Physicians and other health care providers find themselves caught between obligations of confidentiality (HIPAA) and their “duty to protect public safety”. Therefore, practitioners need to educate themselves about the laws of the state in which they practice and their duties of mandatory reporting.  Consultation with an attorney concerning legal obligations is essential.

1.    Immediate danger:  If you feel an older driver is at risk of crashing or doing harm to others, you can call the police and give the dispatcher details of the immediate situation. The police cannot arrest or detain the driver if he has done nothing wrong, or if the impairment is not alcohol or drug related. If he or she is clearly impaired, the police officer will try to convince him/her not to drive or arrange for him to be transported to a medical facility for examination. The police can file a request for the DMV to retest the driver or they can issue a summons for a traffic infraction.

2.    Call the Steuben County Office for the Aging (607) 664-2298 to request a supply of their “At-Risk Older Driver Program” brochures for your office.

3.    Consider treatable or temporary conditions that may be responsible for your  patient’s driving difficulties. Does he need a new prescription for his eyeglasses?  Is he experiencing situational grief or increased stress?  Is he taking a new medication that is altering his mental status or physical well-being?

4.    An excellent resource available to health care providers is called “Physician’s Guide to Assessing and Counseling Older Drivers” and can be obtained by clicking on these links: American Medical Association or the National Highway Traffic Safety Administration .

5.    Providers may consider ordering a driving evaluation by a Certified Driver Rehabilitation Specialist to evaluate driving ability of the patient.  A CDRS is an occupational therapist that can evaluate driving skills and make recommendations for driving improvement or, if indicated, recommend that the patient discontinue driving.  You can find the nearest CDRS by using this LINK: www.aota.org/olderdriver or www.aded.net

6.    Physicians can opt to complete and submit a “Medical Statement for Medical Review Unit” (DS-6) available from the DMV or the Caregiver Resource Center of the Office for the Aging.  This form, when submitted to the DMV, is reviewed by the Driver Improvement Bureau and appropriate action is taken by the Medical Review Unit.  The form must be signed by the physician and identity is not protected under Freedom of Information Law. (from “Physician’s Guide to Assessing and Counseling Older Drivers”)  http://www.nysdmv.com/forms/ds6.pdf

Note: If a physician reports a condition that can affect the driving skills of a patient, the DMV may suspend the driver’s license until a physician provides certification that the condition has been treated or controlled and no longer affects driving skills. If the DMV receives a report form a source that is not a physician, the DMV considers each case individually. (from “Physician’s Guide to Assessing and Counseling Older Drivers”)

7.    Remember that when an older driver stops driving, there must be a plan in place for their continued mobility. To longer drive is a big adjustment!  To smooth the transition, you can help by making suggestions for alternative transportation.  Steuben Coordinated Transportation is a good starting point for assistance. This program can be accessed by calling (607) 776-9467 or 1-800-346-2211.