Advocacy group calls tests unlawful and unfair
Cognitive assessment tests used to determine seniors’ driving abilities are discriminatory, said a seniors’ advocacy group in Alberta.
“Seniors are losing their rights and they don’t even know what happened,” said Ruth Adria, spokesperson for the Elder Advocates of Alberta Society.
Adria has been advocating against cognitive driving tests after receiving many complaints about seniors’ licenses being “arbitrarily taken away.”
She said when seniors reach the age of 75 in Alberta, they receive a medical examination form. Seniors are instructed to take the form to their physician, Adria said, which could result in them being given a cognitive assessment test.
The assessment is administered by a health care professional to determine if they are mentally able to drive safely, said Dr. Bonnie Dobbs, director of the Medically At-Risk Driver Centre at the University of Alberta.
The test assesses patients on memory, selective attention, divided attention, decision-making, judgment and the ability to manipulate information – all the mental tasks required to drive, Dobbs said.
It was first used in July 2010 in Edmonton, Dobbs said.
“The great uptake from the medical community to me speaks to the need for the screening tool – that physicians really want to make evidence-based decisions regarding fitness to drive.
“It’s just proactive screening on their part. It would be like physicians starting to screen for breast cancer.”
But not everybody is happy about this test.
Adria said, “There should be no test. There is no lawful right.”
She said seniors who receive the form should have a physical exam, and if they are physically fit, their license should be renewed.
“Never mind all these other things,” she said.
Dobbs said she has sent letters, made calls and has offered to explain the inaccuracies.
As for the seniors’ outrage, Dobbs said people with dementia or other illnesses often aren’t able to identify when they are unsafe to drive because the illness impairs their judgment.
“The person truly believes that they are still safe to drive. So any attempts by the family or the physician to get them from behind the wheel are often met with resistance,” Dobbs said.
If a physician recommends a driver assessment test, patients will often go to DriveABLE.
Dr. Bonnie Dobb’s spouse, Dr. Allen Dobbs created DriveABLE Assessment Centres Inc. in 1998 to aid physicians in deciding whether people with dementia or cognitive impairment should drive.
An in-office DriveABLE cognitive assessment tool requires drivers complete a 30 to 60-minute test on the computer that looks at their reaction time, the ability to focus and shift attention, decision-making and complex judgment, Allen Dobbs said.
He said one of the computer tasks has a set of lines that move down the screen with gaps between them. The individual is instructed to move the box between the lines by pushing a button at the appropriate time – very much like making a left turn at a stoplight.
Adria countered: “Not everybody is computer literate. When they are confronted by DriveABLE, they panic.”
However, Allen Dobbs said he made sure the test wasn’t prejudiced against people who didn’t use the computer. He said the test is presented on a computer but an assessor sits with them, explains what the task is and lets them practice first.
“All they have to do is touch a screen or press a button. If they can touch an X on a piece of paper they can do the task,” he said.
Gordon McGuffin, 86, took the DriveABLE in-office test almost two years ago. He said he received 63 per cent. He said his score was neither high enough for his license to be renewed, nor low enough for his license to be revoked.
McGuffin then went on to part two of the test – the DriveABLE on-road evaluation.
Unlike the government road test administered to new drivers, Allen Dobbs said his test focuses on confidence errors, not the rules of the road.
Confidence errors are defined as driving on the wrong side of the road, not stopping at red lights, failure to maintain the position of the vehicle in the lane, and merging without looking – errors that healthy, confident people don’t normally do in a driving evaluation, he said.
“The ultimate decision of course comes from (Alberta Transportation’s) Driver Fitness and Monitoring (branch). They make all the licensing decisions. We make recommendations to them based on our assessment process.”
Allen Dobbs said they make use of multiple sources of information to determine whether an individual is fit to drive, such as recommendations from the physician, recommendations from DriveABLE, and the person’s previous driving history.
Again, Adria said she objects to these criteria: “First of all, it is incredible age discrimination. If we are going to have cognitive tests and DriveABLE, then we’ve got to do this across the board.”
But, Allen Dobbs said: “This is not an age issue.
“It is an issue of medical conditions. Granted that as we get older we are more likely to have medical conditions that might lead to impairment, but it’s not the age. It’s the medical condition.”
Meanwhile, McGuffin said he believes spending roughly $200 to get his driver’s license renewed is well worth it for a senior. He said his family doctor approved renewing one lady’s driver’s license and she got into a serious car accident that killed a family of two adults and two children.
“She just killed them all. He said, ‘I’m never, ever going to approve a driver’s license to somebody without them doing a driver’s test,’” McGuffin said.
Adria said she believes these tests are unfair. She said, “If someone were to launch a lawsuit under the charter, it would be found that these things were grossly unfair and even unwarranted.”
Also see: My grandfather’s rules of the road