Occupational therapists play a key role in keeping older drivers safe while on the road. While older drivers tend to be some of the most compliant drivers, a driver over 65 is much more likely to suffer fatal injuries than a younger driver. In addition, the likelihood of having an accident increases for drivers over 70. So how can OTs help?
- Encourage patients to take a self-assessment of driving skills or a driver refresher course.
There are many assessments available online including the AAA Foundation for Traffic Safety: Drivers 65 Plus; The National Institute on Aging: Older Drivers; and AARP’s Smart Driver Course. AARP also offers an online course for drivers over 50 that focuses on the latest automotive safety technology called the Smart DriverTEK Workshop.
- Identify and treat any underlying limitations to safety and independence.
Many factors can impact an older adult’s ability to drive safely including physical limitations in strength, hand function, range of motion, coordination, balance, endurance, or abnormal tone. Driving ability may also be impacted by sensory conditions including tactile, vision, hearing, vestibular and pain. Finally cognitive and behavioral limitations and impairments must be considered. Occupational therapists can assess the impact of these factors and suggest ways to adapt.
- Train in the use of adaptive equipment.
Simple adaptive equipment includes key extenders, swivel seat cushions, leg lifters, steering wheel covers, and seat belt adapters. Adaptive equipment for driving ranges in complexity with some requiring a Driving Rehabilitation Specialist. Some examples of more complex equipment include hand controls, pedal extenders, panoramic or convex mirrors, steering wheel knobs and turn signal crossovers.
- Instruct in use of task modification and compensatory strategies.
OTs can also instruct patients in task modification; for example, patients may be safer if they avoid driving at night and during poor weather conditions or plan trips to sidestep heavy traffic and highways. A patient may also need instruction in transportation alternatives like public transit, ADA transit or for-hire transit options. Some compensatory strategies can include instruction for one-handed driving and low vision strategies.
The ability to continue to drive provides multiple benefits for older adults including better health outcomes, less social isolation and lower rates of depression, so talk to your patients about how OT can help them continue to drive safely.
Cheryl Hall, OT
Author and Illustrator, Occupational Therapy Toolkit
National Highway Traffic Safety Administration
Chihuri, S., Mielenz, T., DiMaggio, C., Betz, M., DiGuiseppi, C., Jones, V. and Li, G. (2016). Driving Cessation and Health Outcomes in Older Adults. Journal of the American Geriatrics Society, 64(2), pp. 332-341.