How high on the list of difficult conversations is this one:

You’re an adult having to tell your mother or father that he/she shouldn’t drive anymore… or a spouse having to give your wife or hubby the same message.

This is often the case after someone has had a stroke… which doesn’t make the conversation (or the decision about whether continued driving is safe) any easier.

But I’ve come across an interesting new study that I think may offer some real practical help in easing you through that tough conversation.

Belgian researchers have identified a series of three relatively simple tests — soon to be available in the US.
Once that happens, taking them should be quite easy. The estimated time needed is only 15 minutes.

The tests can identify who would and who wouldn’t be likely to pass a typical driving road test — a good (but not perfect) indication of who would be a safe driver after a stroke.

Besides sparing you from a wrenching argument with a hurt, defensive and very possibly angry parent or spouse, this might also spare the stroke survivor from having to try to prepare for and get through an official road test — as they may be required to do after a stroke — and ultimately fail it.

HOW SERIOUS WAS THE STROKE?

Before we get to these simple new tests, the first thing to know is that for many people, driving is still safe after a stroke — depending, of course, on the amount and type of damage done and the success of rehabilitation therapy.

To find out more, I checked with the lead author of the study, Hannes Devos, PhD, PT, in the department of rehabilitation sciences at the Catholic University of Leuven in Belgium.

“Much depends on the area of the brain that’s affected,” he explained. If the stroke took place in the temporal lobes, which are key to the ability to perceive and understand information, a stroke survivor might see a street sign and be able to read the words… yet not know what they mean.

If it’s the occipital lobes, which receive and organize input from the eyes, that are affected, then vision might be impaired.

And if the stroke occurred in the frontal lobes, where higher organizational function is maintained, then judgment, problem solving ability and motor skills — all obviously vital to safe driving — might be lacking.

Making things even more difficult is the fact that some stroke patients are not aware, or not fully aware, of their deficits, Dr. Devos added.

“For example, they may think that nothing serious is wrong with the way their body works even when muscles on one side of the body are barely working at all, so they don’t comprehend what’s dangerous or what must be avoided,” he said.

Unfortunately, strokes can be cruel that way… so what I wondered about the new study was, how could all of this — the physical and the psychological — be sorted out in just 15 minutes and tell us who should and who shouldn’t be driving?

HOW THE TESTS WORK

Out of the 1,728 people studied, 54% passed their road tests, the best determinants of success being the following three tests…

The road sign recognition test. In this segment, the person being tested is asked to match 12 road signs, where their meaning must be recognized and matched to cards showing particular driving situations —

for example, they might have to match a road sign indicating construction ahead with a card “depicting” men repairing a road.

The compass test. This is a test of perception, attention and mental speed that involves placing cards with “vehicles” on them so that the vehicles are lined up properly according to the directions indicated on a second card —

a compass with an arrow showing various directions. This tests the ability to understand directions consistently and under pressure.

The trail making test part B (TMT B). In this segment, participants are asked to quickly connect circles containing numbers or combinations of the numbers one to 12 and the letters A to L, as in 1-A, 2-B, 3-C.

What’s measured here are visual motor abilities and the ability to shift one’s attention.

The tests aren’t perfect, but the authors of the study say that they can correctly identify 80% to 85% of those tested who would make unsafe drivers.

Importantly, the tests failed to identify 15% to 20% of unsafe drivers — and researchers point out that they may also fail to identify some safe drivers, as well.

But post-stroke road tests could make up these gaps.

For families who are sure or fairly sure that driving should no longer be an activity for a loved one, these tests can be a big help in terms of satisfying everyone involved that getting behind the wheel is just no longer a good idea.

Dr. Devos says the tests will be available in the US in the very near future and that physicians, neuropsychologists and occupational therapists will be able to help obtain and administer them. I’ll keep my eye out for them.

Source(s):

Hannes Devos, PhD, PT, department of rehabilitation science, Catholic University of Leuven, Belgium.

Many of my friends on Guam called to give me the answer to the question. The consensus seems to be it started with Bush along with his regulations that made sending things to Guam so difficult for the mainland.

The extra cost and paperwork has made fortunes for those in the business of suppling the paperwork to send a package to Guam. If only the American tax payers knew.

Peter

Boy was she right. Now we are even adding silicone to increase them. We went to the mall together yesterday laughing and pointing out the ones who have gotten the message that ass is in and those still a little ashamed of their “Junk.”

So much fun was had by all. Thanks Zen Lill

Katt

The republicans are the ones who once they get there president in the White House, they manage to stay the full 8 years to totally screw up the economy and the judicial system of this country. Only the first Bush didn’t get a second term for the republicans.

But most democrats are unaware that they haven’t been able to give their presidents a two term period in the White House since Roosevelt did it back in 1945, except for Clinton. Obama is up against the odds in more ways than one. Democrats have a long history of not giving their presidents a second term.

The republicans usually figure out what to tell the white voters to get their vote the second time if they lost them the first. So they seem too have this time. Race being another stone Obama has to drag isn’t helping either.

But as Herman said Obama needs to define who he is. And as Wendy said he needs to stand up for the class who’s side he is on in this war. There was another quote from Buffet cited in that article by Robert Kuttner that I read yesterday Obama should be quoting as he campaigns across the country.

He should quote Buffet when he once said of class warfare that there was indeed a class war in America and his class, the very rich, were winning.

Robert