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

Making Informed Decisions that Drive Independence and Safety

© 2013 Griswold International, LLC


The Week ofDecember 2nd is Older Driver Safety Awareness Week

“AOTA's Older Driver Safety Awareness Week

(December 2-6, 2013) aims topromote understanding of the

importance of mobility and transportationto ensuring older adults remain active in the community— shopping, working or

volunteering—with the confidence that transportation will not be

the barrier to strand them at home.”

The American OccupationalTherapy Association


Goals for Today• Understand the nature/scope of driving issues for older adults

• Learn how Occupational Therapists can help older adults and family caregivers with driving skills/decisions

• Access innovative tools to support safe driving, mobility and independence


Marv Lawson, OTR, DRSDirector of Occupational Therapy Clinical ServicesFox Rehabilitation – Cherry Hill, NJ

Chris Kelly, MEd Director of Learning & DevelopmentGriswold Home Care

Presented by:


Thank you for your courage, energy, and dedication!

Professional CaregiversHealthcare Providers

Family Caregivers Older Adults


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

BRAIN WRITINGSolutions

Orange Arrow Button: Minimizes or expands the GoToWebinar control panel.

Lit Review

Social Media

Advocacy

Solutions Webinar & Toolkit



A Complex Issue with Many Voices



“We all experience physical and mental

changes as we age…slower reaction time, night blindness,

and pain and stiffness can affect driving skills but do not need

to prohibit driving.”

AOTA

“Driving helps older adults stay mobile and independent. But the

risk of being injured or killed in a motor vehicle crash increases as you age.”

CDC

“Both the American Academy of Neurology and the Alzheimer’s Association

agree that a diagnosis of dementia is not a sufficient

indicator of driving risk. Over 75% of patients with mild

dementia are able to pass road tests and

drive safe.”AA/AAN/Gayatri Devi, M.D


“It is easy to say, ‘just give up the

keys’. It is important for me to stay active, and if I

don’t drive I am stuck in the house forever. I can’t live that way.”

Quote from older adult driver

“I am worried about my dad. He has had

several ‘fender benders’ over the past year. There is always a good reason, but this never happened before. I am worried

about his safety, and the safety of others. But it is so

hard to bring this up.”

Quote from family caregiver

Learn How Aging CAN Affect Driving



Aging CAN cause changes in…

• Vision• Hearing• Coordination• Reflexes• Physical strength• Attention span

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


Dementia CAN cause changes in…

• Memory• Concentration• Coordination and reflexes• Ability to recognize the purpose of objects• Ability to read and respond to road/traffic signs

http://bit.ly/18GYYv3

Dementia & Driving Resource Center

http://bit.ly/17Q2fqy

Family Conversations about Alzheimer’s, Dementia & Driving


Warning Signs for Unsafe Driving

• Frequent "close calls” on the road• Finding dents and scrapes on the car/fences/mailboxes/etc• Getting lost, especially in familiar locations• Missing/misunderstanding traffic signals• Slow response to unexpected situations• Can’t move foot from gas to brake pedal

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


Learn AboutDriving Assessments

Occupational Therapists Can Help



Find a DrivingSpecialist

Driving and Community Mobility Guidelines for Older Adults

The Role of the Occupational Therapist

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

http://bit.ly/1e5L3q4 http://bit.ly/1f7xQcH


A Driving Assessment can include…

• Medical and driving history• Vision and/or hearing • Cognition (memory, judgment and speed of response)• Motor function (strength, range of motion and flexibility)• Driving ability (online/on-road/simulation)

What to Expect withDriving Assessments

Self-evaluate Your Driving Skills:

http://bit.ly/1j412XV http://bit.ly/1bCo4er


Should you take a driving course?

http://bit.ly/1bMAhS6 http://bit.ly/JgE3s6


Paying for Driving Specialists/Tests• Older adults typically pay out of pocket for driving assessments• Medicare and private insurance do not typically cover driving assessments costs• Average assessment cost ranges (may vary based on region) include: - Initial clinical assessment: $150-$200 - Full driving assessment: $200-$750 - One-hour driving rehab/lesson: $80-$150/hr.• Additional costs may be included for adaptive equipment

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

© 2013 Griswold International, LLC© 2013 Griswold International, LLC

Develop YourAction Plan

© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC© 2013 Griswold International, LLC

Your care teamshould include:

Primary CareProvider (PCP)

Geriatric Care Manager/Social Worker

OccupationalTherapist/

Driving Specialist/AOTA

Department of Transportation

Advocacy/Support Group

Counselor

Area Agency on Aging

Family and Friends

Driving Testing Center

Form your Safe Driving Care Team


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

http://bit.ly/1d8e3s4

Equipment That Can Empower Drivers

http://bit.ly/18qBuPP

Car-fit.org


Improve/Maintain Driving Skills• Stay physically fit and active

• Take a driving course: in-person, online, or simulation

AARP driving courses:http://bit.ly/1gwntmH

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

Staying active can help:http://bit.ly/19HWkW6

© 2013 Griswold International, LLC© 2013 Griswold International, LLC

When Driving is No Longer an Option

Overcoming anger, grief and depression


“Without driving, it has been found that

individuals can risk social isolation, depression, and

may lack a sense of control over their

lives.”Peggy Barco, MS, BSW, OTR/L

“Productive engagement (paid work, formal volunteering, and

informal volunteering) was negatively affected when

older adults stopped driving.”

Angela Curl, PhD

“When an older adult is given a traffic ticket or

has a minor crash, it may feel like a natural time to discuss safety in driving…

the problem is that this is when an older adult feels he or she must

defend the ability to drive, and so the conversation with family members can, unfortunately,

become argumentative.”

Mary Jo McGuireMS, OTR/L, OTPP, FAOTA


Talk About It

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

Family Discussionshttp://bit.ly/1aVuCoo


Common Driving Cessation Emotions

• Avoidance• Confusion• Shock• Fear • Frustration

• Irritation• Anxiety

• Overwhelmed• Helplessness• Hostility• Flight

• Struggling to Find Meaning• Reaching Out to Others• Telling One’s Story

• Exploring Options• New Plan In Place• Moving On• Adjusting

ANGER

BARGAINING

ACCEPTANCE

DENIAL

DEPRESSION

http://www.ekrfoundation.org/five-stages-of-grief/

• Many older adults/caregivers go through stages of grief after “giving up the keys”


Coping with Emotions

• Allow time for grieving • Join a support group• Talk about your feelings• Seek counseling• Fight back! – “when one door closes….”


Learn About Other Ways to Get Around

• Public transportation• Family or friends• Walking• Taxi

http://bit.ly/Jy6YYZ

Finding Transportation Services For Seniors

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


Key Takeaways

• Aging can affect driving skills

• Occupational therapists can help to assess driving challenges and recommend solutions

• Older adults who stop driving are at risk for developing depression and isolation

• It is important to consider alternate forms of transportation when driving is not an option

• Many older adults are safe to drive


Open Q&A

1. Click to expand if necessary

2. Type questions here



National 24x7 Care Line:

800-GRISWOLD

www.GriswoldHomeCare.com

Brought to you by:

Extraordinary Home Careat Affordable Rates Since 1982

Griswold Home Care offers access to affordable non-medical care options to assist your loved one.

CareAssure Screening System™

The Griswold Golden Rule: We only approve caregivers we would trust in our own homes.

QuickCare Placement™

We give each family access to the most experienced caregivers available.

ValueCare Commitment™

Simple Rates. Unmatched Value. Our all-inclusive rates are among the most affordable.

Health & Medicine

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