What Is Driving Rehabilitation? Discussing Mobility Options With Older Adults
By Stephanie Yamkovenko
Driving is important to Americans—the country has more passenger vehicles than licensed drivers.1 With an aging population, our country is also debating the safety of older drivers. AOTA’s Older Driver Safety Awareness Week hopes to raise awareness and increase education about the aging driver’s options. It starts today, running from December 6 through 10.
Occupational therapists have the skills to evaluate a person’s overall ability to operate a vehicle safely, provide rehabilitation for driving if necessary and appropriate, and recommend other community mobility options if driving cessation is recommended. Carol J. Wheatley, OTR/L, CDRS, works at the Adaptive Driving Program at the Good Samaritan Hospital in Baltimore, Maryland and talked to AOTA about driving rehabilitation.
AOTA: Many people have heard of driving rehabilitation services, but they don’t know what happens during an evaluation and intervention. Could you describe the process?
Carol Wheatley: The assessment at Maryland’s Good Samaritan Hospital Adaptive Driving program begins with an interview of the individual to learn his or her driving history and habits, and to determine the impact that driving or non-driving has on daily life. The individual’s physical, visual, visual perceptual, and cognitive skills are assessed to learn about that person’s strengths and weaknesses relative to driving. Next, the on-road assessment is performed in the hospital’s vehicle, which is equipped with dual controls as well as adaptive equipment for steering, accelerating, and braking. The individual is given a period of driving in a no- or low-traffic area to demonstrate basic skills in handling the vehicle. Following the assessment, observations of the person’s driving ability are discussed with the client, with recommendations for future actions, which could include continued driving with no changes, continued driving following training with adaptive equipment or strategies, or driving cessation and transportation alternatives.
AOTA: What is a commonly held myth about driving rehabilitation?
CW: The driving rehabilitation assessment is often viewed as a mechanism by which older drivers lose their licenses. In actuality, the focus is on determining the means, such as adaptive equipment or strategies, to enable the person to continue to drive safely.
AOTA: Why would you suggest an occupational therapist for an individual or family interested in driving rehabilitation?
CW: Occupational therapists have a background in medical conditions, disabilities, and the functional and performance implications of a disabling condition. To specialize in driver rehabilitation, additional training is obtained in the specifics of driver rehab, as well as in driver education principles and techniques. Knowledge of state laws governing reporting and licensing procedures is essential as well.
AOTA: Families will be using the holidays to talk with aging parents about driving. Do you have any advice you’d offer to them?
CW: Ideally, this discussion should be handled in multiple conversations over time, rather than waiting until the situation becomes critical. If alternative transportation options are available—family, friends, cabs, senior transport—encourage the person to try them out so to gain some familiarity with the process and begin using the alternatives for certain trips, such as rides in inclement weather or to medical appointments, which don’t require carrying a lot of items. When the day comes that the important conversation needs to be held, keep the focus on the concern for safety, for the parent as well as others. The key is to have other means in place by which the person can still travel to important destinations and participate in meaningful activities.
AOTA: What stereotypes exist about older drivers?
CW: Older people are often stereotyped as unaware and unconcerned about their driving. Many older individuals have the insight to begin limiting their driving or to use strategies to increase their safety. As others in their circle of acquaintances begin to stop driving, each person may feel the pain as well, as they know that someday they may be in the same situation.
Visit AOTA’s Older Driver site for daily resources and ideas on how to promote older driver safety this week and throughout the year.
Wheatley was recently interviewed and filmed by Inside E Street where she discussed driving rehabilitation. The video will be available in late January 2011—check AOTA’s Older Driver site for updates—and will feature a driving assessment and interviews with individuals and families who have received services.
Stephanie Yamkovenko is AOTA’s staff writer.
U.S. Department of Transportation, Federal Highway Administration. (2008). Highway Statistics 2008: Licensed drivers, vehicle registrations, and resident population. Retrieved December 3, 2010, from http://www.fhwa.dot.gov/policyinformation/statistics/2008/dv1c.cfm