Key takeaways

  • The CDC notes that older adults are more vulnerable to injury in a crash than younger drivers. A small crash is not automatically a small injury.
  • If an older adult who takes a blood thinner was in the crash, the CDC says a health care provider should check them for signs of a brain injury, because these medicines can raise the risk of bleeding in the brain. That is an emergency department or a same-day call to their doctor, not a wait.
  • Stiffness, bruising from the belt and headaches can still show up a day or two later. The week after deserves an exam too.
  • Bring a full medication list to every visit.

West County has a lot of drivers who have been at it for fifty or sixty years. They know Olive Boulevard and Clarkson Road better than any map does, and most of their crashes are the small kind: a backing-out bump at the grocery on Clarkson, a tap at the light at Baxter, a slow slide into the car ahead on a wet morning on Highway 64. This desk hears the same sentence afterward almost every time. "It was nothing. I'm fine." Sometimes it was nothing. This article is about how to tell, and whose job it is to tell.

Why age changes the math

The Centers for Disease Control and Prevention keeps a page on older adult drivers, and one of its points is simple: older adults are more likely to be seriously hurt in a crash than middle-aged drivers, largely because bodies grow more fragile with age. The same seat belt load that leaves a bruise on a younger passenger can do more to older bones and tissue. None of that is a reason to panic after a parking-lot bump. It is a reason not to let "it was slow" be the whole assessment.

The head comes first

Start with this question, before anything else: did they hit their head, and do they take a blood thinner?

The CDC's traumatic brain injury facts page says health care providers should check for signs of a brain injury when an older adult has been in a car crash, and that this matters most for anyone taking blood thinners, which may increase the risk of bleeding in the brain. That means today. Not after dinner, and not after seeing how they feel in the morning. A chiropractic injury clinic is not where that check happens. An emergency department, or a same-day call to their own physician for direction, is.

If they are not on a blood thinner, the CDC's HEADS UP danger signs still apply to everyone: a headache that gets worse and does not go away, repeated vomiting, slurred speech or unusual behavior, or someone who is very drowsy or cannot be woken. Any of those is a 911 call. The emergency list at the bottom of this page is the same list, and it is on every page of this desk for a reason.

Families should also watch for the quieter version over the next few days: more confusion than usual, repeating questions, trouble with balance, a change in sleep. In an older adult those can be easy to write off as a bad week. Write them down and tell a clinician.

Then the week after

Once the head question is settled, the rest of the body follows the same schedule it does at any age. Soft-tissue pain after a crash tends to arrive late, and this desk explained why in two days later. For older readers, a few things are worth watching specifically:

  • The belt line. Soreness or bruising across the chest and collarbone or low across the hips, where the belt held them.
  • The neck. Trouble turning to back out of the driveway or check a mirror.
  • The low back. Getting out of a chair or the car becoming noticeably harder than it was last week.
  • Balance. Any new unsteadiness, which matters more at 80 than at 40 because a fall is its own risk.
  • Old injuries waking up. A shoulder or back that had been quiet for years and is not quiet now.

A new pain on day two or three is not proof of anything serious. It is a reason for an exam that week, with findings written down and a date on them.

The medication list

Bring a complete, current list to every visit, from the emergency department to the injury clinic: prescriptions, blood thinners, pain relievers, supplements. Many older adults take enough medications that nobody remembers all of them under stress. A printed list, or a photo of every bottle, prevents that. It also belongs in the record, which this desk covers in the dated page.

For the adult children reading this

A lot of the people who find this page are not the driver. They are a son in Ballwin or a daughter in Wildwood who got the call. Two suggestions. First, ask the head and blood thinner question yourself, directly, because a parent who does not want to be a bother will not volunteer it. Second, if an exam is needed, offer the ride. The near office for most of Chesterfield is in O'Fallon, west on 64 over the Boone Bridge, and a stiff neck on that bridge is not a good idea.

Then step back. You are getting someone an exam, not managing their care, and nobody should promise them an outcome.

What the clinic does, as published

Missouri Injury Clinic's auto injury lane is diagnosis and a treatment plan after a crash, and the clinic's TBI and concussion rehab lane is rehabilitation after acute injury. Acute means the emergency department's work comes first. For the stiff neck and sore back that remain after a small crash, call the office you can reach this week, say it was a crash, give the date and mention every medication.

The near office. Say it was a crash, give the date, and bring the medication list. O'Fallon, 2163 West Terra Lane, (636) 280-0990: Mon, Tue, Thu 9am to 6pm, Wed and Fri by appointment, closed daily 12 to 2. Book the exam this week

Everything on this desk is educational reading. It is not medical advice, and reading it is not an exam.