there are two post i.e post 1 and post 2 attached on file based on questions mentioned in the file. Please reply each post with reference and in text citation. each with at least 150 words
1. Nurses incorporate questions about driving to identify the need for a more comprehensive assessment. What questions would you ask?
2. What are some common risk factors that can affect driving?
3. What are some common referrals related to driving safety?
4. How will this fit with the geriatric windshield paper?
it is important for the nurse ask how well they can see, short and long distance. Do they have cataracts or glaucoma? They should also ask if they have full sensation in their feet and full range of motion and assess the extremities. It would also be necessary to assess their memory and reaction time by performing a neurological assessment and MSE.
Factors that can affect driving include Vision changes, cognition, physical function and psychomotor response. Vision changes in the older adult include reduced contrast sensitivity which can impair the ability to see lines, marks or hazards in the road. Some other visual problems associated with older age include cataracts, glaucoma, hemianopia (partial loss of visual field), and macular degeneration. The article by Contrada (2017) also mentions that some of these conditions can be corrected with surgery or treatments to allow safer driving.
According to Contrada (2017), as older adults age, “they have a decline in executive function” (p. 37), which affects behavior, judgement, thinking, decision making, and problem solving.
Some medical conditions can impair cognitive function include: Stroke, MS, Diabetes, and Parkinson’s. Physical function and psychomotor function are necessary to safely drive. Range of motion and strength of extremities is vital for driving. Normal aging and arthritis can reduce ROM and muscle strength. Physical function can be improved with physical activities to improve strength and ROM, such as yoga, dance, and exercise programs.
Referrals related to these problems include an ophthalmologist, neurologist, physical therapist, and occupational therapist. There are also driver rehabilitation programs who can assess and determine if a road evaluation is needed. They can provide training and education if the evaluation shows the need. These programs can help the patient not to lose their license and have independence (Contrada, 2017).
For the windshield paper, It will be important that these referrals be nearby the patient and require no highway driving and the appointments would need to be during the day as the patient does not drive in the dark. It would also be important that the professional takes the patient’s insurance since the patient is on a limited income. Considering this patient has mobility and exercises, they might not require all of these referrals. But seeing an eye doctor might be able to improve vision. Driving rehabilitation might be beneficial too.
It is important to assess the health and function of older adults, as they get older because there is going to be some kind of decline physically or cognitively. Some of the assessments completed by nurses are visual exams, cognitive exams, motor performances, medication review, and self-report questions. This type of assessment by the nurse is important because the ability to drive a motor vehicle could be a major safety concern (Miller, 2019). Some of the following questions I would ask is:
Do you drive often?
Do you have any vision problems either during the day or night?
Do you have any illness and what types of medications are you taking?
Do you get lost or forget where you are?
Have you been involved in a car accident recently?
Some of the risk factors are age-related changes to vision, musculoskeletal function, and central and autonomic function. In addition to medication use, cognitive impairment, and medical conditions can also increase unsafe driving (Miller, 2019). Some of the impairments faced by older adults are glaucoma, dementia, arthritis, diabetes, and more. Identifying risk factors for unsafe driving can minimize the risk through the intervention being addressed due to these factors (Miller, 2019).
Nurses have an important role in facilitating referrals for education, evaluation or programs, and rehabilitation related to driving safety. Driver education programs are a type of recourse that can help identify driving issues so that improvements can be made. Some evaluation programs help with modifying cars for older adults with physical limitations and driving rehabilitation (Miller, 2019). Older adults can participate in education programs such as AARP (Maturing Driving Program) and the American Automobile Association (Safe Driving for Mature Operators). The main point of these is not to take away driving privileges but instead improve safety (Miller, 2019).
This will fit with the geriatric windshield paper by addressing these topics that are faced by older adults.