Parkinson's Disease Progression and Driving

How to Decide When to Curtail Your Driving

Older man getting out of car
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As Parkinson’s disease progresses it gets more difficult to react quickly and to think of several things at once. Your vision starts to get a little blurry as well, and you may have double vision.

If you are a friend or relative of a person with PD, you very likely find it difficult to speak to your loved one about this issue as he or she sees the driving as a form of independence that needs to be protected.

Each one of you—patient, friend or caregiver—tries to convince the physician of your case with the caregivers demanding a cessation of driving and the patient denying any difficulty with driving whatsoever. Very often the physician is unaware that he need not make a decision alone and that instead he or she should refer the family to a driver assessment program.

These programs are usually run by occupational therapists. If your doctor does not mention a driver assessment and rehab program, ask an occupational therapist for a referral.

Unfortunately, it usually takes an accident or a near-accident to convince everyone concerned—especially the patient—to seek out a driver assessment program. It may be wise—and life-saving—to undergo a routine driver assessment from day one, after you recently diagnosed, and then each year thereafter. (A large portion of PD patients stop driving by five years of the disease.) Other reasons to undergo a test: sign of intellectual impairment, excessive daytime sleepiness, hallucinations or other serious side effects of drug therapy, and any indications that a patient's medications are becoming less effective ("wearing off" of the positive effects of the medication).

Driving Tips for PD Patients

Even if you pass a driver assessment test with flying colors, prudence suggests that you follow these simple rules for safer driving:

  • Try not to drive after dark or during rush hour.
  • Let other people do the driving if possible.
  • Take public transportation as often as possible.
  • Do not drive at the time of day when you are most fatigued or sleepy.
  • Seek out friends and support groups to set up carpool arrangements or to hitch a ride with safe drivers.

When it comes to driving always err on the safe side: when in doubt, check it out. Take a driver assessment test.

Stewart A Factor, DO and William J Weiner, MD. Parkinson’s Disease: Diagnosis and Clinical Management: Second Edition Edited by. 2008 Demos Medical Publishing.

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