Hi there & welcome back to Aging Together! As a recap, April is Occupational Therapy Month, Stress Awareness Month, & Distracted Driving Month. This week, we’re combining OT Month with Distracted Driving Awareness Month! In this article, I’m taking a dive into how occupational therapy plays a role in aging and driving.

About Driving

Driving is a complex activity that requires a range of cognitive, visual, and motor skills. As individuals age, changes in these abilities can impact their ability to drive safely. According to the Insurance Institute for Highway Safety (IIHS, 2020), older adults are at higher risk for accidents while driving, with the highest risk among those aged 85 and older. However, it is important to note that age alone is not a determinant of driving ability. Instead, it is a combination of factors such as physical and cognitive health, medications, and environmental conditions that can impact driving safety.

Driving is one of those super touchy topics as loved ones get older. You don’t quite know if they should still be driving, and you definitely don’t know how to approach the subject with them. Did you know there are professionals who can help you navigate it all?

About Occupational Therapy (OT)

Occupational therapy focuses on helping people achieve their goals by developing and maintaining the skills and abilities they need to perform daily activities. One of these areas where occupational therapists play a crucial role is in supporting aging adults with driving, an activity that is critical to maintaining independence and quality of life.

Assessment

Assessment is the first step in occupational therapy’s role in driving as it relates to aging adults. Occupational therapists are trained to evaluate the client’s functional abilities related to driving. This may include a review of their medical history, current medications, and vision and hearing tests. Occupational therapists can also administer specialized assessments to help determine the client’s cognitive ability to drive.

Once a general assessment of vision, hearing, motor skills, and cognition is completed, an occupational therapist may refer the older adult to a driving specialist. An occupational therapist certified in driver’s rehabilitation may perform a comprehensive driving evaluation, which involves an on-road assessment to evaluate the client’s driving skills and abilities. This evaluation assesses a range of skills, including speed control, lane positioning, intersection navigation, and decision-making.

Treatment/Intervention

Based on the assessment results, the specialty occupational therapist can develop a customized intervention plan to address any identified deficits. This may involve compensatory strategies to help the client continue driving safely, such as reducing the frequency and duration of trips or avoiding driving at night or during rush hour. The occupational therapist may also recommend modifications to the client’s vehicle or equipment, such as installing hand controls or adjusting the seat height, to improve their comfort and safety while driving.

In addition to compensatory strategies and modifications, these specialized occupational therapy practitioners may provide training and education to improve the client’s driving skills. This may include instruction on defensive driving techniques, hazard recognition, and safe driving practices. These OTs can also teach clients how to use new technology, such as GPS or blind-spot detection systems, to enhance their driving safety.

Driver Rehabilitation Programs

In cases where the client’s deficits are severe and cannot be adequately addressed through compensatory strategies or training, the occupational therapist may recommend driver rehabilitation. Driver rehabilitation programs are specialized programs that are designed to evaluate and treat individuals with disabilities or functional impairments that affect their driving ability. Occupational therapists specialized in driver’s rehabilitation play a key role in these programs, which typically involve a combination of classroom instruction, simulated driving, and on-road assessments.

Driver rehabilitation programs may also include specialized equipment or vehicles, such as modified vans or vehicles with adaptive controls, to help clients learn to drive safely. Occupational therapists can also provide support and education to the client’s family members or caregivers, who may need to assist with transportation or provide support during the rehabilitation process.

Support of Continued Participation in Safe Driving

It is important to note that occupational therapy’s role in driving as it relates to aging adults extends beyond the assessment and intervention phases. Occupational therapists also play a critical role in supporting continued participation in driving and maintaining safe driving practices. This may involve periodic re-evaluations to assess changes in the client’s functional abilities, as well as ongoing education and training to address new driving challenges.

Occupational therapists can also provide support for clients who are considering driving retirement and transitioning to alternative transportation options, such as public transit or paratransit services. This may involve assistance with route planning or training on the use of mobility aids, such as canes or walkers, to help clients navigate their environment safely.

OT Summary

In conclusion, occupational therapy plays a vital role in supporting aging adults with driving. Through comprehensive assessment, customized intervention, and ongoing support, occupational therapists can help clients maintain their independence and quality of life while ensuring their safety on the road. Driver rehabilitation programs, in particular, can provide a comprehensive approach to addressing driving deficits, including specialized equipment and education for both clients and their families.

However, it is important to note that driving safety is a collaborative effort that involves not only the client but also their healthcare providers, family members, and the community. Occupational therapists can work with these stakeholders to develop a coordinated plan that addresses the client’s driving safety needs while also promoting their overall health and wellbeing.

13 Tips for Older Adults to Maintain Safe Driving

Now for some takeaways for all of you! According to the National Institute of Aging, here are some tips for older adults to maintain safe driving:

1. Talk with your doctor – if you have any concerns about your health and driving, see your doctor; don’t risk hurting yourself or others.
2. Be physically active – this will help you keep and even improve your strength and flexibility, which may help your driving abilities. 
3. Consider your car – if possible, drive with automatic transmission, power steering, power brakes, and large mirrors. Newer cars come equipped with backup cameras, which can make parking and backing up easier, as well as other sensors that can alert a driver to a nearby object or vehicle before an accident occurs. 
4. Take care of your eyes and ears – always wear your glasses or contact lenses if you need them to see clearly; if you’re using hearing aids, be sure to wear them while driving.
5. Avoid certain times of the day – cut back on or stop driving at night if you have trouble seeing in the dark; try to avoid driving during sunrise and sunset, when the sun can be directly in your line of vision.
6. Check in with yourself. Don’t drive if you feel lightheaded or drowsy. Be sure to check any warnings on your medications. Try to avoid driving when you are stressed or tired.
7. Don’t crowd. Leave ample space between your car and the car in front of you and start braking early when you need to stop.
8. Plan your timing. Avoid heavy traffic areas or rush-hour driving when you can.
9. Plan your route. Drive on streets you know and find a way to go that requires few or no left turns. Choose a route that avoids highways or other high-speed roadways. If you must drive on a fast-moving highway, drive in the right-hand lane, where traffic moves more slowly.
10. When in doubt, don’t go out. Bad weather, such as rain, ice, or snow, can make it hard for anyone to drive. Try to wait until the weather is better, or use buses, taxis, ridesharing services, or other alternatives.
11. Wear seat belts. Always wear your seat belt and make sure your passengers wear theirs, too.
12. Limit distractions. Eating, adjusting the radio, or chatting can all be distracting. If you use your cellphone while driving (for navigation, for example), use it hands-free and use voice activation when possible. Never type on your phone while driving.
13. Use window defrosters. These will help keep windows and windshields clear.

8 Signs It May be Time to Consider Driving Retirement

While trying our best to ensure seniors can maintain their independence and safety with driving, it may be inevitable that the time comes where it may no longer be safe to do so. According to the NIA, here are some signs that a loved one should probably no longer be driving:

• Multiple vehicle crashes, near misses, or new dents or scrapes on the car
• Two or more traffic tickets or warnings within the last two years
• Increases in car insurance premiums because of driving issues
• Comments from neighbors or friends about erratic, unsafe, or aggressive driving
• Anxiety about driving at night
• Health issues that might affect driving, including problems with vision, hearing, and movement
• Complaints about the speed, sudden lane changes, or actions of other drivers
• Recommendations from a doctor to modify driving habits or quit driving entirely

5 Common Emotions & Feelings Related to Driving Retirement for Older Adults

It’s important to note that if this time presents itself, and there are limited opportunities to regain safe and independent driving, there is a chance that restrictions or complete removal of driving privileges may occur. The feelings or emotions generally associated with decreased ability to drive safely or independently in older adults can vary depending on the individual’s personality, coping style, and the specific circumstances surrounding their driving limitations. However, here are some common emotions and feelings that older adults may experience when faced with the prospect of decreased ability to drive:

• Loss of independence: Driving represents a significant source of independence for many older adults, allowing them to go where they want, when they want, and without having to rely on others for transportation. Therefore, when faced with the prospect of not being able to drive safely or independently, older adults may feel a sense of loss or grief related to the loss of this independence.
• Anxiety and fear: Older adults may feel anxious or fearful about the potential consequences of not being able to drive safely. They may worry about being unable to access essential services, such as medical appointments or grocery stores, or losing touch with friends and family members who live far away.
• Depression: The loss of independence and increased isolation associated with decreased ability to drive can lead to feelings of depression or sadness in some older adults.
• Frustration or anger: Older adults may feel frustrated or angry about their driving limitations, particularly if they feel that they have been unfairly restricted from driving. They may also feel resentful of family members or healthcare providers who they perceive as trying to limit their independence.
• Embarrassment or shame: Some older adults may feel embarrassed or ashamed about their driving limitations, particularly if they feel that it reflects poorly on their abilities or status as an independent adult.

It is important to note that these emotions are normal and understandable given the challenges associated with decreased ability to drive safely.

Summary

Ultimately, occupational therapy’s role in driving as it relates to aging adults is about empowering individuals to maintain their independence and quality of life while also ensuring their safety and the safety of others on the road. By providing comprehensive assessment, intervention, and ongoing support, occupational therapists can help aging adults continue to participate in this critical daily activity for as long as possible. Additionally, healthcare providers, family members, and caregivers can play a critical role in providing emotional support and resources to help older adults cope with feelings and adjust to their driving limitations. 

Do you think you or a loved one could potentially benefit from a driving evaluation? Get a referral from your primary care physician and search for driver rehabilitation programs in your area! It might just be the next step you need in order to maintain continued safety and independence with driving.

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At Caregiver Consulting & Healthy Solutions, we are dedicated to helping you navigate aging together. This blog page is for everyone: whether you are an older adult looking to age in place, a caregiver seeking support and guidance, a young or middle-aged adult planning for the future, or simply someone interested in learning more about the aging process. I hope you’ll join me on this journey. Let’s navigate aging together.