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Driving/Elderly
Geriatrics
| Question | Answer |
|---|---|
| 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
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