It may start with a tremor followed by muscle stiffness and a decrease range of movement but as Parkinson’s disease progresses so do its side effects. Aside from the well-known and more common symptoms of Parkinson’s disease, a positive diagnosis also means a whole slew of secondary symptoms such as a softening of the voice and decrease in facial expressions. These can adversely affect a patient’s ability to communicate and can lead to frustration.
Other secondary symptoms include difficulty sleeping, decrease in cognitive ability and stiffness in the limbs. These symptoms, along with many more, have a significant impact on a patient’s day to day life in particular their independence. This is especially true when those side-effects lead to a decrease in a patient’s ability to do day-to-day activities, such as driving, and results in them having to give up their license and means of transportation.
In a longitudinal cohort study (that means a study in which data is gathered from the same subjects over and over again during a defined period of time that can last years and even decade), two separate groups were studied on a set driving course. The purpose of this particular study was to determine how a disease like Parkinson’s can affect a patient’s driving ability. In this case, researchers worked with a group of drivers who were in the early stages of Parkinson’s and a group of drivers that did not suffer from the disease at all.
How long can PD patients stay behind the wheel?
After completing the baseline assessment and everyone’s driving abilities were measured against one another, it was determined that overall the driving abilities of the PD patients was on par to those of their healthy counterparts. It’s important to note that the baseline assessment also determined which of the patients’ driving abilities had become impaired early on by the disease and other factors.
In as little as two years, when the selected patients in the study were tested again, researchers found that the Parkinson’s patients made a significantly larger number of mistakes then their healthy test mates. In fact, at the 2 year mark, Parkinson’s patients made as many as 49.7 mistakes on the driving courses versus the healthy control group that only made 34.6 mistakes. Tests also indicated that Parkinson’s patients made a much larger number of bad turns, crowding and other poor driving moves ranging from mild to severe mistakes.
It’s not always the tremors
Most assume that the onset of tremors is main reason for a decline in driving ability, but that is not always the case. The reason for the decrease in driving ability of Parkinson’s patients has in itself not been studied. However, after looking at the disease and its many side effects, it’s very easy to make the association between the variety of symptoms of the disease and a PD patient's inability to drive safely. To be a good and safe driver, one must have good reflexes and good vision. A driver who is not able to clearly see signage on the road or to quickly maneuver the car away from a potential accident should not be behind the wheel. Since Parkinson’s disease can not only affect the reflexes and vision but also the ability to grip a steering wheel, it’s clear to see why drivers with PD can quickly lose their ability to safely drive.
Wait before taking away their keys
A study like this does not mean that when someone receives a Parkinson’s diagnosis, they must immediately lose their license. It would be unfair to take away something that provides a sense of independence to someone who has been just given a life changing diagnosis. However, studies such as this one, do indicate that medical providers and the caregivers of patients with Parkinson’s who drive, need to closely monitor the progression of the symptoms and the driving ability of those patients in their lives. PD patients, particularly those whose disease quickly has an effects on their cognitive abilities, motor skills and vision, should also take the steps required to regularly test their driving ability.
While researchers, scientists and doctors are continually studying Parkinson’s in the hopes of reducing symptoms, and maybe one day, finding a cure, there is still a long ways to go. There are however, many theories and practices around what can be done to improve some of the side-effects that come with PD. Many doctors, occupational therapists and psychologists believe that the implementation of physical exercise and cognitive training into daily life could improve patients’ mobility, slow the progression of cognitive impairment and potentially preserve patients’ driving abilities for longer periods of time.
Another and very simple way to prolong a PD patient’s ability to drive is car modification. Special handles installed around the vehicle’s door to make getting in and out of the car easier as well as grips installed on the steering wheel are just two ways to make cars more PD friendly. If a PD sufferer happens to be in the market for a new vehicle, they can even talk to local dealerships as many automotive manufacturers provide accessible vehicles a part of their company mandate.
When is it really time to stop driving?
Despite taking steps to prolong the ability to drive by implementing exercise into daily life and modifying a car, and despite how lost someone might feel without their vehicle and their ability to drive, there does come a time in the progression of Parkinson’s disease when it becomes evident that it’s time to hang-up the keys and stop driving. If the decision is made with the support of their medical team, family and caregivers, it can be an easier transition for the patient and everyone involved.
If there is suddenly an increase in close calls on the road or worse, fender-benders or even more significant accidents than obviously, that is a pretty good indication that PD patients should move to the passenger seat. Less obvious signs can include occasional complaints of weakness in the hands, arms and feet, as this would make driving safely extremely difficult. A complaint of frequent headaches or not being able to clearly see objects at a distance is another indication that should be looked out for. Patients who show signs of cognitive impairment also need to be closely monitored, as those who have dementia are often not able to react quickly enough to be on the road.
When it does get to that point and a PD patient needs to give up their license because their ability to drive has been severely impacted, it’s important that they have a support team around them. From the moment, a person receives their diagnosis, their medical team and their family should have a transportation contingency plan in place. The plan should include options for different ways of getting around from Uber, to transit to volunteer drivers, a list of the signs that indicate that their ability to drive is being impaired and a list of support groups that they can access.
Studies of all the aspects of Parkinson’s disease are cropping up daily, and many researchers are looking at how regular day-to-day activities, such as driving, are affected. More longitudinal studies that follow PD patients, the progression of their disease and how it affects their day to day lives are critical to ensuring that those with PD and their families have the support and resources in place to continue to live a normal life.