Driver Rehabilitation Program
Memorial's driver rehabilitation program lasts about two and a half hours and includes a clinical and an on-road assessment.
What is the driver rehabilitation program?
Our driver rehabilitation program lasts about two and a half hours and includes two assessments.
- Part 1: Clinical Assessment
The first part is a clinical assessment of visual, physical, and cognitive abilities. We look at range of motion, strength, coordination, and things that are needed to drive.
- Part 2: On-Road Assessment
The second part is a one-hour, on-road assessment with a certified driving rehabilitation specialist who's also an occupational therapist. The driving rehabilitation specialist takes them out in a car that is similar to a driver's ed car with a second brake. They perform what we call "open-ended driving" to look at judgment and safety skills when they're navigating to familiar places like Schucks or Walgreens to pick up medicines or groceries.
What types of patients participate in the program?
Our main diagnoses are those who have had a stroke or a major medical setback where the physician's not sure it's the right time to regain independence with driving. Many times the physician will say, "I'd like you to hold off driving at this time, and we'll look at it a little later in your recovery." We do the clinical and on-road assessment and really take a look at where they're at in the rehabilitation part of the process. Then, we determine if they're ready to drive or if they need a little more therapy.
What types of therapies do you use to help patients drive?
In occupational therapy, we focus a lot on visual skills, dual task, and cognitive abilities. Divided attention is a high-level task that we need for driving. Often, it's not the physical limitations following a stroke that limit an individual from driving. It's cognitive and visual skills. Our clinic specializes in that area.
Do you have a success story to share?
Judy is one of our patients who came to therapy for at least six months. She really focused on arm recovery and had some visual changes that required a lot of therapy. We focused on her processing speed, safety, and awareness. At a certain point, we felt Judy was ready to try to go back on the road. She did wonderfully. She needed a few adaptations because she couldn't use her one arm as well while she was driving. We recommended a spinner knob and a few modifications as far as where she drove and what types of driving that she did. But she was able to regain her independence with those modifications.
How do patients feel after completing the program?
Sort of like walking, driving is one of those skills that equate to independence in many people's views. If you ask a patient in therapy, "What are your goals?" They'll say, "Walking," and the next step is driving. Being able to drive yourself, even if it's just to get medicines and groceries, is a big level of independence for many people.
What other diagnoses are appropriate for the program?
Anyone who's had any kind of medical setback is appropriate for driver's rehabilitation. It could be someone who's had a hip replacement or hip surgery. Maybe their right leg is now weak, and they're not sure that they should be driving because the transitions from gas to brake are difficult.
We see those with neuropathy in their feet. Their foot is sliding off the brake pedal at times, so they may need to transition to hand controls. We do evaluations and training with those who need hand controls for diagnoses such as multiple sclerosis or even lower extremity weakness from failed back surgeries or spinal cord injuries. We cover a lot of different diagnoses. Our goal is really just to get people back to driving independently.
What technologies are used to help someone drive?
There are many adaptations for driving like spinner knobs and left foot accelerators. There are many different types of hand controls that allow someone who has very limited movement of the arm and head to still drive from a wheelchair inside a van. We can evaluate and train an individual, so they can regain their driving skills using advanced technology.
Can you assess when a patient might want to consider not driving anymore?
Another part of our driver assessment program is to assess those who might need to retire from driving. Commonly, that's individuals who've had some difficulties with their cognition and memory skills, like dementia. Family members and physicians have concerns about their safety with driving. It's a very difficult topic to bring up and discuss with family members. Our program offers the same clinical and on-road assessments that we do with other diagnoses, but it offers objective information on how they're doing with their driving and determines if it is the right time to retire from driving. When we complete our assessment, we meet back with the patient and their family members and discuss the results of the assessment. We make our recommendations, which are not final. The physician is responsible for making that determination on whether they can continue to drive or whether they should retire from driving.
Why is this program so valuable?
Driving is one of the highest functional things that an individual can regain after they've had a major medical setback. They work so hard to get back to walking, cooking, and dressing. The next step for independence is driving. Driving is such a big opportunity for community access and socialization. It goes hand in hand with our occupational therapy department focusing heavily on the neural population. It's a need that's definitely out there, and we fill it.