afraid to take license away). The GCM’s job is to help the adult child speak to the elderly parent who lives in the here and now and help them understand why they may have problems continuing to drive.
What do older drivers get stopped for? They get tickets for
missing stop signs, and failure to yield, Younger drivers areticketed for speeding
Older drivers have more functional problems that include vision, hearing, sensation, and cognitive and motor abilities that diminish with age
The danger to society from dangerous older from drivers according, to the Center for Disease Control are serious. There is an increased crash rate per mile for older drivers. The decline in peripheral vision may affect the ability to pass approaching vehicles safely. They have a decreased range of motion in an older person’s neck may impair the ability to look behind when backing up. Finally their reaction time decreases by almost 40 percent on average from age 35 to 65.
We are still covering a functional assessment, which is part of a geriatric assessment Aging professionals, among them geriatric care managers do this assessment to help older person continue to function in his environment ( stay at level of care)
A functional assessment also evaluates the quality of care – help get right amount of care in home is example
We have been covering Instrumental Activities of Daily living (IADL’s ) . These activities that an older person needs to survive in a community environment
IADL’s have three major areas. One is
–Household chores: cooking, cleaning, shopping, transporting (using bus). Today we are going to cover shopping.
Is the older person able to assess needs for supplies and plan and execute shopping excursions independently? What type and level of help are needed if the older person cannot do these tasks alone? Asking the person questions about who does the shopping and having the person describe his or her last shopping trip can give information useful for care planning. Some persons may have difficulty carrying grocery bags but be able to make a shopping list and drive to the store. Others may have cognitive problems that interfere with the ability to survey needs, make a list, find the items in the store, and pay accurate amounts at the checkout counter. Other persons may have ambulation difficulties or low stamina as a result of a heart condition, for example, which precludes the person from walking up and down grocery aisles or going to the mall to buy clothing.
If you as an aging professional or geriatric care manager assess shopping ability as part of IADL’s then you will have to come up with solutions in the forms of a care plan. Here are some suggestions that you might add to that care plan.