It may seem like a senior’s basic driving skills and instincts are solid, but then a minor accident occurs, and skills come into question. Driving abilities can also be impacted after a medical event such as stroke or surgery, and cognitive abilities can change due to medication. No one wants to take away another person’s independence before it is truly necessary. One way to make that determination is to undergo an in-clinic driving skills assessment under the guidance of an occupational therapist (OT), who can provide reassurance, identify areas of concern and offer recommendations to improve skills.
A therapist can perform a driving assessment in about 90 minutes; looking at four main skills to determine abilities and providing tips for improvement in these areas:
- Motor Skills – the OT will assess how quickly the individual can move from the gas pedal to the brake by testing lower extremity coordination. Neck flexibility for rotating their head to check lanes and hand strength for holding the steering wheel will also be assessed. If they can’t use both hands, the therapist may recommend a steering knob to make driving easier.
- Visual Skills – these tests assess ability to read signs at a distance and guide the vehicle properly in high and low visibility. There is also an assessment of ocular motor skills (how the person’s eyes move) and if he or she has an impaired peripheral field of vision, double vision or issues with depth perception. The therapist will also check to see how well the individual scans the environment and if they can identify hazards quickly.
- Visual Perceptual Skills – these tests identify how well the individual is perceiving what they are seeing. There is a written test that involves filling in missing information (for instance, if part of a stop sign is covered by a tree, does the individual’s brain fill in the missing information and tell them it is a stop sign they are seeing?) The therapist also checks for spatial relations to see if there is any kind of neglect. For example, someone who has had a stroke may have an impairment that makes them favor one side and ignore the other.
- Cognitive Skills – the OT will also measure the individual’s attention skills. Divided and alternating attention and sustained attention are both assessed. Another test gauges the ability to attend to something when it is right in front of them and when there is something in their peripheral vision at the same time. The therapist will assess short-term memory to see if there is any impairment that might cause the person to forget traffic signs they have seen or even where they are going.
Once the assessment is complete, recommendations are made and resources for further online skill testing and training may be provided. If necessary, the occupational therapist may suggest behind-the-wheel training at a driving school. Driving is an important aspect of maintaining independence and allows people to remain socially active and engaged with their communities.
If you or your family have concerns about a loved one’s ability to drive safely, reach out to their physician for a referral to undergo a pre-driving assessment through El Camino Hospital’s occupational therapy program.
This article first appeared in the December 2018 edition of the HealthPerks newsletter.