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October 2003

By Sarah Schmelling

The evaluation and assessment of older drivers was a topic known to the rehab community long before the Santa Monica, Calif, farmer’s market tragedy in July—when 10 pedestrians were hit and killed by an 86-year-old driver. However, in the wake of this tragic incident and the media and medical community attention that has followed it, much can be learned about the key role therapists are able to play in helping older drivers stay on and—when needed—get off the road. It may also help some therapists see what a valuable and rewarding specialty this is to get into.

According to a September 3 Wall Street Journal article,1 there are approximately 300 driver-rehabilitation specialists across the country, the majority of whom work out of occupational therapy programs at hospitals. This means OTs are playing a crucial part in the assessment and rehab of drivers.

But there is still a need for more OTs to specialize in this area, says Wendy Stav, PhD, OTR, a driver rehabilitation specialist at Cleveland State University. This idea was echoed by the American Occupational Therapy Association (AOTA) in July, when the organization made a concerted push to inform the public about the role occupational therapy plays in this arena, as well as about the need for driver rehabilitation in general. The AOTA also began operating an online course on older driver screening and evaluation this spring for intermediate-level OTs. The American Medical Association is also doing its part, recently releasing The Physician’s Guide to Assessing and Counseling Older Drivers.

Just like any specialty, however, driver rehabilitation does have some challenges. Though most states allow therapists to recommend that an older driver be retested by the Department of Motor Vehicles, some only allow recommendations from physicians. Stav relates one incident in which a driver she was working with hit a tree before even leaving the facility parking lot. The driver was licensed in Illinois, so Stav attempted to report her to driving authorities there, but when she said she was not a physician, they would not accept her report. In a case like this, she says, “If OTs can’t report, the only option is to find out who can report, and pass along as much evidence as possible to the physician.”

It can also be difficult for some therapists to break the news to an older client that it is no longer safe for them to drive. However, if you keep in mind how vital it is to prevent this person from driving, this task can only benefit you, your patient, and the community, Stav says, and this should not keep you from entering such an important field.

“To some extent, you have to develop a thick skin, because your patients may hate you, and that’s the reality,” Stav says. “But you could be saving lives.”

—Sarah Schmelling
cwolski@medpubs.com

Reference

Greene K. Driver’s ed for Miss Daisy. The Wall Street Journal. September 3, 2003.

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