If older drivers decide with serious functional deficits to limit driving or completely stop it, the role of health care practitioners is largely supportive. If the medical examination to identify potentially correctable deficiencies and older drivers recognize these shortcomings, but still want to go, the doctors offer treatments to correct the deficiencies or impairments. Apart from the treatment of diseases that affect the ability to drive, most doctors are ill-equipped to formulate a plan for driving rehabilitation; referral to specialists is often helpful. Driving Rehabilitation Although benefit some older drivers refresher courses (eg. As AARP Driver Safety Program at www.aarp.org), most of them should be referred to occupational therapists who specialize in driving rehabilitation ( be to one of these specialists to find local rehabilitation facilities can be contacted or driving rehabilitation specialist finder or driver rehabilitation specialist member directory queried) – so-called driving rehabilitation specialist.. Driving rehabilitation specialists perform usually full driving ability tests, including clinical testing of vision, motor and cognitive skills as well as a review on the street. During the evaluation on the road, the specialist continues with the older driver in a vehicle and examined the actual driving skills under various traffic conditions. which is used while the vehicle should be equipped with features that allow a secure control of the specialist (z. B. brake on the passenger side). These specialists can help even the following: inserting a tailored rehabilitation plan in order to increase motor skills and cognition and perception in everyday driving provision of driver aids like a dial for one-handed operation or complicated equipment such as hand controls evaluation of the response to the rehabilitation plan and feedback to the driver involved family members and the doctor whether the driver is adequately capable to continue driving or if driving restrictions are indexed providing mobility counseling or advice on alternative means of transport in most countries, the cost of a review of the travel-rehabilitation by insurance (Medicare or private) covered, it can be a private performance. Stop pedaling When older drivers deny their limits or do not know or do not respond deficits to treatment, doctors need to take any more initiative. In these situations, doctors should discuss the relevant issues of driving safety, eventual cessation with driving transport needs of the patient and alternative transportation resources with the patient and the relatives. The physician should consider the safety benefit for the patient, for pedestrians and other drivers against the disadvantage of social isolation, deterioration of functional status, quality of life impairment and depression. In some patients (eg., Patients with severe dementia) outweigh the benefits of a ban on driving significantly heavier than the disadvantages. Alternate transportation should be discussed; these vary from community to community, and how to contact local resources such as the Alzheimer’s Association (www.alz.org) or American Automobile Association Foundation for Traffic Safety (seniordriving.aaa.com) can provide updated information on these options. Family members can find publications and information on conversations with older drivers. See for. B., the Hartford publications “Understanding Dementia and Driving” and “We Need to Talk: Family Conversations with Older Drivers”. The loss of driving can be quite devastating in terms of impact on the maintenance of independence. If no alternative transportation can be arranged and the ability to sustain the activities of daily life is affected, sometimes results from the task of driving the need to move in with a family member or emigrate in an assisted living facility or a retirement community. When reporting the functional limitations or the driver’s medical status seems to justify a ban, doctors should meet the reporting requirements of their state Department of Motor Vehicles. The states differ in their reporting laws. All states have laws on voluntary reporting, some states have laws requiring notification. (See National Highway Traffic Safety Administration [NHTSA] Physician’s Guide to Assessing and Counseling Older Drivers for state licensing requirements and reporting regulations.) In most states, the statutes protect the anonymity of the doctor or they provide immunity for the physician. Legal advice can be beneficial if an authority or an institution developed a policy and a process for reporting. Before it shall report, the doctor should discuss directly with the patient and family recommendations for stopping the driving, rather than simply file a report. Physicians should try everything to convince the patient of them to cooperate with the restrictions of driving. Such a discussion should address why the patient’s limitations make it unsafe to continue driving, and why the doctor is obliged to report. In some situations, doctors must report functional limitations or medical status against the wishes of their patients to government agencies; this often has a negative impact on the relationship between doctor and patient. Regardless of medical information may be disclosed to law if the impaired driving ability of a patient could endanger public safety; Doctors who make to the competent authorities no message, can be held liable for subsequent violations.