DriveWise Driving Evaluation. Ann M. Hollis OTR/L

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1 DriveWise Driving Evaluation Ann M. Hollis OTR/L

2 DriveWise Objective assessment of driving safety with support for patient/family Hospital based, Multidisciplinary team approach ClinicalEvaluation, Research & Education 2018 Innovation & Mobility Exchange 2

3 DriveWise Clients Over 700 individuals People with medical, cognitive or psychiatric problems that may impair driving safety Diagnoses: Dementia, MS, Parkinson s, brain tumors, ALS, Stroke, post ECT, bipolar, orthopedic Ages: Innovation & Mobility Exchange 3

4 DriveWise Demographics by Age yrs 19% yrs 1% yrs 14% yrs 1% yrs 6% yrs 2% yrs 4% yrs 3% yrs 3% yrs 7% yrs 9% yrs 12% yrs 19% 2018 Innovation & Mobility Exchange 4

5 Driving & Older Adults Primary mode of transportation. Enables people to maintain connections & contribute to the community. Relationship between health, sense of autonomy & ability to drive. (Eisenhandler 1990; Dickerson et al., 2007) Cessation associated with depression, health problems, social isolation, and caregiver stress. (Edwards et al., 2009;Fonda et al., 2001; Marottoli et al., 2000; Taylor & Tripodes 2001) Innovation & Mobility Exchange 5

6 DriveWise Process Referral Social Work Evaluation Occupational Therapy Evaluation Road Evaluation Team Meeting Feedback Session w/ Social Work 2018 Innovation & Mobility Exchange 6

7 Social Work Evaluation Participation Agreement Medical, social and driving history Begin to anticipate consequences of driving retirement Set up feedback session at which time good/bad news delivered in detailed letter 2018 Innovation & Mobility Exchange 7

8 Occupational Therapy Evaluation Vision Cognition/Perception Physical Function Standardized On-road Evaluation 2018 Innovation & Mobility Exchange 8

9 Vision Assessment Visual acuity- 20/40 or better, Daytime only restrictions available Visual Field- 120 degrees of lateral field at eye level Tracking & depth perception Contrast Sensitivity 2018 Innovation & Mobility Exchange 9

10 Cognitive/Perceptual Assessment Attention to task & ability to divide attention: TMT (Duncanson et al., 2018) Memory & orientation: MMSE /MoCA (Hollis et al., 2015) Useful Field of View (Ball et al., 1988) Information processing speed Decision making, judgment 2018 Innovation & Mobility Exchange 10

11 Physical Assessment Strength and range of motion Coordination Sensation Functional control Mobility Brake reaction time (Dickerson et al., 2008) 2018 Innovation & Mobility Exchange 11

12 On Road Evaluation The gold standard for assessing driver safety (Amick & Ott, 2008) Standardized: Based on the Washington University Road Test (Hunt et al., 1997) OT and CDI both score and comment on driving performance is only a snapshot of driving 2018 Innovation & Mobility Exchange 12

13 Outcomes of the Evaluations Individuals can either be safe, unsafe or be referred for driving remediation. Overall Results By Gender Pass Safe Fail Unsafe Remediation Unclear 1% 16% 44% Female Male 39% Safe Pass Unsafe Fail Remediation Unclear 2018 Innovation & Mobility Exchange 13

14 The Oldest Old Driver (Hollis et al., 2013) 88 individuals; 27 oldest old (90-97), 61 old (80-87) Drivers age 90+ at no greater driving risk than those 10 years younger Age, in and of itself, does not predict driving safety Procedural memory ages well 2018 Innovation & Mobility Exchange 14

15 Concerned? You should... Start the discussion about driving Get feedback from friends and family Review driving record, history of crashes, near misses, car damage Consult with doctors Schedule a formal driving evaluation such as DriveWise 2018 Innovation & Mobility Exchange 15

16 Thank you 2018 Innovation & Mobility Exchange