Driving Safety and the Senior Driver Driving Safety and the Senior Driver Karl Hoffman, OTR/L, CDRS,...
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Transcript of Driving Safety and the Senior Driver Driving Safety and the Senior Driver Karl Hoffman, OTR/L, CDRS,...
Driving Safety and the Driving Safety and the Senior DriverSenior Driver
Karl Hoffman, OTR/L, CDRS, CDIKarl Hoffman, OTR/L, CDRS, CDI
Director of Driver Rehabilitation ServicesDirector of Driver Rehabilitation Services
ObjectivesObjectives
Aging and the impact on drivingAging and the impact on driving
Discuss the importance of driving Discuss the importance of driving independence for seniorsindependence for seniors
Components of a driving evaluationComponents of a driving evaluation
Driving retirementDriving retirement
Aging and the Impact on Aging and the Impact on DrivingDriving
1 in 8 drivers are over age 65 today; by 2030 it will be 1 in 5 1 in 8 drivers are over age 65 today; by 2030 it will be 1 in 5
70 million people over age 65 by 203070 million people over age 65 by 2030
Seniors have fewer crashes than drivers in other age groups, Seniors have fewer crashes than drivers in other age groups, but are more likely to be seriously injured or killed due to but are more likely to be seriously injured or killed due to decreased physiologic reservedecreased physiologic reserve
For drivers age 70-75, the number of fatalities is almost triple For drivers age 70-75, the number of fatalities is almost triple that of drivers age 30-59that of drivers age 30-59
For drivers over 80 (the fastest growing age group), the rate is For drivers over 80 (the fastest growing age group), the rate is over quadruple that of drivers age 30-59over quadruple that of drivers age 30-59
Common Causes of Unsafe Common Causes of Unsafe DrivingDriving
Vision impairmentVision impairment
Cognitive impairmentCognitive impairment
Side effects of medicationsSide effects of medications
Slower processing/reaction timesSlower processing/reaction times
Muscular difficultiesMuscular difficulties
Limited range of motionLimited range of motion
The Importance of Driving The Importance of Driving IndependenceIndependence
Most seniors depend on the automobile for the bulk of their Most seniors depend on the automobile for the bulk of their travel – 90% of their trips are in a car as either a driver or travel – 90% of their trips are in a car as either a driver or passengerpassenger
Driving a private vehicle provides seniors with independence, Driving a private vehicle provides seniors with independence, enabling them to get essential services, and make social enabling them to get essential services, and make social contact outside the homecontact outside the home
For many, it is a key factor for successful aging in placeFor many, it is a key factor for successful aging in place
The Importance of Driving The Importance of Driving IndependenceIndependence
When driving is curtailed, seniors may find themselves When driving is curtailed, seniors may find themselves isolated from activities that filled their lives, especially if they isolated from activities that filled their lives, especially if they live in an area with limited public transportationlive in an area with limited public transportation
Isolation can undermine one’s quality of life, and accelerate Isolation can undermine one’s quality of life, and accelerate health declinehealth decline
Emotionally, it can represent a loss of independence and even Emotionally, it can represent a loss of independence and even identity. identity.
Driver EvaluationsDriver Evaluations
An evaluation is recommended if any of the following warning signs are observed:
• Doesn’t observe signs, signals, or other traffic
• Poor road position, or lane departures
• Accidents or near misses
• Inappropriate driving speeds (too fast or too slow)
• Slow or poor decisions
• Easily confused or frustrated
• Frequently gets lost, even in familiar areas
• Needs help or instructions from passengers
Components of a Driving Components of a Driving EvaluationEvaluation
Selection of a qualified evaluator
Clinical “Pre-Driving” Assessment
Driving Assessment
Vehicle Modification
Additional Education and Training
Final Counseling
Components of a Driving Components of a Driving EvaluationEvaluation
Selection of a qualified evaluator
Occupational Therapists are uniquely qualified
Select a program licensed as a Commercial Driving School
The clinical evaluator should be dually qualified as a Driving Instructor to ensure continuity and thoroughness
Seek out a Certified Driver Rehabilitation Specialist (CDRS)
Components of a Driving Components of a Driving EvaluationEvaluation
Clinical “Pre-Driving” Assessment
Background: diagnosis, medical history, driving history, license status, vehicle type, “why are you here?”
Visual Assessment: acuity, visual fields, depth perception, color vision, saccades and pursuits
Visual Perception: figure ground, spatial relations, topographical orientation, unilateral neglect
Components of a Driving Components of a Driving EvaluationEvaluation
Clinical “Pre-Driving” Assessment Cont.
Physical Assessment: ROM, strength, endurance, coordination, sensation, proprioception, balance, mobility
Cognitive Assessment: arousal, orientation, affect and demeanor, attention, memory, problem solving, judgment
Traffic Sign Recognition
Driving Knowledge – “road rules”
Components of a Driving Components of a Driving EvaluationEvaluation
On-Road Assessment
Vehicle handling skills: brake and accelerator control, steering, lane positioning, merging
Driving behaviors: vehicle preparation, observance of road signs, use of directional signals, reactions to other vehicles, recognition of hazards, visual attention to the driving environment
Observe performance in a variety of traffic environments
Components of a Driving Components of a Driving EvaluationEvaluation
Vehicle Modification:
Instructing the client on proper positioning
Modified vehicle controls: Wide view mirrors Adapted controls for primary functions Adapted controls for secondary functions
Components of a Driving Components of a Driving EvaluationEvaluation
Additional Education and Training:
Instruction in the use of adapted vehicle controls
Practice safe driving behaviors
Strategies to compensate for deficits
Possible referral for rehabilitative services
Components of a Driving Components of a Driving EvaluationEvaluation
Final Counseling:
Reinforcement of safe driving habits
Discussion of driving restrictions
Consider periodic re-assessment
Compliance with DMV reporting
Discussion and counseling for driving retirement
Driving RetirementDriving Retirement
The client cannot physically manage control of the vehicle, even with adaptive equipment.
The client simply cannot drive safely, and lacks the cognitive capacity to make improvements.
Contradictory to the Occupational Therapy goal of increasing clients’ independence, but a necessary step to prevent injuries and fatalities.
Driving RetirementDriving Retirement
Strive to make the client understand why driving retirement is necessary.
Involve family: To provide support and assistance in the transition to non-driver
status. To assist with transportation alternatives. To prevent the inadvertent or deliberate sabotage of therapist’s
recommendations.
Driving RetirementDriving Retirement
Communication with all members of the healthcare team is crucial.
Copies of reports or recommendations should be sent to referring physician, case managers, and persons holding power of attorney.
The client may seek out opinions from other members of the team, and it is important to avoid offering conflicting opinions.
Driving RetirementDriving Retirement
Strategies for helping a driver accept failure:Ask the driver for their opinion of their performance. The goal is to have the client to come to the conclusion that they should stop driving.
Driving RetirementDriving Retirement
Strategies for helping a driver accept failure:Ask the driver for their opinion of their performance. The goal is to have the client to come to the conclusion that they should stop driving
Driving RetirementDriving Retirement
Questions for the Client:“Do you think your desire to drive has blinded you to some of your problem areas?”
“What are the three most important things in your life ( family, spouse, grandchildren, hobbies)? Driving is probably not one of them. Is it worth putting these things at risk?”
“We will likely outlive our ability to drive safely. How do we decide the exact day to stop? Isn’t it better to stop too soon than too late?”
Driving RetirementDriving Retirement
Questions for the Client:“You do not want to depend on others. But others depend on you. If you were hurt or killed, your (family, friends, business etc.) would miss you very much.”
“Your children are worried about your driving. You raised them to have good judgment, and they obviously care about you very much. Based on this evaluation, do you think that maybe they have reasons to be concerned?”
Driving RetirementDriving Retirement
Questions for the Client:“Others who have stopped driving have found it a relief to not worry about getting in an accident or hurting someone else. They also have extra money without the car, gas, and insurance expenses.”
Driving RetirementDriving Retirement
Provide transportation alternatives:Name, numbers, and availability schedule of friends and family willing to give rides
Phone number of local cab company
Public transit – ride with the individual the first time to make them feel comfortable
Seek out volunteer drivers through community centers and churches
Contact UsContact Us
Located in the Williamsburg Physicians CenterLocated in the Williamsburg Physicians Center
The Center for Excellence in Aging and Geriatric The Center for Excellence in Aging and Geriatric HealthHealth
3901 Treyburn Drive, Suite 1003901 Treyburn Drive, Suite 100
Williamsburg, VA 23185Williamsburg, VA 23185
757-220-4751757-220-4751
www.excellenceinaging.orgwww.excellenceinaging.org