Flashcards in Lecture 11 Sensory function and safe driving Deck (28):
A _ is an electronic device for text communication over a telephone line designed for use by persons with hearing or speech difficulties.
TDD (telecommunications device for the deaf).
Skills related to driving (1 of 2)
1. Lower body strength, range of motion, mobility, and coordination to use *foot-operated controls*.
2. Upper body strength, range of motion, mobility, and coordination to use *hand-operated controls* and to turn head and body to the left, right, and rear to observe for other traffic and pedestrians.
3. Ability to hear other traffic and vehicle warning devices.
4. Ability to see other traffic, road conditions, pedestrians, and traffic signs and signals.
Skills related to driving (2 of 2)
1. Cognitive skills - ability to think, understand, perceive, and remember.
2. Ability to maintain normal consciousness and bodily control - to respond to stimuli.
3. Ability to maintain a normal social, mental, and emotional state of mind.
In order to legally drive *in Louisiana*, a person must be free from loss of consciousness *and* seizure activity for at least _
_ will more readily give up their driving privilege when they feel that they are no longer safe to drive.
*Negative* consequences of driving retirement include _
Decreased freedom and independence, alterations in socialization, changes in mobility, feelings of helplessness.
*Positive* consequences of driving retirement include _
Safety, increased walking, exploration of other transportation and social resources, financial savings.
An over-the-counter medication that is frequently associated with impaired driving is _
Diphenhydramine (Benadryl) - adversely affects speed, mood, attention, vigilance, working memory, and level of activity.
The risk for a car collision at an intersection is greatest when _
Making a left turn (requires crossing more lanes of traffic).
Age-related changes regarding *vision*
1. Presbyopia - far-sightedness.
2. Diminished visual acuity - interferes with perception of fast-moving vehicles.
3. Delayed dark and light adaptation - may impact driving through tunnels.
4. Diminished depth perception.
5. Increased sensitivity to glare - interferes with perception of objects.
6. Narrowing of the visual field.
7. Altered color perception.
8. Slower processing of visual information.
Decreased ability to discern the colors _ and _ is a normal age-related change.
Blue and green.
Older adults retain the ability to discern the colors _ and _ the most.
Red and yellow.
Bright sunlight at sunrise/sunset interferes with perception of _ and _ traffic lights.
Red and blue.
1. Pathologic condition of the eye in which the normally transparent lens of the eye becomes cloudy, transmission of light to the retina is diminished, and vision is impaired.
2. Impact on driving: Problems with night driving; *increased* sensitivity to glare; *decreased* contrast sensitivity; *halos* and blurred objects; diminished color perception; double vision may be present.
3. Can be prevented by protecting one's eyes from *sunlight*.
Age-related macular degeneration (AMD)
1. Pathologic condition of the eye in which the area in the middle of the retina is damaged by deposits of retinal pigment.
2. Impact on driving: Loss of *central vision* - person will only see the outer areas of the visual field.
1. Pathologic condition of the eye in which an abnormal buildup of aqueous humor increases the pressure within the eye.
2. Impact on driving: Loss of *peripheral vision*; poor vision in dim lighting; sensitivity to glare.
*Ototoxic* medications include _
1. Aspirin and NSAIDs.
2. Furosemide (Lasix).
3. Antibiotics (especially aminoglycosides or '-micin' drugs).
Regardless of the source, a referral for a driving evaluation must be accompanied by _
A doctor's order.
Factors related to candidacy for a driving evaluation include _
1. Has known equipment needs.
2. Has a physical or medical problem that would affect driving (e.g., stroke, spinal cord injury, etc.).
3. Has a stable medical status.
4. Is free from visual/perceptual deficits (this does not mean the person cannot be assessed - needs can be identified).
5. Is free from cognitive deficits.
6. Has been seizure-free for at least 6 months.
7. Does not take medications that would interfere with driving.
Mandatory reporting laws for potentially unsafe drivers
In Louisiana, there are *no* mandatory reporting laws. If a physician chooses to report, however, there is a law that protects them from retaliation.
The ideal *funding source* for driving evaluation and rehabilitation is _
Vocational rehabilitation or veterans services.
*Informed consent* for a driving evaluation must be accompanied by _
A disclosure that the patient's driving license may be suspended, revoked, or restricted based on the results of the assessment.
Assessment of Driving-Related Skills (ADReS)
Elderly driving assessment guide developed by the American Medical Association; includes the following tests:
1. Peripheral visual fields by *confrontation testing*.
2. Rapid pace walk.
3. Manual test of range of motion.
4. Manual test of motor strength.
5. Trail making test.
6. Clock drawing test.
Between 25% and 40% of individuals aged 65 and older and 40% to 66% of individuals aged 75 and older have some degree of _
Among older adults with hearing loss, _ is the most common cause.
Presbycusis (age-related sensorineural hearing loss).
Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S)
1. 10-item questionnaire developed to assess how an individual perceives the *social and emotional effects* of hearing loss (i.e., does not assess actual hearing capacity).
2. The higher the HHIE-S score, the greater the *handicapping effect* of a hearing impairment. Possible scores range from 0 (no handicap) to 40 (maximum handicap).
3. *Audiologic referral* is recommended for individuals scoring *10 points or higher*.
Short attention span and easy distractibility are indicators of _