Driving & Community Mobility

What is one thing we can all associate with driving??

FREEDOM

I still remember the day I was handed the keys to my first car; no more waiting on mom to pick me up from practice/school functions, no more having to ask for a ride to the movies, no more aligning of our daily schedules just so I could go eat dinner with my friends that Friday night. Driving is important at any age, but we don’t think of its importance until its gone.

Today in class, our guest lecturer spoke on driving and community mobility for not only the aging population, but also those with varying disabilities. For each of these populations, driving is still an important occupation, and signifies their freedom. And sometimes that freedom can be hard to hand over to someone else.

From today, I can really take away two big ideas:

1)    The way you approach your clients will always matter. Our speaker discussed how hard it can be to tell someone that they did not pass their driving assessment, meaning that the state would not allow them to drive anymore. Most people don’t want to even be at the clinic, much less have someone who is half their age telling them what they can and cannot do. Building rapport with someone throughout the entire session could make these difficult conversations later a lot easier.

2)    Someone is not limited by their disability, only your creativity as their therapist. Thanks to all the amazing technology and techniques out there, you can adapt so many bits and pieces of vehicles, and that is not limited to the most expensive parts out there. You can adapt many things with the smallest budget. Our clients count on us to use our creative brains and really consider what is limiting them functionally, and how to appropriately and simply adapt it for them.

Possible interventions to provide to an individual client:

One specific diagnosis we discussed was a TBI. If a client has had a TBI, they could be prone to frustration intolerance. When driving becomes appropriate for this client again, it will be important to consider this when on the road, as their reactions and driving abilities will depend on this characteristic. One intervention to provide for this client could be breathing activities while driving. The OT could educate the client on knowing their own bodily responses in certain situations, and using breathing exercises can calm their bodies, and not endangering themselves or others on the road.

Possible interventions to provide to a group of clients:

Another specific diagnosis we discussed was Alzheimer’s Disease. This group of individuals are at much greater risk of unsafe driving. Safe driving requires multi-task and multi-stimulus abilities, such as the following: attention, concentration, sequencing, appropriate reaction time, decision making, and more. For those living with Alzheimer’s, these skills will progressively decline over time. An intervention that an OT could use with this client would be to educate the families of those with AD. An OT can assess when it is appropriate to stop driving, and then provide resources and education on where to go from there.

Other Resources:

• AOTA Older Adult Driver Safety
• ADED.net: Association for Driver Rehab Professionals 
• At the Crossroads: The Support Group Kit on Alzheimer’s Disease, Dementia & Driving

Thanks for reading about driving and community mobility!

Sincerely,

The Young OTS