Aging and Driving - Making Informed Decisions that Support Independence and Safety

Making Informed Decisions that
Drive Independence and Safety

© 2013 Griswold International, LLC

The Week of
December 2nd is
Older Driver Safety
Awareness Week

“AOTA's Older Driver
Safety Awareness Week
(December 2-6, 2013) aims to
promote understanding of the
importance of mobility and transportation
to ensuring older adults remain active in
the community— shopping, working or
volunteering—with the confidence
that transportation will not be
the barrier to strand
them at home.”
The American Occupational
Therapy Association


Goals for Today
• Understand the nature/scope of driving issues for older adults
• Learn how Occupational Therapists can help older adults and
family caregivers with driving skills/decisions
• Access innovative tools to support safe driving, mobility and
independence


Presented by:
Marv Lawson, OTR, DRS

Director of Occupational Therapy Clinical Services
Fox Rehabilitation – Cherry Hill, NJ

Chris Kelly, MEd

Director of Learning & Development
Griswold Home Care


Thank you for your courage, energy, and dedication!
Healthcare Providers

Professional Caregivers

Family Caregivers

Older Adults


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BRAIN WRITING

Solutions

Brainwriting is…
• a fun, engaging way to brainstorm
• sharing as many ideas as possible within a short timeframe
Brainwriting Process
• Listen for our questions
• When prompted, enter your solutions using the webinar chat function
• Don’t overthink or agonize…There are no right or wrong answers
Brainwriting Outcomes
• Peer-to-peer learning and sharing
• A publication that benefits older adults
Important
• Avoid sharing any information that you would not want others to see


Lit Review
Social Media
Advocacy
Solutions Webinar & Toolkit


A Complex Issue with Many Voices


“We all experience
physical and mental
changes as we age…slower
reaction time, night blindness,
and pain and stiffness can affect
driving skills but do not need
to prohibit driving.”

“Driving helps
older adults stay mobile
and independent. But the
risk of being injured or killed
in a motor vehicle crash
increases as you age.”
CDC

AOTA
“Both the American
Academy of Neurology and
the Alzheimer’s Association
agree that a diagnosis of
dementia is not a sufficient
indicator of driving risk. Over
75% of patients with mild
dementia are able to
pass road tests and
drive safe.”
AA/AAN/Gayatri Devi, M.D


“I am worried
about my dad. He has had
several ‘fender benders’ over
the past year. There is always
a good reason, but this never
happened before. I am worried
about his safety, and the
safety of others. But it is so
hard to bring this up.”

“It is easy to
say, ‘just give up the
keys’. It is important for
me to stay active, and if I
don’t drive I am stuck
in the house forever.
I can’t live that way.”
Quote from older
adult driver

Quote from family
caregiver


Learn How Aging
CAN Affect Driving


Aging CAN cause
changes in…
• Vision
• Hearing
• Coordination
• Reflexes
• Physical strength
• Attention span

• Reaction time
• Memory
• Judgment
• Emotions (anxiety)
• Medications – some can
affect driving


Dementia CAN cause
changes in…
• Memory
• Concentration
• Coordination and reflexes
• Ability to recognize the purpose of objects
• Ability to read and respond to road/traffic signs
Dementia & Driving
Resource Center

Family Conversations
about Alzheimer’s,
Dementia & Driving

http://bit.ly/18GYYv3

http://bit.ly/17Q2fqy


Warning Signs for Unsafe
Driving
• Frequent "close calls” on the
road

• Confusing the two pedals

• Finding dents and scrapes on
the car/fences/mailboxes/etc

• Having road rage

• Getting lost, especially in
familiar locations
• Missing/misunderstanding
traffic signals
• Slow response to unexpected
situations

• Misjudging gaps in traffic
• Causing drivers to honk or complain
• Being easily distracted
• Can’t turn around to check their
blind spot
• Receiving multiple traffic tickets or
"warnings"

• Can’t move foot from gas to
brake pedal

Learn About
Driving Assessments
Occupational Therapists Can Help


The Role of the
Occupational Therapist
Experts who are trained to:
• Educate about the effects of aging on driving
• Evaluate driving skills
• Evaluate the car for adaptive equipment needs
• Plan for alternative forms of transportation
• Support the older adult and their family caregivers
Find a Driving
Specialist

Driving and Community
Mobility Guidelines for
Older Adults

http://bit.ly/1e5L3q4

http://bit.ly/1f7xQcH


A Driving Assessment
can include…
• Medical and driving history
• Vision and/or hearing
• Cognition (memory, judgment and speed of response)
• Motor function (strength, range of motion and flexibility)
• Driving ability (online/on-road/simulation)
What to Expect with
Driving Assessments

Self-evaluate Your
Driving Skills:

http://bit.ly/1j412XV

http://bit.ly/1bCo4er


Should you take a
driving course?

http://bit.ly/1bMAhS6

http://bit.ly/JgE3s6


Paying for Driving Specialists/Tests
• Older adults typically pay out of pocket for driving assessments
• Medicare and private insurance do not typically cover driving
assessments costs

• Average assessment cost ranges (may vary based on region) include:
- Initial clinical assessment: $150-$200
- Full driving assessment: $200-$750
- One-hour driving rehab/lesson: $80-$150/hr.
• Additional costs may be included for adaptive equipment

Paying for a professional assessment:
http://bit.ly/190gG2h


Develop Your
Action Plan


Form your
Safe Driving
Care Team
Your care team
should include:

Counselor

Department of
Transportation
Advocacy/
Support Group

Driving Testing
Center

Primary Care
Provider (PCP)

Geriatric Care Manager/
Social Worker

Family and Friends

Occupational
Therapist/
Driving Specialist/
AOTA

Area Agency on Aging

Consider Adaptive Equipment
• Low-effort steering
• Ribbon attached to seatbelt
• Hand controlled breaks
• Navigation system
• Swing-out seat
• Swivel Seat Cushions
• Back-up camera
• Extensions (Key, foot pedal, mirror, steering wheel)
Equipment That Can
Empower Drivers

Car-fit.org

http://bit.ly/1d8e3s4

http://bit.ly/18qBuPP


Improve/Maintain Driving Skills
• Stay physically fit and active
• Take a driving course: in-person, online, or simulation

AARP driving courses:

Staying active can help:

http://bit.ly/1gwntmH

http://bit.ly/19HWkW6

Exercise for mature drivers:
http://bit.ly/18JJdXi


When Driving is No
Longer an Option
Overcoming anger, grief and depression


“Without driving, it
has been found that
individuals can risk social
isolation, depression, and
may lack a sense of
control over their
lives.”

“When an older adult
is given a traffic ticket or
has a minor crash, it may feel like a
natural time to discuss safety in driving…
the problem is that this is when an
older adult feels he or she must
defend the ability to drive, and so
the conversation with family
members can, unfortunately,
become argumentative.”
Mary Jo McGuire
MS, OTR/L, OTPP, FAOTA

Peggy Barco, MS, BSW, OTR/L

“Productive
engagement (paid work,
formal volunteering, and
informal volunteering) was
negatively affected when
older adults stopped
driving.”
Angela Curl, PhD


Talk About It
• Talk openly/respectfully about concerns/fears
• Try 1-1 vs. large group discussions
• Stick to the facts vs. assumptions/stereotypes
• Be positive - assume driving may be an option
• Allow grieving and anger

Family Discussions
http://bit.ly/1aVuCoo


Common Driving Cessation Emotions
• Many older adults/caregivers go through
stages of grief after “giving up the keys”
ACCEPTANCE
• Exploring
Options
• New Plan
In Place

• Moving On

DENIAL
• Avoidance
• Confusion
• Shock
• Fear

BARGAINING

• Adjusting

• Struggling to Find Meaning

ANGER

• Reaching Out to Others

• Frustration

• Telling One’s Story

• Irritation
• Anxiety

DEPRESSION
• Overwhelmed
• Helplessness
• Hostility
• Flight
http://www.ekrfoundation.org/five-stages-of-grief/


Coping with Emotions
• Allow time for grieving
• Join a support group

• Talk about your feelings
• Seek counseling

• Fight back! – “when one door closes….”


Learn About Other Ways to Get Around
• Public transportation
• Family or friends
• Walking
• Taxi

• Grocery stores that deliver
• Community shuttle buses
• Trips with places of worship
• Non-medical home care
• Adult day care

Finding Transportation Services
For Seniors
http://bit.ly/Jy6YYZ


Key Takeaways
• Aging can affect driving skills
• Many older adults are safe to drive
• Occupational therapists can help to assess driving
challenges and recommend solutions
• Older adults who stop driving are at risk for developing
depression and isolation
• It is important to consider alternate forms of transportation
when driving is not an option

Open Q&A
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