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Driving/Elderly

Geriatrics

QuestionAnswer
Scanning thorough and systematic recording of visual information. Integration of oculomotor movements, visual acuity, peripheral vision and visual attention
Perceptual processing to determine position in space of stop signs, other vehicles, other objects in driving environment
Cognitive functions memory, judgment, insight, processing speed, reaction time, attention
Visual acuity 20/40 for unrestricted driving. As compared to 20/20 vision, person with 20-40 has 1/2 the time to distinguish details.
Peripheral vision stimuli outside immediate area of focus. Areas of driving environment outside drivers central field of vision. Driving requires 120 degrees of peripheral vision.
Musculoskeletal neck ROM, Joint ROM
Sensory Hearing, proprioception, kinesthesia
Age-related changes affecting driving decreased peripheral vision, sensitivity to glare, divided attention, memory, reaction time, time to process information, OA as a common chronic health condition, hearing loss
Most dangerous maneuvers for older adults left hand turn, changing lanes, merging, parking lots.
Medical conditions associated with driving performance diabetes, cardiac, chronic pain, arthritis, dementia
Medications associated with driving performance Opioids, Benzodiazepines- reaction time, anticonvulsants
Driving assessments may be: self-assesment, off road simulator, on road test, assessment o related performance skills and body function
Fitness to Drive Screening Measure (FTDS) Self-assess for caregivers and family members to assess driving risks.
Warning signs for drivers with dementia a checklist for families
What warrents immediate reactions confusing gas and brake, stopping in traffic for no apparent reason.
Trail Making test TMT-B pen and paper- connect alternating numbers and letters. Good predictor for those with Alzhimers and Parkinsons, not CVA
Cloc-draw test client asked to draw the number on the face of a clock and have hands read 10 after 11, cut off of 3
Visual Acuity 20/40 in one eye for unrestricted driving
Useful field of view (UFOF) visual field area over which information can be acquired in a brief glance without head or eye movements, looks at processing speed and divided attention.
For parkinsons Finger to nose test, contrast sensitivity
Community resources for driving fitness Defensive driving for mature driver, AARP driver safetly program, AAA Mature Driver Class, Car-fit programs.
Car Fit Program keep people on the road longer and safer, begin with checklist, 3 in above steering wheel, 10in away from airbag, mirror adjustments
Role of OT generalist screening for seniors at high risk, provide family with resources for assessment, refer to driving specialists, functional ability to store walker/mobility device, improve endurance and ROM
Helpful hints/compensatory strategies leaving a large following distance, avoid distractions in the car, park so you can drive forward to exit parking space, if endurance is not a problem park further away.
Transition plan plan ahead, identify services, family, friends- create a worksheet with contract info, start early
Role of driving specialist formal on and off road test, modifications: cushions,pedal extenders, spinner know for one handed driving, hand controls, other interventions
Reporting Physician reporting form, request for driver renewal
Community Mobility- Walking Outdoors source of physical activity, meaningful activities/occupations:health maintenance, shopping, social participation,leisure.
Barriers to walking outdoors conditions fo streest and sidewalks, personal safety awarness, lighting, clearance o sidewalks, traffic saftey
Motivators to walk outdoors nice weather, having a walking buddy, nature/plants/gardens
SWEAT-R measures neighborhood walk ability related to seniors. considers functionality, safety, destinations, esthetics.
SWEAT-R Includes the following: Crossings, crosswalks, curb cuts, buffer zones, traffic signal, signal time.
Use of SWEAT-R identify safer places to walk, promote advocacy call 311 and complain
Other interventions for community mobility build activity tolerance for IADLs, increasing gait speed, fall prevention strategies, safest way to carry items- backpack
Created by: crystalfmulligan