Accident in shopping center parking lot leads to task force

A May 20 accident in which the vehicle driven by an 81-year-old seriously injured a 16-year-old girl has led to the formation of a task force whose members will try to convince state legislators of the need for a law requiring elderly drivers to pass an examination to get or keep a license.

Julie Mitchell, nurse administrator, and Beverly Poole, director of nursing at the Gardens Care Center, are heading the effort.

"We have a man in his 90s who is cognitively impaired that visits his wife here and can't remember being here the day before or conversations about his wife's condition," Poole said.

"He's very confused, walks with a cane and stops to rest.

His vision is poor, although his hearing is probably adequate."

Despite these issues, Poole said, the man continues to drive.

Memory loss is the key reason why Poole and Mitchell have contacted state Rep.

Joe Hart ,.

R-Kingman, and state Sen.

Linda Binder, R-Lake Havasu City, about pushing for a law that ties renewing a driver's license for older people with a mental skills examination.

Poole and Mitchell said they will continue gathering data on accidents caused by elderly drivers, especially those 75 and older, and present their data later this year or early next year to legislators.

They also will find out about similar laws in other states.

Poole said most people age 65 still are competent, whereas signs of dementia often begin at age 75.

Poole began her effort after a van driven by Dolan Springs man struck teen-ager Ashley Ketchner in a shopping center parking lot in Kingman and dragged her under the vehicle for more than 300 feet (see related story).

Mitchell said she has seen several instances when elderly drivers leaving the Gardens Care Center drove over curbs.

An elderly woman leaving the facility about two years ago got into a fatal accident, Poole said.

"I did not feel she should be driving, as she was kind of feeble," Poole said.

"She misjudged distance at an underpass and was killed."

Poole stressed that she and Mitchell are advocates for the elderly and have their safety foremost in mind in pursuing a law requiring that people older than 75 be tested for memory as part of the licensing procedure.

"We want impaired drivers off the road," Poole said.

"People with early signs of dementia can live at home, but as it progresses they should be screened."

One of the memory tests given by Mitchell and Poole, both registered nurses, is the Mini Mental State Exam, which is put out by Psychological Assessment Resources of Odessa, Fla.

It tests the responder's orientation to time and place.

Responders also are asked to repeat the words apple, penny and table up to five times and to go as far as possible in subtracting seven from 100.

"The test is one tool we use in determining the degree of memory loss," Mitchell said.

"We do them for Adult Protective Services whenever they call us regarding a possible memory loss patient."

But a serious problem is that there is no financial reimbursement from Medicare for administering the test, making physicians reluctant to give it, Mitchell said.

Kitty Young is president of the Bullhead chapter of the American Association of Retired Persons.

She said she hasn't thought through the "wisdom" of a mental skills exam but would want to see any such law applied uniformly.

"I would say anyone (seeking a driver's license) should have to pass a mini-mental exam whether they are 17 or 70 if we're going to make it a law," Young said.

Bill Solper teaches a defensive driving class for seniors in Kingman on behalf of the AARP.

He also said he would like any new law regarding an exam to apply to all drivers.

"There could be people out there 30 or 40 years old that are not really mentally capable of driving," Solper said.

Solper said he was a driver's license examiner in Wisconsin, working nearly 30 years for the Department of Motor Vehicles.

He has not seen any instances of older drivers driving erratically in Kingman but did in Wisconsin.

"It was a red flag for law enforcement," Solper said.

"They'd write up the driver and he'd have to come in for re-testing."

Paul Harrington is director of programs for the Alzheimer's Association Desert Southwest Chapter.

"It's a tough issue of protecting an older person's safety and that of others, while at the same time balancing people's independence and autonomy," Harrington said.

"What I would say is there is pretty strong evidence (through studies) that a person with Alzheimer's or a related form of dementia puts them at risk in driving for a number of reasons.

"Not only are there changes in the ability to remember things but other brain changes can put people at risk, including visual spatial changes.

Processing and responding to information also becomes slower."

Advancing age is the greatest risk factor for dementia or Alzheimer's disease, Harrington said.

"If we know advancing age puts people at risk for Alzheimer's it would seem to me some sort of screening of mental status would be helpful in identifying people with early symptoms of Alzheimer's to help them make adjustments in their lifestyle so my feeling is a routine physical should not only include checks of blood pressure, temperature and listening to the heart but a mental screening," he said.