Technician Manual

AAA, AARP, and the American Occupational Therapy Association (AOTA) have developed and

implemented a turnkey educational program (“CarFit”) that offers older drivers the opportunity to check

out how well their cars “fit” them and to become aware of community-specific resources and activities that

could make the fit better. The program enables trained CarFit technicians under the supervision of CarFit

Event Coordinators, and working with occupational therapists or qualified driver rehabilitation specialists,

to observe the older adult driver in their vehicle and to use the opportunity to open a conversation and

provide some collateral materials for follow-up action. CarFit is designed to operate successfully in a

variety of community-based settings such as senior centers and in conjunction with existing community-

based programs, such as safe driver programs run by AAA and AARP.

Record of My Technician Training Name: ___________________________________________________________ Address: ___________________________________________________________ (Address used for CarFit website registration)

E-Mail: ___________________________________________________________ (E-mail address used for CarFit website registration)

Location of Classroom/Outside Practice (Lab): __________________________________________________________Date _______ Location of CarFit Training Event: _____________________________Date _______ Name of Event Coordinator/Instructor: ___________________________________ Location of Training: ________________________Date______ CarFit Instructor Email: ____________________________________________ Note: If you are seeking continuing education credit, record your hours of education and retain your class schedule with this packet.

Note to Trainees This manual and the accompanying PowerPoint presentation were prepared to train you to participate in CarFit events as a Trained Technician. After working with this manual in the classroom and practicing with the CarFit Checklist in the lab portion of the training, you will not need to refer to the manual as you work with each driver. You will not be deemed a Trained Technician until you successfully complete a CarFit event. A Trained Technicians is eligible to become a CarFit Event Coordinator by attending additional training classes specifically for CarFit Event Coordinators. Note to Trained Technicians Thank you for taking the time to refresh your familiarity with the CarFit program. Please note that the CarFit Checklist was extensively updated in 2012. Some activities have been simplified and some checks are now performed in a different sequence than you might remember. Based on input from experts from the sponsoring organizations, Event Coordinators and volunteers, this revised manual provides new safety pointers, ideas to communicate more effectively with participants and suggestions to make CarFit events more valuable and enjoyable. Note to occupational therapists The title occupational therapist is used throughout this manual. However, this role may be filled by an occupational therapy assistant or occupational therapy student. Driver rehabilitation specialists may also participate in CarFit events, working alone or alongside occupational therapists.

CONTENTS

1. Program Objectives 2. Program Background 3. CarFit Roles and Positions 4. The CarFit Event 5. Traffic Direction and Check-In Station Overview 6. Checkup Station Overview 7. Overview of the CarFit Checklist Item 1: Are you the only driver? Item 2: Safety belt (seat belt) use Item 3: Steering wheel tilt, position to airbag Item 4: Head restraint Item 5: Distance between chest and steering wheel Item 6: Line of sight above steering wheel Item 7: Positioning to gas pedal and brake pedal Item 8: Mirror adjustment Item 9: Neck mobility for visual blind spot check Item 10: Ignition key and system Item 11: Operation of vehicle controls 8. Checkout Station Overview Role of the occupational therapist Item 12: Vehicle walk-around 9. Waiver of Liability Form 10. Tire Information…Know the Facts! 11. CarFit Technician Training PowerPoint

Section 1: Program Objectives The CarFit program was designed to:

Promote continued safe driving and mobility among older drivers by focusing attention on the “fit” between driver and vehicle.

Create an open environment that encourages conversations about driving,

Provide information, education, and community-based resources to older drivers in a non-threatening, quick and easily accessible manner.

Section 2: Background What is CarFit? CarFit is a community-based educational program that gives older drivers the opportunity to assess how they “fit” within their vehicle. CarFit provides non-judgmental safety information and raises awareness of resources, such as adaptive devices, that can help drivers become more comfortable and confident behind the wheel. The primary purpose of CarFit is to educate drivers and share safety information. Occupational therapists who participate in CarFit events suggest ideas to enhance each individual driver’s safety based on the results of a CarFit Checklist. This 12-point guide is not a test! It is simply a tool to guide a thorough review of important safety issues related to the fit between a driver and a vehicle. CarFit was created to empower drivers by providing suggestions, resources and options. It is not a mandatory inspection or performance evaluation. No information is provided to law enforcement or health care providers. No one leaves with a list of required actions. Who runs CarFit? The CarFit program was created by the American Society on Aging and developed in collaboration with AAA (American Automobile Association), AARP and the American Occupational Therapy Association (AOTA). Across the country, CarFit events are led by volunteer Event Coordinators, who have themselves completed Technician Training followed by additional training. Event Coordinators deliver classroom instruction to technicians, oversee a required training lab and supervise Trained Technicians working CarFit events. Other countries as far away as Australia and New Zealand are beginning to use the CarFit model to share important safety information with their drivers.

Why is CarFit important? People over the age of 65 are the fastest growing population in the United States. By 2030, there will be 58.9 million people age 65 and older— and many will still be driving Personal mobility is critical to healthy aging. It allows people the opportunity to age in place – growing older without having to leave their homes or communities. Losing the option to drive has been shown to contribute to depression, social isolation and a decline in overall health. Increasingly sophisticated safety features may require active adjustment to optimize the benefit to drivers and passengers. This need for individualized adjustment to attain the safest fit represents a change from the bench seats and fixed steering wheels of the past. Unfortunately, age-related changes can make it uncomfortable and unsafe to drive. The founding organizations, as well as various government agencies, professional associations and private-sector organizations are taking steps to provide resources that improve knowledge, safety and mobility for older drivers. How can aging affect driving? Age brings changes to vision, information processing (cognition), flexibility and the speed of reflexes. As drivers age, they may need new strategies or adaptive tools to ensure their safety and comfort. As a CarFit volunteer, it is your responsibility to provide a fun, non-threatening, educational experience that makes participants feel respected throughout the entire process. The chart on the next page explains some common age-related changes that can affect driving. If a participant needs help or you are uncomfortable speaking with a participant, involve your Event Coordinator.

Age-Related Changes Impact on Driving How You Can Help

SIGHT Decreased elasticity and increased cloudiness of the lens of the eye can increase sensitivity to glare and the need for illumination and contrast and decrease adaptability to changes in light. It may also alter color vision, such as the distinction between blue and green.

Diminished light (or drastic change from outdoor to indoor lighting) may make it difficult for older drivers to maneuver in public parking garages or find their cars.

Allow time for participants to adapt to changes in lighting. Remain friendly, courteous and patient as their vision adjusts.

COGNITION With age, the speed with which we process information from multiple sources slows.

Older drivers may need more time to filter out irrelevant information. Focusing attention on the most important information may be challenging.

Provide clear transitions. Offer cues about what you will discuss. Example: Now, let’s take a look at the position of your mirrors.”

HEARING With age, we may lose sensitivity to high-pitched sounds, causing distortion to what we hear.

Sounds most difficult to distinguish are: s, t, th, ch, sh, c and k

Stand slightly in front of the driver’s door. Speak face-to-face, clearly and slowly. Lower your pitch. Minimize background noise.

TOUCH/GRIP Reduced circulation may reduce sensation in hands and feet. This lessens the ability to feel hot, cold, vibration and pressure.

An older driver may struggle with gripping the steering wheel or controls and fatigue easily.

Encourage the driver to take a break if they experience any discomfort.

MOBILITY As we age, muscles can become smaller, joints wear and the space between vertebrae decreases.

Changes in our muscles, bones and joints may change our posture, height, gait and flexibility.

It may take an older driver longer to perform certain tasks. Be patient. The CarFit Checklist will help you guide drivers in making adjustments that make them safer and more confident and comfortable.

Adapted from: Understanding Mind and Body Changes, SeniorDriving.AAA.com

How is a CarFit checkup conducted?

The CarFit checklist is reviewed with a driver seated in their own vehicle. CarFit is designed with the flexibility to operate in a variety of settings. For example, a CarFit event maybe offered by senior centers or in conjunction with safe driver programs run by AAA and AARP. At a CarFit event, occupational therapists and technicians trained by the CarFit program volunteer to work side-by-side, reviewing a 12-point CarFit Checklist with drivers. Checkups generally take 20 minutes. At most CarFit events, participants move between a station staffed by a CarFit Technician and a final checkout station staffed by an occupational therapist or driver rehabilitation specialist. However, some events are staged so drivers park their cars in one spot and both the CarFit Technician and occupational therapist or driver rehabilitation specialist come to them. Sometimes, a CarFit program offers the option of one-on-one appointments with drivers. In every case, a CarFit event is under the supervision of an Event Coordinator. If concerns are identified, the occupational therapist suggests solutions and makes the driver aware of community resources. Options might include the use of adaptive devices or adjustments to seats or mirror positions. CarFit events are publicized within communities and older drivers are invited to schedule a review. The heart of the program is a Checkup followed by a Checkout. During Checkup, a trained CarFit technician takes the participant through the CarFit Checklist, noting observations and answers to standard questions. The technician notes any items of concern and directs the driver to a Checkout Station. During Checkout, an occupational therapist or driver rehabilitation specialist conducts a vehicle walk-around with the driver. The driver has the opportunity to ask questions and learn about available solutions, resources and individualized services. The specialist points out opportunities to achieve a better fit and ensure the driver’s safety. Every participant is given the top copy of their CarFit Checklist and information about other driver safety resources in their community. What is the setting? CarFit events can take place in a variety of settings, such as parking lots at senior centers, hospitals and AAA and AARP offices. A CarFit event can be customized to almost any location where a parking lot can be safely blocked off for use.

Section 3: CarFit Roles and Positions There are many roles within CarFit: Instructors: Have responsibility to communicate with national organization staff, issue invitations to instructor candidates, and ensure that new Event Coordinator information is entered into the CarFit database. Instructors receive specialized training and can teach Event Coordinators. Only Instructors can teach Event Coordinators. Event Coordinators: Event Coordinators hosts CarFit events, manage logistics, and provide training to the volunteers and Technicians participating at the CarFit event. Event Coordinators receive additional training and are able to train Technician. Technicians: Technicians participate in and follow the direction of the Event Coordinator overseeing the CarFit event. After completing today’s training and a CarFit event, you will be trained as a Technician. Technicians work in teams and review the 12 point checklist with participants. You must complete a CarFit event after training to become a Technician. Occupational Therapists or Driver Rehabilitation Specialists: OT’s or DRS’s bring an understanding of aging and medical conditions to the conversation. OT’s or DRS’s are also Technicians, but their role at a CarFit event is to address any concerns that may have come up during the checklist review and provide information and resources on issues related to driver safety during the check-out station of the event. Volunteers: Persons that are not trained to conduct a vehicle check using the 12 point checklist may also participate in an event. Untrained Volunteers can assist with traffic direction and Check-In.

Section 4: The CarFit Event Size of Event CarFit events range in size, based on available sites, the number of trained volunteers and occupational therapists available and the community response. A CarFit event may be geared to any size – from just a few drivers using a few designated parking spaces to a community event held at a large indoor or outdoor parking lot. Site for Event Typically, the CarFit event site is an easily accessible parking lot with at least one separate entrance and exit. Paths to the entrances and exits should not cross. Ideally, this lot will have shaded or covered areas and easy access to restrooms. Some communities host CarFit events at indoor parking lots. This is a good alternative as long as drivers and volunteers have adequate lighting to note the observations on the 12-point CarFit Checklist, move safely between stations and complete the vehicle walk-around. On the day of the event, volunteers will lay out a simple and intuitive flow of traffic and clearly mark directions to allow drivers to enter and exit the parking lot safely. The traffic flow is usually designed so drivers do not have to put their vehicles in reverse. All technicians should be aware of the layout of the site and designated stopping places. Every volunteer, regardless of their assignment, is expected to be constantly aware of the flow of traffic throughout the event. To ensure personal safety, all volunteers should step entirely away from the flow of traffic if they must take phone calls. All other distractions should be avoided to ensure that volunteers concentrate on vehicles as they move into and out of the site and between stations. The number of lanes designated is based on the number of participants who schedule CarFit appointments and the number of available volunteers. Participants are routed to three major stations: • Check-In. • Checkup (led by CarFit Trained Technicians) • Checkout (led by the occupational therapist). Materials for Event: Setting Up CarFit Event Coordinators are trained to identify the Carfit planning team, secure the location, schedule and train volunteers, arrange for materials, manage logistics and run the CarFit event. Event Coordinators may arrange for the following items on-site for the safety and comfort of both volunteers and the public: • Tents to provide shelter from sun and rain • Tables and chairs to provide areas from which to complete and distribute paperwork • Water and light snacks • Signs and traffic cones to direct traffic flow • Safety vests and chock blocks

Section 5: Traffic Direction and Check-In Station Overview Traffic Direction Volunteers Volunteers are assigned to welcome participants, direct traffic in, out and throughout the event site. They also monitor the location of pedestrians and passengers waiting on participants to ensure their safety. All volunteers need to pay attention to drivers. Stay seen to stay safe! It is recommended that one volunteer be assigned to Traffic-Inflow and another to Traffic-Outflow. However, these positions are optional depending on the size of the event and configuration. Traffic direction volunteers are not required to attend CarFit Technician Training. Check-In Station Technicians The Check-In Station should be located far enough into the site that even if several vehicles are waiting to check-in; they will be safely in the event site, not in the roadway. Technicians assigned to the Check-In Station greet drivers and provide the Waiver and the CarFit Checklist. It is the responsibility of the Check-In Technician to write down the date, participant ID number, and vehicle make, model and year on the CarFit Checklist. Sample Script – Greeting Drivers and Explaining Paperwork

Activity Comments

Gesture to the driver to roll down vehicle windows if they have not done so.

Hello. Thanks for coming to CarFit. My name is _____________. Did you schedule an appointment? Depending on response: “Great!” or “No problem, we’ll get you in or schedule you now.”

Give the driver the clipboard with the Waiver and pen. Retain the signed Waiver. (If the driver refuses to sign the Waiver they may not participate.)

The Waiver indicates that you are here voluntarily and all the information we provide is for educational purposes only. It is required.

Activity Comments

Place the checklist on the clipboard and hand it to the driver and ask them to place it on the passenger seat.

This is your CarFit Checklist. It’s the tool we use to help determine the fit between you and your car. It is NOT a vehicle inspection or a test. You’ll keep your personal checklist when it’s completed.

Observe whether the driver is wearing a seat belt. Is it fastened properly? Note this in the top right hand corner of the checklist (near date, participant # and vehicle make model and year).

If the driver is not wearing a seat belt, direct them: “Please buckle-up.”

Direct the participant to the Checkup Station.

Thank you. Would you honk your horn for me to signal the Technician at your next stop? Drive up to the Checkup Station slowly. (Any directions needed.)

Section 6: Checkup Station Checkup Station Technicians As a Trained Technician, you will work in teams assigned to the Checkup Station to examine the driver’s positioning in their vehicle, field of view, and determine their knowledge and use of vehicle controls. You will go through the CarFit Checklist in order, from start to finish, and mark each item with a response or measurement, as requested. Remain friendly but focused in order to keep the discussion between 15-20 minutes. This is a voluntary educational event. Drivers may decline to participate in any part of the CarFit Checklist. (Drivers attending this public event may represent a wide range of needs and/or expectations.) If a driver becomes upset about a particular item on the Checklist, circle the item (rather than check it off) so the occupational therapist or driver rehabilitation specialist might explore any concerns. Technicians are encouraged to call Event Coordinators over if a driver seems unhappy. The Event Coordinator might offer the option of continuing to work through the CarFit Checkist with another Technician. Provide education only. Do not make hands-on adjustments yourself. Only drivers should adjust their seats, steering wheels, head restraints and mirrors. “Circling the Check” for Discussion Note areas of concern on the CarFit Checklist by “circling the check” to signal the occupational therapist (or driver rehabilitation specialist) working the Checkout Station to initiate a conversation and possibly suggest solutions, such as the use of adaptive devices. Circling the check on the CarFit Checklist does not necessarily indicate a serious safety concern. On the contrary, sometimes the driver simply has questions the Technician isn’t prepared to answer or the item warrants further discussion. Sometimes there is just an opportunity to make a driver more comfortable or knowledgeable about a “fit” related issue. If the individualized professional services of an occupational therapist or driver rehabilitation specialist might be of benefit, the expert-volunteer can share materials on local driving programs and safety resources.

Section 7: CarFit Checklist Overview The CarFit Checklist guides you through an assessment with drivers. You will cover 11 of the 12 points, then direct them to the Checkout Station where an occupational therapist suggests solutions and aids, based on items you have noted and their own observations. If questions about a specific vehicle arise, the owner’s manual typically provides details about the location and operation of vehicle controls. Remember:

Be careful not to communicate with drivers in a way that makes them feel judged, tested or criticized.

Explain each Checklist item so drivers understand why the discussion on positioning is safety-related,

Guide drivers in adjusting seats, mirrors and the steering wheel. Do not make hands-on adjustments for them.

Checkup Introduction The Technician assigned to the Checkup Station begins by directing the driver to pull up to a stopping place. The CarFit Event Coordinator may arrange for vehicle wheel blocks (also called chock blocks) to prevent vehicles from moving unexpectedly during Checkup. Do not stand directly in front of a moving vehicle. When the vehicle is safely stopped, move to the driver’s window and offer a brief introduction and description of the Checkup process. Ask the driver to remain in the vehicle with the gearshift in Park (or Neutral if the vehicle has manual transmission), the engine off and the parking brake engaged. (Exception: If the parking brake has been unused for 10 years or more.) Conducting the Checkup Ask the driver to remain sitting in the vehicle for the entire Checkup. Choose a position that allows you to maintain eye contact with the driver. Stand near the driver door, squat next to an open door, or, with the driver’s permission, take a seat on the passenger side. (Base your position on height, mobility, comfort and the driver’s preferences.)

Sample Script – Introducing the Checkup

Activity Comments

Hello. My name is _____________ and I will be taking you through a quick CarFit Checkup. During Checkup, we look at how you are positioned in the driver’s seat and how you operate vehicle controls. The whole process should take less than 20 minutes. Based on the fit between you and your vehicle, we might have some tips on adjustments, new techniques or even some gadgets to make you more comfortable and keep you safer. Please:

Put the gearshift in Park. (Neutral if the car has manual transmission).

Set the parking brake.

Turn off the ignition.

Stay in the driver’s seat. Let’s get started…

Item 1: Are You the Only Driver?

What we check: If others – such as a spouse or partner – also drive the vehicle. Ask if the partner is also participating in CarFit. Why we check: Drivers of the same car may require different adjustments to the seat, steering wheel, wheel tilt and mirrors for visibility and comfort. Suggest participants go over their CarFit Checklist with others who drive the vehicle. Sample Script – CarFit Checklist Item 1: Are You the Only Driver?

Activity Comments

It’s important to achieve your best person-to-vehicle fit each time you drive. Are you the only one who drives this vehicle? (Yes? Proceed to Item 2)

(No?) If there is more than one driver in a car – even a valet or a grandchild who is just moving your car for you -- there may be a difference in how each one adjusts the seat, steering wheel and mirrors.

Is your spouse or partner participating in our CarFit Event today?

(No?) You can check the CarFit website to find out when the next CarFit Event is scheduled. The website address is in the brochure you’ll get in your Goodie Bag.

You’ll take your CarFit Checklist with you today, so you can go over it with your husband/wife and remind them to do a pre-driving check and make individualized adjustments when they drive the car after you.

Item 2: Safety Belt (Seat Belt) Use

What we check: If the driver consistently uses the vehicle’s seat belt, uses it correctly and identifies any problems in doing so. (See what the Check-In Technician noted on the CarFit Checklist.) Why we check: This is an opportunity to help drivers understand that seat belts keep them properly positioned during a crash and prevent ejection if they are worn correctly – over the shoulder and low on the hips. Placing the belt behind the back or under the arm could lead to injury. Sample Script – CarFit Checklist Item 2: Safety (Seat Belt) Use

Activity Comments

Look at the CarFit Checklist to see if the driver was wearing a seat belt. or says it is not a habit.

If the driver says wearing a seat belt is not a habit, note their response on the CarFit Checklist.

I see you have your seat belt on. Are you in the habit of wearing it all the time?

If the driver says wearing a seat belt is uncomfortable, note any comments on the CarFit Checklist.

Wearing a seat belt can prevent injuries and even save your life. Research shows people are more prone to serious, life-threatening injuries if they are not wearing a seat belt. You’re less likely to be ejected from the vehicle when you are secured. Does the belt feel comfortable to you?

Activity Comments

Observe how the seat belt is adjusted.

Your lap belt should fit low and tight across the hips or pelvis. The shoulder belt should cross the collar bone, away from the neck, and cross the chest. The shoulder belt should never be fastened behind the back or under the arm.

Three easy adjustments may improve the fit of the seatbelt if it is uncomfortably close to the neck:

Raise the seat, which will bring the line of sight above the steering wheel.

Bring the seat back closer to an upright – but still comfortable –position.

Adjust the seat belt slider on the side pillar.

(It looks like your seat belt can be adjusted/ It looks like your seat belt can’t be adjusted.)

Guide the driver in adjusting the seat belt to a better position.

If you’d like, I will guide you in adjusting your seat belt to a position that’s still effective but may be more comfortable. You might need to get out of the car to make the adjustment.

Observe the tilt of the seat.

Adjusting the tilt of the back of your seat may also improve the fit of the seat belt.

Observe any difficulties in unbuckling or buckling the seat belt and provide feedback.

Let’s look at the movement of the seat belt. Please unbuckle your seat belt and let it retract all the way back into the mechanism. Ok, now please re-buckle your seat belt.

At this point, the Technician will take the initial measurements of the driver vehicle fit to the steering wheel position. Measure the distance between the chest and steering wheel, and the line of sight above the steering wheel. Taking an initial measurement will provide us with a guide as we check items #3-#6 on the checklist. Distance between chest and steering wheel: Either give the driver the ruler and ask them to do the measuring, or do the measurement yourself. Record the measurement on the CarFit Checklist. To get this measurement, ask driver to look straight ahead and place one end of the ruler/measuring tape about the middle of the participant’s chest and place the other end on the middle of the steering wheel. About how many inches are there between the participant and the steering wheel? Line-of-Sight above steering wheel: Ask the driver to look straight ahead. Position yourself at the driver’s eye level. Ask the driver to hold a ruler in a straight, horizontal line from the eye level to the windshield. Using a second ruler*, measure the distance from the first ruler to the top of the steering wheel. Record the distance in the space provided in the CarFit Checklist. * Options for rulers:

A 10” ruler with a 3” piece of ribbon hanging down.

A 10” x 3” CarFit Ruler. Turned sideways, it allows you to approximate a 3” measurement.

Item 3: Steering Wheel Tilt, Position to Airbag

What we check: If the steering wheel is tilted at an angle that allows the driver to have good forward vision, unobstructed view of dashboard instruments and indicators, good control of the wheel and optimal protection by the airbag. Why we check: Many drivers do not know how to adjust the tilt of the steering wheel to a comfortable position that also provides good forward vision and wheel control. They may not understand the clearance required between drivers and airbags, which are intended to absorb crash forces at the chest, not the face.

Sample Script – CarFit Checklist Item 3: Steering Wheel Tilt, Position to Airbag

Activity Comments

Observe the original position of the wheel. There should be at least 2” of space between the top of the driver’s thighs and the bottom of the steering wheel so leg movement is not impeded. The driver should also be able to reach the wheel easily, with arms slightly bent and shoulders relaxed. For some vehicles, power settings may allow drivers to program both driving and entry/exit positions, which may not be the same.

Let’s look at your steering wheel. Can you clearly see the speedometer? Does your steering wheel have a tilt feature?

(HIGH) If the wheel is tilted too high, ask if you may guide the driver in readjusting the wheel.

Your wheel seems to be too high. You will see the dashboard and the road more clearly and maybe even relax your shoulders if you tilt it down. It also better positions the airbag, which is housed in the center of the steering wheel.

The steering wheel tilt level is usually on the left side of the wheel, behind the turn signal or underneath the steering wheel column

Would you like to try adjusting the steering wheel so it’s lower?

(LOW) If the wheel is tilted too low, ask if you may guide the driver in readjusting the wheel

Your wheel seems low. That can block your sight of the dashboard and make it difficult for you to move your leg between pedals.

Activity Comments

The steering wheel tilt level is usually on the left side of the wheel, behind the turn signal or underneath the steering wheel column

Would you like to try adjusting the steering wheel so it’s higher? Be certain to lock the wheel into place once the adjustment is complete.

Item 4: Head Restraint

What we check: If the driver’s head restraint is adjusted properly. Why we check: A properly adjusted head restraint protects drivers from whiplash and other injuries, particularly if the vehicle is rear-ended.

Sample Script – CarFit Checklist Item 4: Head Restraint

Activity Comments

Observe the position of the driver’s head in relation to the head restraint. The restraint should be positioned mid or above the ears, with 2 ½ inches or less from the back of the head to the restraint pad.

Let’s look at the adjustment of your head restraint. Positioned correctly, it can protect you from whiplash and minimize neck injuries, particularly if your vehicle is rear-ended. The middle of the back of your head should hit the middle of the back of the restraint pad. If the restraint is too low, your head may fall over the device. If it’s too high, you may not have enough support.

Determine if the head restraint needs adjustment.

Would you like me to show you how to raise/lower your head restraint for a better fit?

Item 5: Distance Between Chest and Steering Wheel

What we check: If the driver’s chest is a safe distance from the steering wheel. Based on possible adjustments made in #3, the measurement will be taken again to ensure a safe distance between the chest and steering wheel. Why we check: Many drivers do not understand where the airbag is located and what happens when it is activated. Drivers might not realize they should sit at least 10 inches back from the airbag to allow it to inflate without potentially causing injuries. (This is also true for passengers.) They should also be able to position their seats so there is no slack in their seat belts.

Sample Script – CarFit Checklist Item 5: Distance Between Chest and Steering Wheel

Activity Comments

You will be directing the driver to take a measurement to complete this item.

Point out the location of the airbag.

We need to look at the distance between your chest and steering wheel, which is where your airbag is.

The distance from the driver’s chest to the center of the steering wheel can be estimated with a ruler, tape measure or even an 8 ½ x 11 piece of paper.

There should be at least 10 inches from your chest or to the center of the steering wheel. You need this clearance because when the airbag deploys, it fills with air and moves toward you like a big balloon. It only stays inflated for a quarter of a second. The airbag cushions the driver as it deflates. It deploys so quickly that many drivers don’t realize it until the airbag is already deflated.

NOTE: Do not touch a female driver’s chest.

Either give the driver the ruler and ask them to do the measuring, or take the measurement for them. Record the measurement.

Look straight ahead and place one end of this ruler at about the middle of your chest and place the other end against the steering wheel.

Activity Comments

If the measurement is more than 10 inches.

It looks like you are more than 10 inches away. That’s good. We don’t need to make any adjustments. Keep that number in mind so you can check periodically.

If the driver’s chest is less than the recommended 10 inches of clearance, assist the driver in finding and operating the seat adjustment controls. (Remember to let them make any adjustments.)

It looks like you are less than 10 inches from the steering wheel. The government agency that regulates vehicle design and manufacturing reports that being that close could result in injuries.

Guide the driver in using the seat controls to move the seat backwards.

May I show you how to use your seat controls to move your seat back?

Allow them to return their seat to the original position. Re-measure and record. If the distance is still less than 10” circle the check.

It looks like you may not be able to sit 10 inches back and comfortably reach the pedals. Go ahead and move your seat up. I’ll make a note for the occupational therapist to share some suggestions with you during Checkout.

If the driver will not move the seat back, do not press the issue. Make a note so the issue will be revisited during Checkout.

Item 6: Line of Sight Above Steering Wheel

What we check: If the driver has the proper line of sight over the steering wheel for an adequate view of the road ahead. Based on possible adjustments made earlier, the measurement will be taken again to ensure a proper line-on-sight about the steering wheel. Why we check: Drivers may not realize that at least 3 inches above the top of the steering wheel is ideal for a safe, straight line of sight. Sample Script – CarFit Checklist Item 6: Line of Sight Above Steering Wheel

Activity Comments

NOTE: You will guide the driver in making a measurement to complete this item.

Ask the driver to look straight ahead. Position yourself at the driver’s eye level. Ask the driver to hold a ruler in a straight, horizontal line from the eye level to the windshield. Using a second ruler*, measure the distance from the first ruler to the top of the steering wheel. Record the distance in the space provided in the CarFit Checklist. * Options for rulers:

A 10” ruler with a 3” piece of ribbon hanging down from its side.

A 10” x 3” CarFit Ruler. Turned sideways, it allows you to approximate a 3” measurement.

Now we’ll determine your line of sight above the steering wheel to make sure you have an adequate view of the road ahead. Please look straight ahead, through the windshield. Experts recommend that drivers maintain a line of sight at least three inches above the steering wheel. We will take two measurements.

If the driver’s line of sight is 3 inches or more above the wheel …

Your line of sight is 3 inches or more above the steering wheel. That’s good – you want to maintain that position. If you find it ever drops below that level, you could try adjusting your seat.

Activity Comments

If the driver’s sight is less than 3 inches above the wheel, suggest a seat adjustment.

Your line of sight is less than 3 inches above the wheel. Does your seat adjust up and down? Do you know how to make that adjustment? Try that now, please.

If the seat does not adjust, suggest that the driver adjust the tilt of the steering wheel.

Provide guidance on adjusting the seat tilt, if needed. Check that the driver’s seat is not tilted too far back. The driver must make all adjustments. Make sure that in doing so, the driver does not adjust the horizontal seat position. This would reduce the distance to the airbag, which you measured earlier.

Is your seat tilted too far back? If it is, go ahead and adjust that.

If the driver cannot adjust the seat to maintain a line of sight 3 inches above the wheel AND comfortably reach the pedals, suggest that the driver adjust the tilt of the steering wheel.

Your feet need to remain in comfortable reach of the pedal, so see if adjusting the tilt of the steering wheel improves your line of sight.

After the driver has made adjustments, have the driver re-measure the line of sight.

Ok, that adjustment created the 3 inches you need …. OR Your line of sight might be too low to give you good control.

If adjustments to the seat and wheel tilt do not bring the driver’s line of sight to 3 inches or more, check “No” for this item of the CarFit Checklist and circle the check mark.

We are still short of the 3-inch mark. I’m noting that so the occupational therapist can offer some solutions during Checkout.

Item 7: Positioning to Gas Pedal and Brake Pedal

What we check: If the driver can easily and effectively depress the gas pedal without reaching. Are the brake lights working? Is the driver able to move between gas and brake pedals without difficulties? If the driver’s footwear – such as thick soles, high heels or flip flops – is affecting their performance, note this on the CarFit Checklist for the occupational therapist to discuss. Why we check: Drivers should not need to fully extend their legs or use their toes to depress the gas pedal through the full range. Reaching in this manner can fatigue the leg muscles. This check is an opportunity to make drivers aware of safe, non-fatiguing gas pedal use. Aging can diminish a driver’s strength, flexibility and range of motion, which in turn may affect their ability to pick up and move their foot quickly and efficiently between the gas pedal and brake pedal. Physical limitations can slow reaction time. We are not measuring or discussing reaction time, but we are observing the driver’s ability to quickly move the foot squarely to the middle of the pedal and depress the brakes. If there is room for improvement, note this on the CarFit Checklist for the occupational therapist to address. Sample Script – CarFit Checklist Item 7: Positioning the Gas Pedal and Brake Pedal

Activity Comments

SAFETY CHECK: Make sure the engine is off.

Position yourself so you can see the driver’s right foot.

Now we are going to take a look at how comfortably you can reach and depress the gas pedal.

Observe foot placement on the gas pedal. Can the driver reach the pedal easily?

Keeping the engine off, place your foot on the gas pedal and press the pedal, please.

Activity Comments

The driver should be looking straight ahead (not down at their feet.) If the driver appears to “reach” with their toes to get full pedal movement, check “No” for this item on the CarFit Checklist.

It looks as if you are reaching out with your toes to depress the gas pedal. This can slow your foot’s movement to the brake pedal. It may also fatigue your leg and foot muscles. I’m going to note this so the occupational therapist can help you find the best seat adjustment or another solution.

If the vehicle has a standard transmission, observe the foot movement to and from the clutch and the movement to depress and release the clutch.

I notice your vehicle has standard transmission. Please put your right foot on the brake and use your left foot then depress the clutch all the way. Is that comfortable for you? Go ahead and release it now.

Position yourself to see the driver’s right foot. (Some driver’s will use their left foot to brake.)

We’re going to check positioning to the brake pedal. On my go-ahead, please put your foot on the brake pedal and depress it all the way.

Observe the foot movement and watch for signs of problems, such as grimacing, shifting in the seat or reaching with the toes. If you observe any difficulty, check “No” on the CarFit Checklist.

Depress the brake pedal. Do you have any difficulty doing that?

SAFETY CHECK: Make sure the engine is off and the parking brake is on.

Now we’re going to take a look at the movement of your foot from the gas pedal to the brake pedal. Keep the engine off and the parking brake on.

Observe how quickly and efficiently the driver can move between the gas and brakes with his or her foot landing squarely on the pedals.

For a safe stop, you need to brake quickly with your foot landing squarely on the brake pedal. Put your foot on the gas pedal but do not depress the gas. When I say “Stop,” move your foot to the brake. I’m going to signal you to do this three times.

Activity Comments

To encourage a quick response, make the request in a slightly louder voice with about 3 seconds between commands. Observe the foot movement. Is it smooth, quick and accurate? If there appears to be any difficulty, check “No” on the CarFit Checklist.

Your foot should be on the gas pedal… now STOP … Return your foot to the gas pedal … now STOP …Return your foot to the gas pedal…now STOP. Now move your foot back to the gas pedal and relax.

Item 8: Mirror Adjustments

What we check: If the driver is able to use the rearview and outside mirrors effectively to check blind spots. We have already checked forward field of vision. Equally important are good side and rear views. Using the outside and rearview mirrors effectively requires that each mirror be adjusted properly. Why we check: For older drivers, many crashes involve merging and lane changing. Proper use of mirrors or the use of special mirrors can make these maneuvers safer. If the driver is not able to obtain appropriate views through adjusting mirrors, the occupational therapist can recommend special mirrors and other solutions. Many drivers have not been instructed to adjust mirrors correctly. Some drivers get into the bad habit of not using a mirror or mirrors. Others may have a physical limitation, such as arthritis or a cervical fusion that prevents them from turning their neck far enough to see an outside mirror. Ask the driver if they have used the BGE method, which stands for Blind Spot – Glare Elimination and demonstrate (there is a color handout as reference). Drivers who have attended a driver refresher course may be familiar with this enhanced mirror setting, but may not have put them to use in their own vehicles. Sample Script – CarFit Checklist Item 8: Mirror Adjustments

Activity Comments

SUGGESTION: Work in pairs. One Technician moves around the vehicle. One provides direction to the driver.

We are going to look at the positioning of your rearview and side mirrors. Do you feel they are adjusted to give you the best view? Many crashes occur when drivers change lanes or merge. Minimizing any blind spots and maximizing visibility to the rear and to the side is an important way to stay safe.

Activity Comments

Walk to approximately 10 feet to the rear of the vehicle. For cars, hold 1, 2 or 3 fingers up just above the level of the trunk. For minivans or SUVs, hold fingers just above the lower part of the rear window. (Technicians working solo may have to walk back to the driver’s door to hear their responses.)

I am going to walk to the rear of your car and hold up a number of fingers. Please put your hands on the steering wheel as if you were driving. When I ask “how many fingers?” look through your rearview mirror and answer. No turning around, use the mirror. How many fingers am I holding up?

Mark the CarFit Checklist based on driver’s response.

NOTE: If the vehicle does not have a right outside mirror, mark N/A on the CarFit Checklist.

Walk to the right side rear bumper and stand 2-3 feet to the right of the car, facing forward. Hold 1, 2 or 3 fingers at the level of the car’s right outside mirror.

Now we are going to do the same thing using the right outside mirror. Again – use only your mirror. How many fingers am I holding up?

If the driver cannot see you, the mirrors are improperly positioned. Mark on the CarFit Checklist whether or not the driver can see through the mirror prior to adjusting it.

Check to see that the rearview mirror is adjusted so that the reflection frames the rear window.

First we will check the position of the rearview mirror. Does your rearview mirror frame your rear window?

Check to see that the rearview mirror is adjusted so that the reflection frames the rear window.

First we will check the position of the rearview mirror. Does your rearview mirror frame your rear window?

Advise that you can demonstrate an enhanced

We can minimize your blind spot by adjusting

mirror setting, called the “BGE” Method (Blind Spot Glare Elimination)

your mirrors. Would you like me to show you an improved method of adjusting your mirrors?

Demonstrate BGE. First, identify blind spots by walking up from the rear of the car. Adjust mirrors using BGE method. Repeat the walk-up emphasizing the reduced blind spot. Repeat on the other side

You’ll be given a handout today to take home with you that explains the BGE Method in more detail.

Enhanced Mirror Settings

There is a simple yet powerful technique to reduce the size of your vehicle’s blind spots. It involves only a couple of adjustments to your vehicle’s side mirrors. From a parked position, follow these steps: 1. To adjust the left side mirror, rest your head against the closed window and set the mirror to barely show the edge of your vehicle. 2. To set the right mirror, lean to the right so that your head is directly below the rearview mirror or above the center console. Adjust this mirror the same way, so you can just barely see the edge of the right side of your vehicle. With the side mirrors now angled outward slightly more, you’ll gain increased visual coverage of your blind spots. You should still perform a quick head check before changing lanes, but you’ll now have almost seamless visual contact with all areas behind your vehicle. Another way to enhance your vision to the rear is to install special mirrors to reduce your blind areas:

Consider installing larger side mirrors - right and left.

Use a panoramic (curved) rearview mirror inside. You may also want to attach a small convex (curved) mirror on a side view mirror. Although convex mirrors make objects seem farther away, they can help you detect movement more easily. However, don’t depend solely on a convex side mirror, which might make you think you have more room than you really do.

1. 2.

Item 9: Neck Mobility for Visual Blind Spot Check

What we check: If the driver is able to identify visual blind spots on both sides of the vehicle by turning their neck and trunk. Why we check: Some drivers do not have the mobility of their head, neck or trunk to perform this vital task. An inability to move one’s neck adequately when merging and lane changing can contribute to collisions. Many drivers check only rearview and outside mirrors – and these mirrors may not be adjusted for the best visibility. Explain to the driver that using the enhanced mirror settings (as outlined in #8 above) does not eliminate the need to further check blind spots, thus why neck mobility is important. Sample Script – CarFit Checklist Item 9: Neck Mobility for Visual Blind Spot Check

Activity Comments

SUGGESTION: Work in pairs. One Technician moves around the vehicle. One provides direction to the driver.

Now let’s check see how easily you can move your neck to check for blind spots. I’m going to stand in a blind spot and ask you to try to see me by just looking at your left outside mirror.

Position yourself on the driver’s side, even with the back of the rear passenger’s seat. Step 5-6 feet to the left and face forward.

Once we determine I am in you blind spot, I’ll ask you to turn your head and tell me how many fingers I’m holding up. Place your hands on the steering wheel and leave them there throughout this check. You just have to turn to look over your shoulder far enough to see where I’m standing.

Have the driver look in the left outside mirror and ask if the driver can see you in the mirror. If the driver says “yes,” take another step to the side and ask again until the driver no longer sees you.

Activity Comments

Now stand in the blind spot so the driver can only see you by turning their head and/or trunk.

Look straight ahead until I ask you to turn your head …Ready?

Hold up your fingers at the level of the outside mirror, or slightly higher.

OK, please turn your head and tell me the number of fingers you see.

If the driver releases their hands from the steering wheel, politely remind them to try again with their hands on the steering wheel.

NOTE: If you observe the driver turning and scanning over their shoulder, you do not need to require them to repeat the process.

If the vehicle has a right outside mirror, repeat the process on the right side. If not, mark N/A on the CarFit Checklist.

Ok, now we are going to repeat this check of blind spots on your right side.

If the driver cannot turn his or her neck or head, note this on the CarFit Checklist so the occupational therapist can address this issue during Checkout.

Item 10: Ignition Key or System

What we check: Is the driver able to properly use the ignition key or system? Observe any difficulties or complaints of pain or discomfort. Why we check: There may be new techniques or adaptive devices that improve the comfort and safety of drivers experiencing difficulties. Sample Script – CarFit Checklist Item 10: Ignition Key or System

Activity Comments

If the key is in the ignition switch, ask the driver to remove it. If the key is not in the ignition, ask the driver to put the key in the ignition and then remove it. Observe the driver inserting, then removing, the key. Watch for any signs of weakness or pain. Positioning the wheel so the ignition is in sight makes this process much easier.

Now we are going to look at how you turn the engine on, with your key or keyless system. I’d like to watch you put the ignition key in the switch and the remove it. Go ahead and do that, please. Did you experience any problems or discomfort?

SAFETY CHECK: Make sure the vehicle is in Park.

In observing how the driver turns the key, watch for signs of limitation or discomfort. For example, drivers may move their trunks to get closer to the switch because of limited reach. Or they may need to use both hands. Note any difficulties on the CarFit Checklist so the occupational therapist can address this and suggest adaptive devices.

Now, please make sure the car is in Park (Neutral for vehicles with manual transmission). Stick the key back in the ignition and start the engine. Is it painful or difficult to turn the key?

Item 11: Operation of Vehicle Controls

What we check: Does the driver have any difficulty operating the secondary controls: wipers, turn signal, horn, and parking brake? During this check, inform the driver if you notice headlights or taillights are not in working order or need to be cleaned. Why we check: There may be new techniques or adaptive devices that improve the safety and comfort for the driver. Sample Script – CarFit Checklist Item 11: Operation of Vehicle Controls

Activity Comments

SAFETY CHECK: In some vehicles, controls may not operate if the engine is off. Make sure the parking brake is off and the vehicle remains in Park (or Neutral for vehicles with manual transmission).

Ask the driver to apply the parking brake, put the car in Park (or Neutral for manual transmission vehicles) and set the ignition key to the accessory position.

We’re going to check your fit with secondary controls – your turn signal, lights, wipers, horn. Please make sure the parking brake is on and you are in Park. Turn your ignition key to the accessory position.

Stand beside the driver door and instruct the driver to operate the left turn signal. Note any issue on the CarFit Checklist.

Turn the left turn signal on. OK, cancel it. Was that uncomfortable for you?

Activity Comments

Stand beside the driver door and instruct the driver to operate the right turn signal. Note any issue on the CarFit Checklist.

Turn the right turn signal on. Cancel the signal. Thank you.

Stand at the driver’s door and observe the driver reaching for and operating the headlight switch/button.

Now turn the headlights on. Turn on your high beams. Turn off the high beams. Turn off the headlights. (If the vehicle is not equipped with daytime running lights.)

Stand at the driver’s door, observe the driver reaching for and operating the emergency flashers.

Please turn on your emergency flashers. Turn them off.

Now let’s look at the operation of the parking brake. Release the parking brake.

Observe whether the parking brake is operated by hand or foot. Note any issues on the CarFit Checklist.

Apply the parking brake. Do you have any difficulty doing that?

SAFETY CHECK: Parking brakes that are not regularly used may stick. For older vehicles, we recommend skipping this check.

Move away from the front of the vehicle in performing this check.

We have one last task inside the vehicle. Turn the engine on. Keep the car in Park.

Observe as the driver turns the steering wheel one full turn – but not all the way to its stopping point. Watch for difficulties in steering in terms of smoothness, quickness, grasp of the wheel and reach.

When I ask, look straight ahead and turn the steering wheel to the right, one full turn. Now turn the wheel back to the center. Turn it to the left one full turn. Return the wheel to the center. Please turn the engine off.

Activity Comments

Some drivers use the new recommended method of sliding the steering wheel through the hands while they are positioned at 4 o’clock and 8 o’clock. Note any issues on the CarFit Checklist.

SAFETY CHECK: Confirm that the steering wheel returns to center so front wheels will not be turned when the driver leaves your Checkup Station.

Ask driver to sound the horn. Note if it is not in working order.

Could you please sound your horn? Thank you.

Review the CarFit Checklist to make sure it is complete and any comments are legible. Hand the clipboard to the driver and direct them to proceed slowly to the Checkout Station.

Your next stop is Checkout. Our occupational therapist will use your CarFit Checklist to suggest methods or adaptive devices that might make you safer and more comfortable in your vehicle. Do you have any questions? Thank you. It was a pleasure meeting you.

Section 7: Checkout Station At the Checkout Station, an occupational therapist completes the CarFit Checklist by conducting Item 12 – Vehicle Walk-Around. Occupational therapists help people with various limitations and disabilities perform daily activities and retain their independence. They have the expertise to notice nuances (such as gait, balance and lack of flexibility). During Checkout, the occupational therapist discusses any questions the driver may have and suggests solutions ranging from the use of adaptive devices to considering driving programs for mature operators. Your CarFit event may also involve a driver rehabilitation specialist. Their expertise is in working with adaptive driving equipment and aids, such as special mirrors and pedal extenders. Drivers have the option of declining to do the Vehicle Walk-Around. Events without Occupational Therapists Some CarFit Events do not have an occupational therapist on site. If you note any concerns in completing the CarFit Checklist, recommend that the driver consult an occupational therapist or driver rehabilitation specialist to find solutions that keep them safe and comfortable in their car. At Checkout, a volunteer will distribute Goodie Bags that include a list of community resources available to drivers.

Item 12: Vehicle Walk-Around

What we check: Does the driver demonstrate any difficulties getting out of the vehicle and walking around it? Does the driver have questions or concerns? Is any education needed on safety issues related to tires (such traction or tire pressure)? Why we check: This is an opportunity to observe any concerns with the driver’s mobility and balance. Occupational therapists should not comment on the participant’s long-term ability to drive, but should suggest that participants consult their physicians if they identify a concern. It is also an opportunity to talk with the driver about any damage to the vehicle, such as cracks in the windshield or significant dents and scratches. If the driver is receptive, the occupational therapist may ask how damage occurred. Sample Script – CarFit Checklist Item 12: Vehicle Walk-Around

Activity Comments

Review the CarFit Checklist with the goal of finding opportunities to suggest new techniques or the use of adaptive devices.

Hi. My name is ___________________. I’m an occupational therapist (or driver rehabilitation specialist.) It is OK to identify your workplace.

Observe how the driver exits the vehicle. Did this appear to be painful or difficult? Did the driver pull up using the door or seat for assistance?

I’d like to ask you to get out of the car and walk around your vehicle with me.

Activity Comments

NOTE: Drivers may decline. If so, conclude the Checkout by giving them the Goodie Bag and letting them know it contains a listing of community resources for drivers.

Walk beside the driver around the car, providing a steady hand if needed. Note if the driver has any balance problems, requires a cane or walker, or has artificial legs.

Is walking difficult for you? Do you have any problem with balance or dizziness? Any discomfort?

(Consistent with your experience, expertise and comfort, suggest any improved methods or available adaptive devices to help the driver remain safe and comfortable.)

Point out any issues related to tire condition or pressure. Review tire safety handout with participant.

Examples of conversation: Do you have any questions related to your tires? Tire problems to watch out for are over-inflation, under-inflation, tread wear on the edge and erratic tread wear. If the tread is raised, that might indicate a radial belt inside the tire has separated.

NOTE: Do not confront, question or challenge drivers. This is a positive and supportive discussion in which you share observations.

Point out any significant dents, scratches or cracks on the vehicle. Allow the driver the opportunity to share how the damage occurred.

Examples of conversation: I notice a scratch on your bumper. Were you aware that had happened? Your back wheel is missing a hubcap. Were you aware that had happened?

Activity Comments

NOTE: You may bring a reference file with printouts of state laws related to cracked windows and burnt out taillights. Point out this information as a courtesy to the driver.

If you notice any safety issues related to the condition of the vehicle, call them to the driver’s attention.

Examples of conversation: Your windshield has a crack that could get worse and make it hard for you to see. I would recommend you fix that as soon as possible. Many insurance companies will pay for the entire cost of replacing the window – some make the repair at your home or office. Your tail light has a crack. That might short out. I would recommend you fix that as soon as possible to help protect you from being hit from the rear.

Observe whether the headlights, tail lights, side mirrors rear and front windshields are dirty. Ask the driver if a volunteer may wipe them off with glass cleaner.

You lose some of the brightness from your lights when they get dirty, so make it a habit to clean them at each fill-up.

Double-check that you have completed the CarFit Checklist and addressed any concerns.

Do you have any questions for me? OK, you can get back in the car. Please fasten your seat belts.

Review the contents of the Goodie Bag and demonstrate any adaptive devices that may be useful to the driver.

We have a Goodie Bag for you. It contains educational materials and local resources.

Thank the driver and direct him or her to the exit.

Thank you for participating in CarFit. Please recommend us to any other drivers you feel would benefit. Please drive slowly to the exit.

Activity Comments

SAFETY CHECK: The CarFit Event Coordinator should brief you in advance on how to handle drivers who appear to be at risk. If a driver appears at-risk to drive away from the event, the designated person might offer to:

Provide water or food and a place to rest.

Call a friend or family member to drive the participant home.

Arrange a ride from a cab (with voucher) or volunteer. As a last resort, call law enforcement.

In a case of acute distress, call 9-1-1 immediately.

Questions? Your CarFit Event Coordinator can answer questions about how your specific CarFit event is organized and will operate. There is also information available (to read and download) on the CarFit website: www.car-fit.org. When you complete your training, you will gain access to these valuable resources.

Waiver of Liability Form

Revised 12/12

CarFit

Helping Mature Drivers Find Their Perfect Fit CarFit is an educational program created by the American Society on Aging and developed in collaboration with AAA (American Automobile Association), AARP, and the American Occupational Therapy Association. Data from the program will be collected, but no names will be associated with the information collected. Group data may be used by AAA, AARP, and AOTA to evaluate and develop future programs. Participants will be given a copy of their individual CarFit Check-Up results. I understand and agree that I am voluntarily participating in the CarFit program. I further understand and agree that the purpose of the CarFit program is to help me learn ways to enhance the fit of my personal vehicle to me as a driver; that this program is being provided to me as a free service; and that any changes I decide to make to my vehicle as a result of the information I receive during the CarFit Check-Up are made voluntarily. In consideration for the opportunity to participate in the CarFit program, I hereby release and forever discharge the American Automobile Association, its affiliated clubs, AARP, the American Occupational Therapy Association, and their officers, directors, employees, and agents, from any and all present or future liability, claim, loss, cost, or expense, arising from or attributable to my participation in the CarFit program or to any negligence, action, or omission to act, of any such organization or person.

Print Name Number/Street City/State/Zip

_______________________ ____________________________________ Participant Signature Date

__________________________ _________ How did you find out about CarFit? Radio TV Flyers Signs Newspaper Other _______________________

Tire Information…Know the Facts!

While it's easy to overlook those four patches of rubber called your tires,

performing a few simple checks can yield better fuel economy and improved

vehicle handling. Since most tire damage and wear is a result of driving on tires

that are improperly inflated, tire experts suggest checking your air pressure once

a month.

Maintaining proper tire pressure is important for many reasons other than

reducing the potential of a flat tire or a blowout. In order to achieve optimum

handling from your vehicle, from everyday driving to making emergency

maneuvers, tire pressure needs to be at the proper inflation level. Even a tire that

doesn't appear to be low on air can result in reduced vehicle handling and

excessive tread wear.

How to Check Your Tire Pressure To check tire pressure, use an air pressure

gauge. These inexpensive items are available at auto parts stores, gas stations, or

in the automotive section of department stores. Many gas stations have one that

you can borrow in a pinch.

How Much Air Pressure? You can find the vehicle’s recommended air pressure in your owner’s manual or on a placard typically located on the driver’s doorjamb. The placard may also be located in the glove box or inside the trunk lid or fuel filler door.

Checking Tread Depth. Place a quarter into several tread grooves across the

width of the tire. If part of Washington’s head is always covered by the tread,

your tires have more than 4/32 of an inch of tread depth remaining and are safe

for use. If the top of Washington’s head is exposed at any point, you should

replace the tires. This replaces the previous method of checking tire tread depth

using a penny to measure 2/32 of an inch. Although legal at 2/32 of an inch, a

safer choice is 4/36 of an inch.

Source: AAA DIP Program

1

The CarFit Manual

Your manual and this presentation were prepared to train you to participate in CarFit events as a Trained Technician

Trained Technicians are eligible to become CarFit Event Coordinators by attending an additional training class designed specially for Event Coordinators

You must successfully complete a CarFit event to be certified a CarFit Technician

Today’s Agenda

1. Program Objectives & Background

2. The CarFit Event

3. CarFit Roles & Positions

4. Review of the CarFit Checklist

Break

5. Lab Portion: Outside

6. Instructions and Plan for CarFit Event

2

Program Objectives

Promote continued safe driving and mobility among older drivers by focusing attention on safety, comfort and fit

Create an open environment that promotes conversations about driving

Provide information, EDUCATION, and community-based resources to older drivers in a non-threatening, quick, and easily accessible manner

Program Background

Program Background

Created by the American Society on Aging in collaboration

with:

� AAA

�AARP

�American Occupational Therapy Association (AOTA)

Launched nationally in 2006, CarFit is available in 46 states, and abroad in Canada, Australia and New Zealand

This initiative depends on the efforts of volunteers to work effectively

3

Why do we need a program like CarFit?

People over 65 are the fastest growing age group

By 2030, there will be 58.9 million people age 65 and older— that’s 1 in 4 drivers over 65

Personal mobility is critical for healthy aging

Our bodies change as we age—ill fitting

vehicles can make it uncomfortable and unsafe to drive

Program Background

CarFit is a community-based program that focuses on driver fit with their vehicle

Primary focus of the program is to provide active drivers with safety information and

education

CarFit is NOT an evaluation for ability to drive� No Pass/Fail messages� Information is confidential

Program Background

CarFit check-ups are designed for community-based settings�Senior/community centers, church or school parking lots�Hospitals and health centers�AAA or AARP offices

Uses a trained team of volunteers & health professionals

Appointments are designed to take approximately 20 minutes to asses the “fit” between the driver and the vehicle

The central point of the program is the 12 point CarFit checklist

4

Roles Within CarFit

InstructorsEvent

Coordinators

Trained

Technicians

Untrained

Volunteers

There are four roles within CarFit for volunteers

Roles: InstructorsInstructors have responsibility to communicate with national organization staff--as leaders in CarFit, they oversee the program’s integrity and consistency

Instructors receive specialized training and can teach Technicians and Event Coordinators

Roles: Event CoordinatorsEvent Coordinators hosts CarFit events, manage logistics, and provide training to the volunteers

and Technicians participating at the CarFit event

Event Coordinators receive additional training and

are able to train Technicians

5

Roles: Technicians

Technicians participate in and follow the direction of the Event Coordinator overseeing the CarFit event

After completing today’s training and a CarFit event, you will be certified as a Technician

Technicians work in teams and review the 12 point checklist with participants

You must complete a CarFit event after training to be certified as a Technician

Roles: OT’s or DRSOccupational Therapists or Driver Rehabilitation Specialists bring an understanding of aging and medical conditions to the conversation

OT’s or DRS’s are also Technicians, but their role at a CarFit event is to address any concerns that may have come up during the checklist review and provide information and resources on issues related to driver safety during the check-out station of the event

Roles: Untrained Volunteers

Volunteers that are not trained to conduct a vehicle check using the 12 point checklist may

also participate in an event

Untrained Volunteers can assist with traffic

direction, Check-In, and serve as runners

6

Education is Key…

DO NOT make adjustments for the driver…only the driver

should make the adjustment

If you demonstrate a recommended position, the driver is to

make the change if they choose to do so

A good rule of thumb: the driver is the last person to touch the

wheel, head restraint, seat, etc

This is a public educational event—our

role is to educate, not make changes for

the driver

Following the demonstration, the driver can choose to return

the settings to the original position, or keep the new adjustment—provide them with these options

Keep in Mind…

As driver’s age, they may need new strategies or adaptive tools to ensure their safety and comfort

Age related changes can have an impact on driving safety; our goal is to provide education and make participants feel comfortable

Speak slowly and clearly, and make eye contact with the participant

Provide clear transitions and offer cues about what you will discuss

Be patient! Allow the driver the time they need to understand and perform each task

The CarFit Event

The checklist is the primary tool for conducting a Carfit check

What we review on the checklist…

� Safety belt use� Steering wheel tilt

� Head restraint setting

� Line-of-sight over the steering wheel

� Positioning to airbag� Positioning to gas and brake pedals

� Mirror adjustment/blind spot check

� Operation of parking brake and ignition key

� Operation of Vehicle Controls

Working under the supervision of the Event Coordinator,

trained Technicians work in teams of two to conduct the CarFit

check using the checklist

7

The CarFit Event

How is a CarFit Check-Up Conducted?

A trained team of community volunteers and health professionals review each checklist item with drivers while seated in their own vehicle

At the end of the 12 point check, an Occupational Therapist discusses areas of concern with the participant

Appointments take approximately 20 minutes and asses the “fit” between the driver and the vehicle

The CarFit Event

Carfit events range in size, based on availability of sites, volunteers and community need

A CarFit event can be geared to any size—from a single car, to a large community event that serves dozens of drivers

CarFit can be customized to almost any location where a parking lot can be safely secured for use

The event site should have an easily accessible parking lot with at least one separate entrance and exit

Ideally, this space will have shade/covered area and easy access to restrooms

The CarFit Event

Participants are routed to three stations:

Check-In: Staffed by Technicians or volunteersCheck up: Staffed by Technicians in teams of twoCheck out: Staffed by the Occupational Therapy Practitioner

Each Technician must be aware of the site layout and designated stopping places

We’ll take a closer look at the three stations in just a minute…

8

The CarFit Event

Enter

Exit

Check Up Station

#1

Check Up Station

#2

Check Out

Check In

Every

CarFit

Event is

Different!

The CarFit Event: Setting Up

A tent is great for protection from the sun and rain and may be available at your event

Tables for paperwork

Paperweights for windy days

Chairs for resting

Snacks and water for volunteers and participants

Available restrooms for volunteers and participants

The CarFit Event: SignageYellow signs with black lettering are great for visibility

The Event Coordinator is responsible for all signage, but may assign a member of staff to “manage” the placement of signs

Signs should note the following:

� CarFit Today (placed in road)

� Welcome to CarFit

� Entrance signs� Check-In signs

� Signs at each check up station

� Sign at the check out

� Exit signs

Don’t forget to collect all of the signage at the end!

9

The CarFit Event: Safety First

Event Coordinators receive special training

that covers parking lot safety and site

logistics

We use cones to map out the parking lot

and lanes

Safety vests for volunteers are required for visibility…be bright, be seen!

The Event Coordinator may delegate a

member of staff to assist with the placement/collection of cones either before

or at the completion of the event

Traffic Direction & Check-In

I’m looking for

the shopping

plaza

Why a Traffic Director? As participants arrive, the Traffic Director guides drivers to the

Check-In area and helps with all aspects of traffic flow

This is the first person to greet the participant—they should be

familiar with the event, local area, and names of nearby roads

The Traffic Director should have good communication skills and

enjoy talking to people

This person can be a non-trained volunteer from the community

(senior volunteer, local law enforcement, cadets, etc)

I’m looking

forward to learning

something new

today!

10

Safety Note for Traffic Directors

Always wear your safety vest to be seen

Don’t try to waive in cars from a public street

Give simple, clear direction

Overemphasize what you want drivers to do

Never work against traffic controls…if there is a STOP sign, don’t tell people to “go” until after they’ve come to a complete stop

Don’t multi-task! Stay alert and omit distractions

Check-In Station

Enter

Exit

Check Up Station

#1

Check Up Station

#2

Check Out

Check In

Check-In Station

Location: Far enough into the site that cars are not blocking the roadway

Check-in personnel greets participants, confirms appointments (managing participants without appointments according to the Event Coordinator’s plan) and completes all paperwork

Check-in personnel are not required to attend the Technician Training. This position can be managed by a volunteer from the Host agency, for example, only performing Check-in duties

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Check-In Station

Responsibilities at Check-in include:

Reviews and collects signed Waiver Form, placing it in marked folder or bin

Scans for the safety belt check and notes on the checklist

If available, offers the participant a bottle of water

Hands driver the clip board with checklist attached, and directs the driver to proceed with caution to the check up area (or safe holding location)

Check-In Station: Seatbelt Check

TAKE NOTE!! The first person to observe the driver at Check-In should fill out this portion of

the checklist (located in top right-hand corner)

DATE PARTICIPANT # VEHICLE MAKE, MODEL & YEAR

1/6/2013 006 2012 Hyundai Sonata

________________________________________________________

Was driver wearing seatbelt when they arrived at event? Y N

Check-In Station: Waiver Form

Waiver form must be completed in order for the driver to participate—no

exceptions

If the participant refuses to complete the waiver, politely explain they cannot go through the event today, or alert your

Event Coordinator so they can speak to the participant and inform of this policy

This form protects the CarFit program,

the event and facility, Event Coordinator and staff/volunteers from liability

Should be retained in a folder for the Event Coordinator to keep in files

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Check-In Station: Model Release

If media is present, collect media

waiver/model release forms at Check-

in (all forms found on CarFit website)

The driver does not need to sign this

form and has the right to decline to be

on camera

If the participant declines to be on

camera:

Place a Post-It note on their

windshield so the media and check up personnel are aware

Notify your Event Coordinator, so they

can ensure the driver’s wishes are met

A Note About Media…

Event Coordinators or designated PR representatives are the only

staff at the event authorized to speak to media

If the Event Coordinator has granted access for staff to speak to

the media, this will be planned in advance and staff will be notified

Check-In StationSample Script/Role Play

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Check-Up Station

Enter

Exit

Check Up Station

#1

Check Up Station

#2

Check Out

Check In

Check-Up Station

Technicians use the 12-point checklist to examine the driver’s positioning in their vehicle during the check-up

We provide information and educate on proper positioning in vehicle

Volunteers work in two-partner teams # Volunteers + size of lot = multiple check-up stations

Issues needing additional education are brought to the OT or DRS’s attention for review at check out

If a driver becomes upset, or has questions you cannot answer, simply circle the √ for the OT to address

Check-Up Station

Briefly introduce yourself and organization when driver pulls into your station

Make them feel comfortable and welcome

Have the driver:� Put the vehicle in park � Roll down passenger & driver windows� Turn off the engine

Reminder! This process is to take 20 minutes, so be friendly, but punctual

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How to Conduct a CarFit Check

Now we will review the 12 items on the checklist and how to conduct a vehicle check

Time will be provided today to practice what you’ve learned in teams with the use of vehicles outside

Tip: The owner’s manual

typically provides detail about

the location and operation of

vehicle controls

Using the √ mark on the Checklist

The √ mark feature on the Checklist is to be used to notify the occupational therapist of items that

need further attention at Check-out

Below is an example of a Checklist properly

completed in which the driver’s safety belt was worn correctly, but caused discomfort

Discomfort with belt

Using the √ mark on the Checklist

Circling the √ is not reserved solely for serious safety concerns, but is also used as an opportunity to make a driver more comfortable or knowledgeable about a “fit” related issue

If the professional services of on occupational therapist or DRS might be of benefit, materials on local driving programs and safety resources will be shared at checkout

15

Item 1: Number of Drivers

What we check: If others – such as a spouse or partner also drive the vehicle

Why we check: Drivers of the same car may require different adjustments to the seat, steering wheel, wheel tilt and mirrors for visibility and comfort

Item 1: Number of Drivers

If there are additional passengers, invite them to either wait in the waiting area, or stay in the vehicle to observe the check-up

Ask the participant if there is more than one driver of the vehicle

If yes, ask if they are participating today

If no, encourage them to enroll their spouse/friends in a future CarFit event

Explain that drivers of the same car may require different adjustments for optimal safety

Item #1Sample Script/Role Play

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Item 2: Safety Belt Check

Discomfort with belt

What we check: If the driver consistently uses the vehicle’s safety belt and uses it correctly

Why we check: This is an opportunity to help drivers understand the life saving benefits of the safety belt

Item 2: Safety Belt Check

Safety Belt: Also more commonly referred to as the seat belt (both terms are correct)

Note comments from Check-in about use

If the driver is wearing the seat belt, ask if this is a habit

Provide education on why it is important to wear the seat belt on every single ride

Item 2: The Safety Belt

Explain the lifesaving benefits of wearing the vehicle’s seat belt

� Reduces ejection

� Helps keep person in place in the event of a crash

� Helps absorb some of the energy forces from the crash by allowing passenger to “ride-down” the crash

� It’s the law!

17

Item 2: The Safety Belt

Observe if the belt is being used correctly (over the shoulder--mid

collar bone, and low on the hips)

If placed behind the back or under the arm, injury may result

Ask the driver if the seat belt is comfortable and if they normally

use it

If the driver says it is uncomfortable or cutting across their neck, make a note for the OT

Make the driver aware of the possible adjustments, show them

where they can adjust the safety belt

It is then the driver's choice to apply changes

Item 2: The Safety Belt

Also observe any problems the driver has in

turning/reaching for the safety belt and buckling it

correctly

Have the driver buckle & unbuckle the safety belt

several times

Make sure it retracts completely before re-buckling

If there are problems, note and refer to the OT to

address at check out

Take Initial Measurements

What we check: At this point, the Technician will take the initial

measurements of the driver-to-vehicle fit for steering wheel position

and line of sight by measuring the distance between the chest and

steering wheel, and the line of sight above the steering wheel

Why we check: Taking an initial measurement will provide us with

a guide as we check items #3-#6 on the checklist

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How To Take MeasurementsDistance between chest and steering wheel:

Either give the driver the ruler and ask them to do the measuring, or

do the measurement yourself

If taking measurement for the driver, use good judgment and be

careful to protect their personal space

To get this measurement, ask driver to look straight ahead and

place one end of the ruler/measuring tape about the middle of the

participants chest and place the other end on the middle of the

steering wheel

Note how many inches are

between the participant and the steering wheel

in the space provided

How To Take Measurements

Line-of-Sight above steering wheel:

Ask the driver to look straight

ahead with hands on wheel in normaldriving position, and position yourself

at the driver’s eye level

Ask the driver to hold a ruler in a straight, horizontal line from the

eye level to the windshield

Using a second ruler, measure the distance from the first ruler to the top of the steering wheel

Note both measurements on the checklist before proceeding

to item #3

Item #2Sample Script/Role Play

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Item 3: Steering Wheel Tilt & Airbag Position

Made recommendation

What we check: The steering wheel should be tilted at an angle that allows the driver to have good forward vision, unobstructed view of dashboard, and good control of the wheel

Why we check: Many drivers do not know how to adjust the tilt of the steering wheel and don’t understand the clearance required between drivers and airbags

Item 3: Steering Wheel Tilt

Explain the reasons why the tilt of the steering wheel is important

� The airbag should be positioned pointing to the driver’s chest, not their face, to minimize injury in the event of a crash

� The steering wheel should be at least 2 inches above thigh to prevent injury to the legs

� Driver should be able to reach the wheel easily, with the arms slightly bent for comfort

Item 3: Steering Wheel Tilt

Look at steering wheel angle

Driver should be able to see gauges and speedometer

Based on the initial measurement, is the steering wheel a safe distance from the driver?

10+ inches from chest to wheel is ideal for optimal safety in the event of a crash

20

Item 3: Position to Airbag

Hands should be positioned at 9 and 3 o’clock OR at the 8 and 4 o’clock positions to prevent injury to the arms if the airbag deploys…most drivers are accustomed to the “old way” of 10 and 2

Note! Some newer vehicles have hand controls—in this case, the 8 and 4 o’ clock position is preferred

Don’t forget to provide education and review how to make adjustments if they are needed

Item #3Sample Script/Role Play

Item 4: The Head Restraint

What we check: If the driver’s head restraint is adjusted properly

Why we check: A properly adjusted head restraint protects drivers from whiplash and other injuries, particularly if the vehicle is rear-ended

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Item 4: Head Restraint

Check to see if the vehicle has an adjustable head restraint and note Yes/No on the checklist

Educate on proper positioning for the head restraint

� Explain that the recommended position is to optimize protection in a crash, prevent whiplash and protect the head/neck

Item 4: Head Restraint

Measure the distance from back of head to head restraint for the driver

Height: Should be mid-ear

Distance: 2 ½ inches or less from back of head (touching is fine)

Show driver how to reposition the head restraint

Driver then chooses to make theAdjustment to the head restraint

Item #4Sample Script/Role Play

22

Item 5: Distance to Steering Wheel

What we check: Based on possible adjustments made in #3, the measurement will be taken again to ensure a safe distance between the chest and steering wheel

This is the second measurement, so it could differ from the first measurement

Why we check: If the driver is too close, or cannot reach

the pedals, they may need to move their seat

10

Once adjustment was made, driver could no longer reach the pedals

Item 5: Distance to Steering Wheel

Explain to the driver why it’s vital to sit a safe distance from the

airbag

� There should be at least 10 inches from your chest or to the center of the steering wheel

� You need this clearance because when the airbag deploys, it

fills with air and moves toward you like a big balloon

� It only stays inflated for a quarter of a second, and the airbag

cushions the driver as it deflates

� It deploys so quickly that many drivers don’t realize it until the

airbag is already deflated

� It’s job is to protect you, but we need to ensure you are sitting a safe enough distance away

Item 5: Distance to Steering Wheel

Use the ruler to take the second measurement, or allow the driver to take the measurement

In addition to sitting at least 10 inches back from the airbag, the driver should be able to position their seat so there is no slack in the safety belt or difficulty in reaching the pedals

If an optimal adjustment cannot be made by moving the seat, make a note for the OT to address at check out

23

Item #5Sample Script/Role Play

Item 6: Line of Sight

4

What we check: If the driver has the proper line of sight over

the steering wheel for an adequate view of the road ahead

Again, this is the second measurement, so it could differ from

the first measurement

Why we check: Drivers may not realize that at least 3 inches

above the top of the steering wheel is ideal for a safe, straight

line of sight

Item 6: Line of Sight

Explain to the driver why a good line of sight is needed for safety

� If the driver has a proper line of sight over the steering wheel, they have an adequate view of the road ahead

� Experts agree that at least 3 inches above the top of the steering wheel is ideal for a safe, straight line of sight

24

Item 6: Line of Sight

Use the method from earlier to measure the distance from the

first ruler to the top of the steering wheel

Record the distance in the space provided on the checklist

If the line of sight is less than 3 inches, suggest a seat

adjustment or steering wheel tilt adjustment

DO NOT adjust the seat for the participant, let the driver make the adjustment

If adjustments to the seat and wheel tilt do not bring the driver’s

line of sight to 3 inches or more, note for the OT to address at

check out

Item #6Sample Script/Role Play

Things To Consider… Remember: When one adjustment is made, it may alter the

settings for another part of the vehicle

Example: Participant was sitting too close to the airbag, but

by moving the seat, they can no longer reach the pedals

Note for OT: If there is difficulty in finding an optimal fit,

always note for the OT to address at check out

Best Practice: The Event Coordinator is available to come to

your station to assist as needed—always involve the EC if

you feel uncomfortable or have questions regarding a particular vehicle or check

25

Item 7: Position to Gas/Brake Pedal

What we check: If the driver can easily and effectively depress the gas pedal without reaching, and if they can move between gas and brake pedals without difficulty

Why we check: This check is an opportunity to make drivers aware of safe, non-fatiguing pedal use

.

Item 7: Position to Gas/Brake Pedal

Caution: Be sure the engine is OFF

Ask driver to place hands on wheel and look straight ahead at road

Position yourself so you can see the driver’s right foot

Is the ball of foot on the pedal? Can the driver reach easily?

Driver should not strain to reach the pedals

Item 7: Position to Gas/Brake Pedal

Explain to the driver why we check this

� Certain footwear – such as thick soles, high heels and flip flops – can affect safe movement between pedals

� Drivers should not need to fully extend their legs or use their toes to depress the gas pedal through the full range

� Reaching in this manner can fatigue the leg muscles

26

Item 7: Position to Gas/Brake Pedal

With hands on the wheel, looking straight ahead, ask the driver to move their foot from the gas to brake pedal

Is the driver able to move between the gas and brake pedals without issue, using the “pivot” method?

Could the driver benefit from an adjustment? If so, provide education

With your partner, check if the brake lights are in working order

Note any areas for the OT to address at check out

Item #7Sample Script/Role Play

Questions on 1-7?

27

Item 8: Mirror Adjustments

Driver could benefit from additional info on mirror adjustment

What we check: If the driver is able to use the rearview and side view mirrors effectively to check blind spots

Why we check: For older drivers, many crashes involve merging and lane changing; proper use of mirrors or the use of special mirrors can make these maneuvers safer

Item 8: Mirror Adjustments

Work in pairs on items #8 and #9

This is the most involved part of the checklist and will take the most time

First, observe if the vehicle has mirrors in good condition (clean, not broken)

Item 8: Mirror AdjustmentsExplain to the driver the importance of proper mirror adjustment

� Many drivers have not been instructed to adjust mirrors correctly

and some drivers get into the bad habit of not using mirrors

� We have already checked forward field of vision; equally important

are good side and rear views

� Using the side view and rearview mirrors effectively requires that

each mirror be adjusted properly

� The Blind spot Glare Elimination (BGE) Method can be demonstrated during this item

� If the driver is not able to obtain appropriate views through

adjusting mirrors, the OT can recommend solutions

28

Item 8: Side View Mirrors

Proper Adjustment: It allows the driver to see along side and to the rear of

the vehicle

The traditional way adjusts the side mirror to just see

the edge of the vehicle

Mirrors are designed to warn the

driver when another vehicle is

entering the vehicle’s space cushion

Item 8: Checking Side Mirrors

Driver should have hands on wheel, in normal driving position

Partner places himself even with the rear bumper, and 3 feet to the side

Using only the mirrors, ask the driver to identify the cue (the number of fingers your partner is

holding up at hip-level)

Item 8: Rearview Mirror

Proper Adjustment: Driver should be able to see the edges of the rear window in the rearview mirror

Function: Rearview mirrors allow the driver to see

behind the vehicle

29

Item 8: Checking Rearview Mirror

At the rear of car, partner stands 10 feet back

Partner holds up 1, 2 or 3 fingers near hip-level

Driver identifies in rearview mirror while facing

forward with hands on wheel in normal driving position

Item 8: Checking Blind Spots

Checking for Blind SpotsDo this exercise to test blind spots

Driver seated facing forward, hands on wheel, uses side mirrors

Volunteer begins at starting point at rear of car, then walks forward slowly

Driver identifies when volunteer “disappears” into blind spot using side view mirror

Repeat this process with the other side view mirror

Item 8: BGE MethodIf mirrors were not sufficient in previous exercise, adjust

sideview mirrors using Blindspot Glare Elimination (BGE)

method:

For the driver’s side mirror, participant leans the left side of their

head against the driver’s side window and sets the mirror so

they can just see the side of the car

For the passenger’s side mirror, participant leans to the right so their head is in the center of the car

and sets the mirror so it has

the same view

Confirm the new setting is correct

by repeating the blind spot check in previous exercise

30

Item #8Sample Script/Role Play

Reminder! Education is Key…

Changing mirror settings requires practice and familiarization

It is recommended that mirror adjustments should be done in gradual increments

Suggest home use of written handout as a guide for the participant

If driver chooses to make adjustments, remind them that the “feel” may be unfamiliar when they leave the check up

Those who would benefit from additional instruction about mirrors should be referred to the OT

Item 9: Neck Mobility/Blind Spots

What we check: If the driver is able to identify visual blind spots on both sides of the vehicle

Why we check: Some drivers do not have the mobility of their head, neck or trunk to perform this vital task, and an inability to check blind spots adequately when merging and lane changing contributes to collisions

31

Item 9: Neck Mobility/Blind Spots

Explain to the driver that neck mobility and the prevention of blind spots go hand-in-hand

� Goal is to check for mobility in neck and check for blind spots

� Many drivers check only rearview and side view mirrors and these mirrors may not be adjusted for the best visibility

� Visual awareness also depends on physical ability/flexibility to rotate the neck and trunk

Item 9: Neck Mobility/Blind Spots

With hands on wheel in normal driving position, ask the

driver to turn to look at your partner (you want to be in their

blind spot at this point, so you may need to adjust where

you’re standing)

Ask the driver to identify the number of fingers partner is

holding up

Repeat the process on the right side

Note of caution! You are observing flexibility, there is no

need for the driver to repeat head turning multiple times (doing so can lead to injury)

Note if the participant has any difficulty moving their

neck for the OT to address at check out

Item #9Sample Script/Role Play

32

Item 10: Ignition Key/System

What we check: If the driver is able to properly use the ignition key or system

Why we check: There may be new techniques or adaptive devices that improve the comfort and safety of drivers experiencing difficulties

Item 10: Ignition Key/System

Explain to the driver why we check the ignition system

� We are going to look at how they turn the engine on, with a key or keyless system

� Our goal is to identify any problems or discomfort they may experience when performing this task

Item 10: Ignition Key/System

If the key is in the ignition, ask the driver to remove it

If not, ask the driver to put the key in the ignition and then remove it

Ask the driver to put the key into the ignition and start the vehicle

Use same method for keyless ignition

Ask driver if they have any difficulty with this task

Note any problems with mobility in the hand, wrist and fingers that the OT can address at check out

33

Item #10Sample Script/Role Play

Item 11: Vehicle Controls

What we check: If the driver has difficulty operating the secondary controls: wipers, turn signal, horn, and parking brake

Why we check: There may be new techniques or devices that improve safety and comfort

Item 11: Vehicle Controls

Explain to the driver:

� Item 11 is done with the parking brake engaged and engine on

� Working in pairs, you will note any equipment failures such as burnt out lights

� You will note if there is any difficulty operating the secondary controls: wipers, turn signal, horn, and parking brake

34

Item 11: Vehicle Controls

After going through the points in item 11, note any issues for the OT to address at check out

Review the checklist for any missed items, and then ask driver to sound their horn—it’s fun for the participant and it alerts staff that a vehicle is on the move

Note on the checklist if the horn is in working order

Hand driver the clipboard and direct them to the check out area

Item #11Sample Script/Role Play

Check Out Station

Enter

Exit

Check Up Station

#1

Check Up Station

#2

Check Out

Check In

This is the last step for the

participant

35

The OT or DRS conducts a vehicle walk-around at check out using item #12 on the checklist

Reviews the other checklist items and addresses any concerns the Technician has noted

Demonstrates adaptive device items in the OT gadget kit

Discusses community resources and reviews items in goody bag

Item 12: Vehicle Walk-Around

Key holder and walking cane

A few scratches on bumper—driver unaware. Reviewed in-depth handout for BGE mirror method and tire education

What we check: If the driver has any difficulties getting out of the vehicle and walking around it

Why we check: This is an opportunity to observe any concerns with the driver’s mobility and balance and answer questions

Item 12: Vehicle Walk-Around

Explain to the driver:

� Introduce yourself and briefly explain the role of an Occupational Therapist at CarFit

� In addition to vehicle walk around, you will provide education on tires and review the handouts on tire pressure and mirror settings that are in the goody bag

�You will also discuss adaptive equipment and answer any questions

36

Item 12: Vehicle Walk-Around

Observe how the driver exits the vehicle; did this appear to

be painful or difficult?

Did the driver pull up using the door or seat for assistance?

Point out any issues related to tire condition or pressure

and review tire safety handout with participant

Point out any significant dents, scratches or cracks on the

vehicle and allow the driver the opportunity to share how

the damage occurred

Double-check the checklist for any missed concerns and

review the contents of the goodie bag with the driver

Item #12Sample Script/Role Play

Check-Out Station

Thank driver for their participation and collect the forms

Driver Keeps:� Top copy of checklist

� Goodie bag

We Keep:

� Duplicate copy of checklist

� Clipboard

Direct the driver to proceed with caution to

t the exit of the parking lot

37

Check-Out Station

During checkout, the OT discusses any items flagged

by the circled checkmark and responds to questions from the

driver

OT’s educate the driver about possible solutions and

resources—from the use of adaptive devices to considering a

driving rehabilitation program or education offered by driving

programs for mature operators

AAA and AARP offer driver safety programs/courses

Driver Rehabilitation Programs also offer specialized services

Helpful Tips…

� The purpose of CarFit is to improve safety: if you see something unsafe going on, report it to the Event Coordinator

� Don’t forget to explain why we do something when reviewing a checklist item with a senior; teachable moments are the moments they will take home with them and remember

� Wear your safety vest at all times –be safe: be seen

� Do not step in front of moving cars; even at slow speeds

Helpful Tips…

� Don’t listen to your iPod or MP3 player while working an event – pay attention to what is going on around you

� If you have to make or take a phone call or send a text, step away from where traffic may be moving

� Remember your role at CarFit is to provide education—never make a driver feel bad or uncomfortable

� Have Fun!!!

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Questions?