Canadian Association of Occupational Therapists

On the road again: Driver rehabilitation

Bill Blight, a retired physician, had to stop driving after he had a stroke last August. Like many other seniors, he experienced the challenge of losing his licence. “I hadn’t been driving for nine months and I really wondered whether I could still drive,” said Bill.

Bill was referred to the Driver Assessment Management Program (DAMP) run by occupational therapist Linda Johnson at the Health Sciences Centre in Winnipeg, which takes a closer look at a person’s ability to drive. When he worked as a family doctor, Bill found the program to assess at-risk drivers invaluable. “How do we determine how safe people are to drive?” he asked.

The process begins when a person or his doctor notifies the provincial licensing bureau of a change in his medical condition that impacts his driving ability. Depending on his medical information, the bureau will make a referral to DAMP.

Bill found the DAMP experience “quite fascinating.” After doing a few tests in the occupational therapy department that looked at his perception, concentration and physical abilities, he went on a road test. “These simple tests correlate with the ability to drive,” said Bill.

With over 16 years experience assessing drivers, Linda Johnson has come to the conclusion that “driving is 99 per cent above the neck.” It takes a lot of planning, memory and concentration. “How well you attend and see will determine how you make your decisions and what you decide to do,” she said. Safe driving is a major concern for seniors who are the majority of her referrals, as statistics show that their accident rate is very high for every mile that they drive.

The large number of accidents may reflect problems with seniors’ abilities which can get worse over time. Linda notices that many people who come through the program have already changed their habits to avoid accidents. For example, they avoid rush hour and eliminate distractions while driving. Linda has found that when you look at the statistics this is not an effective strategy. If it was, the accident rate for seniors would not be as high.

For Bill who is 68 years old, DAMP was very familiar as his wife Donna went through the program four years earlier after a brain aneurysm. With retraining sessions through the DAMP program to fine tune her driving, Donna passed the road test after a few attempts.

Some of the clients who come through the program have difficulty with the physical part of driving, perhaps due to weakness or paralysis. For this group, the occupational therapy department has a stationary car with adaptations such as hand controls, a left foot accelerator or a turn signal on the right side. The person can try them out and then have them installed by the Rehabilitation Engineering department at the Health Sciences Centre.

Bill did not have any problems completing the in-house pre-screening tests or the driving assessment done with Linda and Grace Galezowski, the program driving instructor. Now the next step will be the formal road test with the provincial licensing bureau.

Not everyone who goes through the program will be appropriate for a provincial driving test. Some people may have to stop driving. According to Linda, common problems are people being too hesitant, impulsive or difficulty keeping the car in a straight line. Often they do not improve with re-training and it may be the result of dementia that is getting worse.

“Driving is very important to people,” said Linda. “It represents their self esteem, independence and the practical ability to get around.” But often they lack insight into their ability. People will often tell her that they are “good drivers and haven’t hurt anyone.” Linda feels that this is not enough and is confident that a DAMP assessment provides better information about their driving abilities.                                               

—by Fern Swedlove

top photo: Occupational therapist Linda Johnson in the department’s stationary car that includes adaptations for people to try. 

For more about what is involved in driving evaluations, click here.

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