In recognition of the American Occupational Therapy Association (AOTA) Older Driver Safety Awareness Week and in an effort to improve road safety across the country, USAHS trains hundreds of occupational therapy students each year to help older people drive more comfortably and safely.
AOTA created Older Driver Safety Awareness Week, which falls on December 7–11 this year, to promote the importance of mobility and transportation and ensure that older adults remain active in the community. AOTA partnered with AAA and AARP to develop CarFit, a program in which occupational therapists and OT students assess the fit of drivers to their cars. In CarFit events across the country (which are currently on hold due to COVID), OTs work one-on-one with older drivers, highlighting actions they can take to improve the fit of their car to their body and encouraging greater communication about driver safety.
“As people grow older, changes in physical, mental, and sensory abilities begin to occur,” says Jennie DiGrado, OTD, assistant professor of the USAHS Master of Occupational Therapy (MOT) program and a CarFit facilitator. “These transformations can lead to challenging a person’s ability to drive. Here at USAHS, we focus on both traditional and innovative solutions in occupational therapy to help patients of all ages. We began facilitating CarFit technician training on the San Marcos campus in 2015, and we have trained several hundred students over the years.”
Students in Dr. DiGrado’s course, Clinical Applications in Gerontology, first learn the elements of the 12-point CarFit assessment, which includes mirror adjustments, steering wheel tilt, position of body relative to the airbags, position of foot on the brake and gas pedal, and the operation of vehicle controls.
(NOTE: Images above were taken pre-COVID-19)
Students then practice CarFit assessments with mock patients in our state-of-the-art simulation lab, the Center for Innovative Clinical Practice (CICP). The CICP is equipped with a driving simulator built from actual car parts, including a six-speed transmission and a force-feedback steering wheel. Its three video monitors play programmed simulations, so the user feels like they’re really driving. OT students use the driving simulator to assess mock patients’ reaction speeds and visual perception. Students would then assess drivers from the community at events held at a senior center in San Marcos.
“Occupational therapists understand the importance of driving and its role in autonomy, independence, and even self-worth,” Dr. DiGrado says. “OTs use their expertise in body structures and various progressive conditions often seen in the aging population to provide education on the different adaptive items available for the vehicle.” Of OTs practicing in the United States, about 350 are driver rehabilitation specialists, but the need for such specialists is much greater.
Findings from checklists completed at CarFit events and follow-up surveys of participants have shown that 37% of participants had at least one critical safety issue that needed addressing, 10% were seated too close to the steering wheel, and 20% did not have a line of sight at least 3 inches over the steering wheel. The vast majority of survey respondents indicated that, as a result of having gone through the CarFit event, they made a change to improve the fit of their vehicle, their use of safety features in their vehicle, and their willingness to discuss their driving with family and/or healthcare providers.
“CarFit is an extremely valuable program for the community,” DiGrado says. “Unfortunately, CarFit events do not always end up having a great turnout due to the perception that we are assessing driving and may ‘take away the keys.’ Of course, this is not the case. CarFit events are created to be a safe zone to openly discuss safe driving and help educate drivers on the options that can make a car better fit an individual. Most of the equipment we recommend is easy to use and allows participants more freedom to drive safely in their car.”