Staying Safe on the Road: Driver Screening at DH

It’s a tough conversation that no one wants to have: Adult children talking to their elderly parents about whether or not it’s still safe for them to continue driving. They might have witnessed physical or cognitive losses in their parents that their parents don’t notice or feel. Those losses might be a result of aging, injury, or illness.

Whatever the reason, most parents don’t want to hear from their adult children that they may not be a safe driver any longer. And their children often don’t want to be “the bad guys” in delivering this news.

“Family doesn’t want to say, ‘Mom, you can’t drive.’ So, it’s important to have a third party be able to say, ‘These are the things we’re looking at and this is where our concern is...’” says Nicole Dennison, OTR/L, occupational therapist at Doylestown Health Rehabilitation. “It’s not just saying yes or no, you can or cannot drive. There’s much more to it than that.”

Still, the situation doesn’t have to be so stressful for the family. Our Clinical Driving Screening program can be an impartial go-between for these families.

“Many people think, ‘Well, I’ve never had an accident and I’ve been driving for decades, so I’m fine.’ But there are so many things that go into safe driving,” says Nicole. “It’s not just being able to operate the car. It’s the higher level cognitive skills that can get overlooked. Medications can also slow processing and make people foggier and have slowed reactions.”

These are in addition to the typical vision and hearing changes that happen as we age, she adds.

How it Works

It may be a son or daughter who first notices the safety issue or it may be the individual’s physician. Either way, all that’s required to get some answers is to schedule a clinical driver screening at our Ambulatory Center (a physician’s order is not required but the physician will receive a copy of the report).

These comprehensive, one-hour evaluations are conducted by our occupational therapists who will assess that individual’s cognitive abilities, memory, attention, and processing speeds as well as visual skills (acuity, visual fields, and visual perceptual skills), reaction time, and motor coordination (range of motion, strength, and upper and lower extremity coordination).

“For example, we have a brake reaction simulator that can test how quickly drivers can move their foot from between the brake and accelerator pedal to test their reaction speed,” notes Nicole.

Driving Rehab Recommendations

After all the testing and the results are in, the therapist would recommend either continuing driving with medical clearance or a further evaluation with possibly a behind-the-wheel test on the road (performed outside of Doylestown Health). All screening reports will be sent to the individual’s physician to review.

Sometimes a screening might mean that individual needs rehabilitation: either physical therapy, occupational therapy, or speech therapy to build up their strength, flexibility, or other skills to stay behind the wheel. Other times modifications to the vehicle might be required that could include using a steering knob, seatbelt adjusters, extra handles to get in and out of the car, and even additional mirrors.

Unfortunately, the driving screening will occasionally signal that the individual should not continue driving. When our therapists find that driving is not appropriate for someone, the results will go to the physician who will tend to take the next step and have the discussion with that individual. If needed, Nicole explains, our staff will report directly to the state saying that the patient is not safe to drive.

“We’re not looking at taking away anyone’s independence,” explains Nicole. “We’re looking at being able to keep them safe and keep others safe around them.”

Red Flags to Look for

While it’s not always cut and dried when someone might not be a safe driver, there are a variety of indicators to look for, which include the following:

In and Around the Car

The family member is:

• More nervous or agitated when they’re driving
• Experiencing accidents
• Receiving tickets
• Having suspicious new dents or scratches on the car

Personal Behaviors

Individuals having more difficulty with:

• Remembering where they’re going or what they’re doing (being forgetful)
• Walking and being steady (having falls)
• Daily activities like dressing, eating, and bathing
• Their vision
• Their hearing
• Managing medications
• Handling their finances
• Strength (opening the door and turning the steering wheel)

When family members are on the fence about a parent being able to drive, Nicole will often ask them, “Is this someone you would trust putting your child in the car with?” If they have concerns, then it might be time to suggest to their parent to get screened.

“Overall, if you’re concerned about a parent, it’s important not to point fingers at their driving abilities. Instead, emphasize that you’re trying to make sure they’re staying safe on the road and that you want to keep everyone else safe,” Nicole says.

• To schedule a Clinical Driving Screening, call the rehabilitation department at the Clark Outpatient Rehabilitation Center at 215.345.2634.