Monday, February 20, 2017

DriveABLE BC

The following is a report done by the Social Concerns Committee of the Retired Teachers Association. In BC when a person reaches 80, they are required to take a test to determine their ability to drive. This test is done every two years and there is no standard fee for the test. As a result, some seniors have paid over $300 for the test by the Doctor and some have paid $50.00.

 

The Province's DriveABLE program tests drivers with a computer touch screen and has resulted in people having their drivers' licence cancelled. We believe recent efforts to improve the DriveABLE program's image and accessibility are simply wrongheaded. 


The program is not "misunderstood" – it is simply wrong: poorly conceived, unsupported by current science, a violation of our charter rights and tainted by conflict of interest. Improved access will only bring more harm.

 

BC Motor Vehicles Fitness to Drive
A member’s bitter experience led us to look into the DriveABLE program. His wife's driving licence was revoked after failing a computer-based test. We did some digging and "put out the word". Our members and others are really angry. Rather than a scientific breakthrough in public safety, we have a program based on out of date research. We have privatized public policy developed by consultants, delegated to clerks and computers and outsourced to independent contractors.

Recent Developments

On March 19, 2016 Shirley Bond, Minister of Justice and Attorney General, announced changes to the DriveABLE program: "… a decision regarding a person’s ability to continue driving will not be made solely from an in-office computer assessment. People who fail the computer assessment will be offered a DriveABLE road assessment. The results of the in-office assessment combined with the on-road evaluation and medical information will ensure licence decisions are made in the fairest manner possible. The Province will pay for the cost of both assessments."

Our efforts, and those of others advocating for seniors have had some impact. Drivers' licences will no longer be suspended "on the spot" as a result of a screening test.

Are we there, yet? No.

We believe that efforts to improve the program's PR and accessibility are simply wrongheaded. The program is not "misunderstood" – it is wrong. It should be cancelled. Improving access will only result in more people's lives being damaged.

Background
There are two programs under the Office of the Superintendent of Motor Vehicles (OSMV) that affect seniors' driving: the 80+ medical assessment and DriveABLE.
      After the age of 80, accident free or not, drivers are required to get a doctor’s assessment of their medical fitness to drive. While most receive a positive report, others may be referred for further assessment. (DriveABLE)
      Under the DriveABLE program, a report from the police, health care provider or "concerned citizen" may result in having to take a DriveABLE test. The purpose of the test is to assess cognitive fitness.

The DriveABLE program is based on an out-of-date view of the world. Twenty years ago, there was what amounts to a moral panic about aging and driving; an apocalyptic vision of a "grey wave" of demented "wrinklies" careening down the roads. It was not hard to convince funding agencies and academic journals of the risks inherent in the rising tide of demented drivers. Clever entrepreneurs have used fear, uncertainty and doubt to promote their agenda and their products.

The real world, thank goodness, has not cooperated. Seniors' accident and death rates have gone down, not up. Cooler heads have prevailed in the academic world. Where mass screening of drivers for cognitive fitness was sliced bread in the '90's, a respected voice in health care now says:

…the available literature fails to demonstrate the benefit of driver assessment for either preserving transport mobility or reducing motor vehicle accidents."

adding their reasons:

the cognitive test that most strongly predicted future crashes would … prevent six crashes per 1000 people over 65 screened, but at the price of stopping the driving of 121 people who would not have had a crash.

Attitudes about senior drivers are changing but we still have work to do. Too many conversations about aging drivers include words like these:

"No one wants unsafe drivers on the road"

thus justifying almost any level of heavy-handed intervention into seniors' lives.

This is unhelpful. We will always need to strike a balance between mobility and safety. The only way to have no unsafe drivers on the road is to have no drivers or close the roads. Drawing neat little lines in the sand isn't possible.

Our Continuing Concerns
      The harm caused by the DriveABLE program far outweighs the benefits. The program casts too wide a net, damaging people's lives. We have seen little acknowledgement of the impact of driving cessation. We need a balanced, thoughtful review of this program with community input. The review must exclude those who have an institutional bias or business interest in the outcome. • The driving record should be the "gold standard" not the DriveABLE road test.
      The over 80 medical exam should be discontinued. In reviewing European experience, the UK Transport Research Laboratory stated: "There is no evidence that any licence renewal procedure or requirement for a medical examination has an effect on the overall road safety of drivers aged 65+"
      Since the fatal crash rate for 70-74 year olds, 75 - 79 year olds and 80+ year olds is now less than that of 35-54 year olds there is no justification for discriminating against seniors.
      Retraining and remediation are absent from the OSMV's program. The belief seems to be that cognitive impairment is incurable, decline inevitable and remediation impossible. This doesn't square with modern science. One cognitive factor which modern research has found to be strongly predictive of crashes is the Useful Field of View - UFOV. Training is readily available which remedies UFOV problems and would undoubtedly reduce risks and promote independence. There are likely other remedial approaches. OSMV relies solely on driving cessation.
      Our doctors have been misled into believing that they are liable for damages under case law if they don't report on those they believe unfit to drive. A professional development document for BC doctors cites a 1973 precedent that was overruled in 2003. A minor quibble, you say? Ask your doctor how she feels about being misled and bullied into reporting. We believe this program damages the doctor-patient relationship; patients becoming guarded about disclosing information to doctors; doctors reluctant to bring up the subject of driving. Medicine doesn't work on a "don't ask, don't tell" basis. We support the Neurologists position; physicians should be free to report or not report based on their assessment of the needs of the individual, the family and the community.
      If seniors must be screened and assessed, then individual and community needs must be taken into consideration. We believe that physicians - people we trust - should be the major players in the complex decisions about driving restriction, retraining, remediation or cessation. We need the "meaningful and trusted consultation" that only our doctors can provide, not a heavy-handed approach with all of the decisions being made by clerks, computers and contractors.

If you or anyone you know has lost a drivers' licence through taking a DriveABLE test, you should write to:
Office of the Superintendent of Motor Vehicles
Attn: Driver Fitness Unit
PO Box 9254 STN PROV GOVT Victoria, BC V8W 9J2

and request a road test.

Sunday, February 19, 2017

More Resources for Seniors

The information listed here is for seniors in BC but if you do a Google Search with your location in the search, you may find your community, state or province has similar services

Information here was taken from Office of the BC Seniors Advocate website at: https://www.seniorsadvocatebc.ca/  

The Office of the Seniors Advocate monitors and analyzes seniors’ services and issues in BC, and makes recommendations to government and service providers to address systemic issues. The OSA was established in 2014 and is the first office of its kind in Canada. Isobel Mackenzie, the BC Seniors Advocate, has over 20 years’ experience working with seniors in home care, licensed care, community services and volunteer services.

Health Care: Resources for Seniors
There are three main provincial websites detailing programs and services for seniors’ health care.
View the B.C. Health website to learn more about:
§  Financial assistance for Medical Services Plan coverage
§  Financial assistance with the cost of prescription drugs and medical supplies through Fair PharmaCare
§  Accessing health care services including assisted living, residential care, and home & community care.

View the Seniors’ Health website to learn more about:
§  Specific health concerns such as cataracts, dementia and heart disease
§  Advanced care planning
§  Emergency preparedness

View the Planning for Healthy Aging website to learn more about:
§  Healthy lifestyle choices
§  Protection from elder abuse and neglect
§  Lifelong learning and community participation

Housing: Resources for Seniors
There are two main sources of information on provincial government housing programs and services for seniors.
§  Home Improvement Assistance Programs
§  Rental and affordable housing
§  Supportive housing
§  Home Adaptations For Independence
§  Shelter Aid for Elderly Renters (SAFER)
§  Assisted living
§  Seniors’ supportive, rental and subsidized housing
Income Supports: Resources for Seniors
Both the federal and provincial governments have income support programs for seniors. The federal government runs the Canada Pension Plan, Old Age Security and Guaranteed Income Supplement programs.

View the Government of Canada’s seniors’ website for information on:
§  The Canada Pension Plan
§  Old Age Security
§  Guaranteed Income Supplement
The provincial government runs programs for low-income seniors to access medical services and supplies, transportation and housing. It also contains legal information on protecting yourself and finances.

View the Province of B.C.’s website to learn more about:
§  MSP and Fair PharmaCare programs for low-income seniors
§  Subsidies for housing and transportation
§  Legal information on protecting yourself and your finances

Personal Supports: Resources for Seniors
Personal supports help seniors live as independently as possible. These supports are complimentary to the medical services provided by Home & Community Care programs in B.C.
There are three key websites with information about personal supports:
§  Visit the B.C. Personal Supports website for services and programs to assist people with disabilities, including mobility, hearing and communication challenges.
§  Visit the Better at Home website to learn more about the services that might be offered in your community, including housekeeping, home maintenance and repairs, and friendly visiting.
§  Visit the BC211 website, or dial 2-1-1, to find community, social or government services in your area.

Transportation: Resources for Seniors
§  Driving your own vehicle, carpooling and car-sharing
§  Public transit, including HandyDART
§  Taxis
§  Walking and cycling
§  Ferries
§  Volunteer driver programs
§  Medical travel assistance


The Seniors Transportation Access and Resources (STAR) website also has useful information for seniors and their families. Click here to visit the STAR website.

Saturday, February 18, 2017

Spotlight on Vulnerable Seniors in Vancouver

Information taken from an Infographic by Sparc BC (Social Planning and Research Council of BC) and United Way of Lower Mainland
 ·       Between 2001-2011, the seniors’ population increased from 70,335 to 81,930. (an increase of 16%)
·       Between 2001-2011, the number of people over the age of 100 increased from 95 to 165 seniors. (an increase of 74%)
·       Between 2001-2011, the number of seniors living alone increased from 20,030 to 21,575. (an increase of 8%)
·       In 2011, the Vancouver Health Service Delivery Area found that 26% of seniors had per-ceived their health as fair to poor.
·       Between 2000-2010, 3,345 new immigrant seniors settled in Vancouver.
·       One-third senior households spend 30% or more of their income on housing. Between 2006-2011, this number rose from 12,635 to 14,025 seniors. (an 11% increase in seniors at risk of losing their homes.)
·       Between 2009-2012, the number of seniors and persons with disabilities (PWD) on BC Housing’s social housing waitlist in-creased from 1,575 to 2,172 people. (a 38% increase)
·       In 2011, 15,190 seniors lived on a low income. Seniors living alone had after-tax incomes of approximately $19,500 or less. Seniors living in couples had after-tax incomes of approximately $27,250 or less. (one in five seniors live on a low income)
·       Between 2001-2011, the number of seniors who could not speak English increased from 15,755 to 17,740 seniors. (23% of seniors cannot speak English)
·       In 2011, Cantonese (12,305) and Mandarin (9,410) were the most commonly spoken languages among seniors other than English. (63% of seniors do not speak English as their first language)


Friday, February 17, 2017

Hearing is a problem for Boomers

I use a hearing aid, and I have done so for about three years. My hearing loss, took a long time and it was gradual, so I did not notice that I needed the aid. When I looked at the stats I was surprised. Here is some background information on this problem.

About 31.5 million Americans—one in 10—experience impaired hearing. Hearing loss affects all ages, but specifically, there are more baby boomers aged 45-64 with hearing loss (10 million) than there are people over the age of 65 with hearing loss (9 million). As baby boomers reach mid-age, a time when hearing loss frequently becomes more noticeable, they face concerns about what to do about their hearing loss. Boomers may have more hearing problems at an earlier age than previous generations.

Boomers had a noisy lifestyle, many had prolonged exposure to rock concerts, loud stereos, city traffic, power tools, and lawn mowers and this may take its toll on our ears. My problem was a result of shooting guns when I was younger, according to the Audiologists I saw, she also said that listening to loud stereos and going to concerts did not help.

Hearing care professionals confirm that they are seeing more younger clients seeking help with hearing loss. The National Institute on Deafness and Communication Disorders reports that 20 million Americans are exposed to dangerously noisy environments. Of the 31.5 million Americans with hearing loss, 10 million of these impairments are partially attributable to damage from exposure to loud sounds. Most hearing loss
How does your hearing work?
As sound passes through each ear, it sets off a chain reaction. The outer ear:
1.   Collects pressure (sound) waves and funnels them through to the ear canal. These vibrations strike the eardrum. The eardrum vibrates the delicate bones of the middle ear
2.   That conduct the vibrations into fluid in the inner ear
3.   The vibrations stimulate tiny nerve endings (hair cells) that transform vibrations into electro-chemical impulses. The impulses travel to the brain
4.   Where they are understood as sounds, such as speech, music, or noise.

What are the signs of hearing loss?
While a history of hearing loss in your family or exposure to high noise levels may cause hearing loss, the easiest way to identify hear­ing loss is to notice how your hearing affects your daily life. You are probably the best judge of whether your hearing has declined. You should have your hearing checked if you have experienced more than a couple of these signs of hearing loss.
·       Tired or stressed from trying to hear
·       Believe that everybody mumbles
·       Find it easier to understand others when you are looking directly at their faces
·       Frequently ask others to repeat themselves
·       Increase television or radio volume to a point that others complain
·       Have difficulty understanding speech in noisy places like cars, restaurants and theaters.
·       Fail to understand doctor’s instructions about medications
·       Make inappropriate responses because you didn’t understand the question
·       Miss essential sounds like doorbells, alarm clocks, smoke alarms
·       Have trouble hearing on the telephone
·       Turn one ear towards a speaker to hear better


I know I used excuses such as “people aren’t speaking as clearly as they used to, or  I can hear just fine, if only you would speak louder”. Excuses don’t cut it, having a hearing loss is detrimental to your health and to your cognitive ability. 

My audiologist told me at one point, that I was compensating for my hearing loss, with my brain filling in the words, I was not hearing. She explained to me, that over time, this ability to fill in the blanks would go away and I would never get it back. I would lose cognitive function. I don’t know if that was true, but about a year later I did get my hearing aids, and I immediately noticed an improvement in my social interactions.