Translating research findings and public health initiatives into practical everyday applications for patient-centered care is a constant challenge for clinicians engaged in the care of older adults. Nearly everyone, regardless of profession or specialty, will be working with older adults as either patients or caregivers in the next 20 years as the baby boomer generation enters their retirement years living longer and being more active than any previous generation. As the most mobile generation to date, these older adults are already putting in more miles behind the wheel and expect to remain mobile in the community as they age, ideally with a driving “life expectancy” that keeps up with their lifespan. In order to support older adults’ access to health care, social interaction, and nutrition through independent mobility, interprofessional clinical team members need office-based tools to screen for medical and functional issues which may affect driving ability, assess the risk of driving impairment, intervene to optimize treatment and functional ability, refer appropriately for specialized care and driving rehabilitation, and provide counseling about planning for transitioning from driving if necessary. The American Geriatrics Society (AGS) entered into a cooperative agreement with the U . S . Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) to update and expand the Physician’s Guide to Assessing and Counseling Older Drivers that was originally developed by the American Medical Association (AMA) under a prior cooperative agreement with NHTSA. The current title of the guide – Clinician's Guide to Assessing and Counseling Older Drivers, 3rd Edition – reflects the interprofessional nature of the team caring for an older adult driver. The main goal of the guide remains helping health care practitioners prevent motor vehicle crashes and injury to older adults. Motor vehicle injuries persist as the leading cause of injuryrelated deaths among 65- to 74-year-olds and are the second leading cause (after falls) among 75- to 84-year-olds. While traffic safety programs have had partial success in reducing crash rates for all drivers, the fatality rate for drivers over 65 has consistently remained high. Increased comorbidities and frailty associated with aging make it far more difficult to survive a crash, and the expected massive increase in the number of older adults on the road is certain to lead to increased injuries and deaths unless we can successfully intervene to prevent harm. Health care practitioners caring for older adults are in a leading position to address and correct this public health concern at the individual patient and caregiver level. By providing effective health care, clinicians can help their patients maintain a high level of fitness, enabling them to preserve safe driving skills later in life and protecting them against serious injuries in the event of a crash. By adopting preventive practices–including the assessment and counseling strategies outlined in this guide–clinicians can better identify older drivers at risk for crashes, help enhance their driving safety, and ease the transition to driving retirement if and when it becomes necessary. (Author/publisher)
Abstract