Monday, 27 October 2008

Reeling in Pain

Dear Little Sister,

Dad went for his two hour evaluation at Sunnyview Hospital for his
driving today.
He had some sitdown tests and then he and the evaluator went out
driving for 45 minutes.

Although Dad's reaction time is above average for his age,
he has visual inattention, poor visual scanning, poor color
discrimination, depth perception and

peripheral vision losses, poor impulse control all which indicate that
he should not be driving at all.

It was obvious to me during the pen and paper testing that Dad does have
some cognitive losses, memory losses (can't remember three words a few

minutes later-- 2 out of 3), sequencing difficulties (drawing lines
dot to dot in order
and serial sevens), has visual discrimination problems (multitude of
examples throughout

the testing and not able to be corrected by glasses) and his distance
vision corrected
is 20/40 (near for reading corrected is 20/30).

When the evaluator took him driving, she had to grab the wheel at one point
in order to prevent Dad from turning in front of another vehicle.

There were other problems with the driving also:
high distractibility, driving 15 mph below the speed limit at some points,

stopping too soon before a red light, allowing someone at a stop sign to
proceed through even though Dad himself didn't have a stop sign in
front of him...

and other stuff. The driving evaluator told Dad emphatically and several
times in several different ways that the time for him to quit driving is NOW.

His safety while driving is inconsistent. The fact that he was at one time an
excellent driver shows however it is about 50/50 right now. During the

45 minute driving session he was either excellent for 50 percent of the time
and totally unsafe the other 50 percent.

Dad did not take this news very well (as was expected-- who would?) and
does not wish to talk about it yet. He did allow me to drive home and to

the diner for lunch. He also does not want to talk about his own dad
who died in a car crash in Florida when I was in second grade.

The evaluator is not allowed to send the results to motor vehicles but
she is forwarding the results to George (our primary care doc) who is

supposed to write Dad a letter. I will see if I can get him to go see George
to talk about it without me there. Dad really needs to see a neurodoc

(fortunately there is an excellent neurodoc in Albany who is an expert
on dementias and is also informed about traumatic brain injuries)

at this point so we can get a definitive diagnosis on exactly what type of
dementia he is having (or if it is an undiagnosed brain injury from one of his

accidents?) and then the proper medication for the kind of dementia it is.
The proper meds are specific to what kind of dementia as some meds are

counter-indicated in some types of dementia but work well for others.
I am going to inquire about trains since there is a station in Montvale and

there are decidedly times when Dad wants to go to New Jersey without me.
Also because of my own brain injury I really have to stop at every rest area

or every other rest area on any trip longer than 45 minutes. So at this point
unless the State of New Jersey steps in and pulls the license, I really can't

stop Dad from driving. At least we know definitively and from an objective
source that Dad should not be driving at all.

It is bad news for sure, more evidence that Dad is not well neurologically.
Hard for us to hear and go through. Even harder for him.