#16 Tips for Older Drivers and Their Families
Terry Cassidy, Occupational Therapist and owner of Health Partners specializes in the evaluation and support for older drivers. The week of December 7 is Older Driver's Awareness week and an ideal time to learn more about safe and comfortable drivers to take into their senior years. To see more about the week's activities visit
https://www.aota.org/Conference-Events/Older-Driver-Safety-Awareness-Week.aspx
Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country. We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado. The Pikes Peak Area Agency on Aging is the producer. Learn more at Pikes Peak Area Agency on Aging.
Transcript:
This is Studio 809.
Cynthia Margiotta:
Hello everyone. This is Area Agency on Aging, Aging with Altitude Podcast. Welcome to all of you. This is where we provide answers, assistance, and advocacy for our elders. Thank you for joining us today. Our topic today is Older Driver Safety Awareness Week that’s coming up in a couple of days, yes?
Terri Cassidy:
Starting December 7th.
Cynthia Margiotta:
So let’s get that in our heads. I’m your host, Cynthia Margiotta. I’m a geriatric social worker and a volunteer with the Pikes Peak Area Council of Governments Area Agency on Aging. That’s a mouthful. And CEO of a program called PEARLS Program of Colorado. With me today is Terri Cassidy. Thank you for being here today, Terri. Thank you. She’s got all these wonderful letters after her name so I’m gonna just tell you what they are. The first one is OTD. What is that?
Terri Cassidy:
Doctorate in Occupational Therapy.
Cynthia Margiotta:
And then the second one is OTR/L.
Terri Cassidy:
And that’s just licensed and registered occupational therapist in the state of Colorado.
Cynthia Margiotta:
There’s no “just.”
Terri Cassidy:
No just.
Cynthia Margiotta:
No just. And the third one is CDRS.
Terri Cassidy:
Certified Driver Rehabilitation Specialist.
Cynthia Margiotta:
And that’s a mouthful girlfriend. I like the letters. OK, she’s here to talk to us today about Older Driver Safety Awareness Week. Terri has her doctorate in occupational therapy and is a certified driver rehab specialist, as she mentioned. As the owner of Health Promotion Partners, she empowers people to take positive action toward their health and well-being. She and her team provide driver evaluations and home evaluations to help older adults stay independent and connected with our community. Wonderful, wonderful. So let’s get started with some of the questions. I have a million of them. What is Older Driver Safety Awareness Week?
Terri Cassidy:
Yes. Well, thank you, Cynthia. I’m excited to be able to be here and talk about this topic. Older Driver Safety Awareness Week has such a long title, partially because it’s trying to explain what it is. It was started through the American Occupational Therapy Association really to have a set time to raise awareness to this topic. Just safety of older drivers really in a way that’s non-threatening. That’s really just about a topic that people don’t like to talk about, maybe. So trying to bring some attention from different sectors. So starting with AOTA, but there’s a lot going on even statewide with the Colorado Department of Transportation, nationally with AARP and other partners to promote this week. It’s always the first full week of December so this year is December 7th through the 11th to encourage people to think about and talk about older driver safety.
Cynthia Margiotta:
That’s a very important thing. There’s so many out there and it would be helpful, yes?
Terri Cassidy:
Yes.
Cynthia Margiotta:
So what do you do as a driver rehab specialist?
Terri Cassidy:
So in my role as a driver rehab specialist, I do driving evaluations and driver training. As an occupational therapist is really the background that I bring to this driving perspective. So particular to older drivers, I might see somebody when there is some concern or question either by the family, sometimes by the physician, sometimes by the client themselves. Am I still doing well with driving? Is this still something I should be doing? And so we do see clients and we do an evaluation here in the clinic and then also out on the road to give people feedback about maybe how age related changes are or are not affecting their driving. For some people that’s just giving them a really good baseline of this is what’s going on now so that if there’s concerns in the future, they could come back.
Cynthia Margiotta:
And this office is so easy to get to. You’re just off of Filmore and on Beacon which is not far from I-25 in Colorado Springs.
Terri Cassidy:
Yes. I’m glad that you were able to get here today.
Cynthia Margiotta:
Yeah, me too.
Terri Cassidy:
Something I like a lot about this space is our, we have a very accessible parking lot so it’s a good place for a driving program.
Cynthia Margiotta:
I even parked in it. Not so straight in the line.
Terri Cassidy:
Oh I didn’t look at your car.
Cynthia Margiotta:
Don’t look, don’t look, don’t look. I backed into a parking spot. What are some trends related to older drivers?
Terri Cassidy:
Well, I would say just for starters that when we’re talking for me, talking about driving evaluations, or even in general, for older driver safety. To me it’s not so much about age. I’m really looking at function overall. So for anybody that we’re talking about driving with, I don’t see that you know, a certain age means yes or no in terms of driving or anything like that. Like we’re really looking at physical skills, visual skills, cognitive skills is what makes up a lot of that. And older drivers tend to be more safe drivers. They tend to have less risky driving behaviors, tend to drive less at night, less overall miles. However, the data does show that over the age of 75, the fatality rate for individuals over 75 increases quite a bit compared to drivers of any other age. Except new drivers kind of mirrors that. So the concern becomes, you know, are there just changes that are happening that are affecting ability to drive and there is also an issue of frailty adding to the increased fatality rates. So somebody who’s 80 who’s involved in a crash is more likely to have more injuries, potentially life threatening injuries than a 40 year old person involved in that same crash. So there’s a couple of factors going on there, but I think overall older drivers have good driving habits, safe driving habits. We just want to find ways to keep them safe.
Cynthia Margiotta:
That makes a lot of sense to me. How do we, you know, what’s the biggest barrier to having discussions with folks about older drivers? Those barriers that, you know, I’m fearful of losing my driver’s license. She’s going to take my driver’s license away.
Terri Cassidy:
You said it. I mean that’s basically. You know, it’s a type of topic, and like I said in the beginning, people don’t always like to talk about this subject. Once you bring it up, so when I’m out talking to people, it doesn’t matter the population of people I’m talking to, everybody has a personal story about a relative, a family member, a friend where driving was iffy or where that person successfully decided on their own to stop driving. It’s a type of thing that everybody can relate to, but it’s touchy. Because, I think the biggest reason that it goes so far into our own identity and our independence of being able to drive. So if your child comes to you and says, “I have some concerns, dad, about your driving.” I think it can be hard to not take, get defensive around that discussion. So I would say the barrier is almost this stigma around removing driving, or stopping driving and really, what I would love to see is that our focus, or our value is on being engaged in the community, continuing to do things that are important to you. If you’re the driver or the passenger, it’s ok. You know, how can we just keep people involved in what they’re doing. But sometimes we get really stuck on the who’s in the driver’s seat.
Cynthia Margiotta:
Yes, yes. I have known multiple women who haven’t driven in 20 or 30 years because the husband, or even sometimes the wife, has to be the driver. You take their driver’s license away and it’s almost, and I can’t, you know, it’s for people, I guess for women to understand because it’s generally men who are very sensitive about losing their driver’s license. The closest I can think of to coming to that is you take away a woman’s home, her ability to care for her home. Because the generation we’re talking about, you know, women’s homes were their jobs. And you take that away from them, maybe they would understand a little better about their husband’s feeling about losing their driver’s license. Am I off?
Terri Cassidy:
Yeah, I appreciate that because I think it does go back to the person’s role. And so, you know, in your example, talking about the husband as the primary driver, that’s his role. And when we’re talking about changing that it’s a big deal. So yeah, no, that’s a good analogy of taking, shifting, or changing that person’s role there.
Cynthia Margiotta:
We don’t like losing our roles.
Terri Cassidy:
It’s true. It’s true and I think any ways we can help redefine our roles as we age, but hold on to, kind of figure out what the most important piece of that is, but on the surface it’s a discussion people tend to shy away from.
Cynthia Margiotta:
Yeah. Oh yeah. What are some good ways to make sure you’re a safe driver?
Terri Cassidy:
So, yes. There’s a great quote. I think it’s a Dave Barry quote that says, “Everybody feels they’re an above average driver.” Something along those lines. Everybody thinks they’re a safe driver. It’s just kind of our mentality. But things change in our bodies as we age and so sometimes it’s worth having those things checked up. In terms of being a safe driver, it’s not just important for your own self-perception. I felt safe during that drive, but doing kind of just routine medical visits. That’s going to affect your safety as a driver. Vision is a huge one, so getting an eye exam, talking to your eye doc about driving. Certainly, just medical routines, typical health examinations, things like that. There are some self-assessments of driving that are available online. I know both triple A and the AARP have those on their websites that people could fine. They’re just asking you questions about your driving. I feel like when it comes to family members, a good question is do you feel comfortable having your children in the car with your loved one. You know, so I think sometimes if you’re the older adult who’s interested in being like, how am I doing? How’s my driving going? Asking people who have driven with you. Just being, opening up to that feedback a little bit of do you feel comfortable driving. Usually, it comes the other way. Usually comes after the fact where people are saying, they’re finding out about it for another reason.
Cynthia Margiotta:
So what you’re saying really, I guess I can equate that to people who have not had glasses. And they get their very first pair of glasses. And they look out the car window. I’ve heard this story from lots of people. And they say oh my gosh. I can see the leaves on the trees.
Terri Cassidy:
Right. I’ve had that experience, yes.
Cynthia Margiotta:
Right. It’s a shock because an older driver thinks they’re being safe, being careful, but maybe they’re driving, maybe they’re weaving a little bit. Or they aren’t using their blinker in time. You know, a hundred things, right. So that’s what I can equate it to that might help listeners to hear gee yeah, I remember when I first got glasses.
Terri Cassidy:
Yeah, and that idea of oftentimes things change slowly so we don’t notice the change. Vision is a great example of that. Of your vision, and something we see a lot is trouble with contrast. So a lot of people maybe their night vision isn’t as good anymore, but they don’t notice it because they’ve just gotten used to it slowly over time. And that’s where I do feel an outside, objective opinion or evaluation can be really helpful.
Cynthia Margiotta:
Yes, that way we can’t blame the kids. We can’t blame the doctor. We can blame that lovely lady, Terri.
Terri Cassidy:
Yes! Absolutely.
Cynthia Margiotta:
It’s all her fault. OK. So driving concerns about an older family member have long been considered a family issue. Shouldn’t this topic just be addressed by family members?
Terri Cassidy:
Yeah, and that kind of gets back to the barriers question and I feel like that has in the past been a big, just part of our culture of, in a different time. Let’s say where people say “Oh, Mr. So and So is not safe behind the wheel. We know what his car looks like and we just try to avoid it” for example.
Cynthia Margiotta:
Yes, yes. I remember that person.
Terri Cassidy:
But our world has changed and sped up and there’s, there’s too many cars on the road to keep track of which ones to stay away from. And I think that, you know the research that’s been done in terms of focus groups, talking to older adults about who do you, who would you want to bring up problems with driving, or concerns that could potentially could affect your driving. The answer has tended to be spouse. Although for a certain percentage the answer is definitely not spouse, so that’s kind of a tricky one. The other person that ranks high is the doctor. So a lot of individuals feel like my doctor will tell me if I’m not safe enough to drive.
Cynthia Margiotta:
Whoa, yeah. Wait a minute.
Terri Cassidy:
It doesn’t necessarily happen that way.
Cynthia Margiotta:
Yeah.
Terri Cassidy:
But I think that’s a perception of, you know, they’re looking at my health. They’re going to look at these decisions with me. And that’s where, you know, a lot of my education is to the medical community. Say hey people are looking to you for making these decisions, here’s some suggestions on some ways that we can do this together.
Cynthia Margiotta:
How could a doctor do that? I don’t understand how they could. Seriously I don’t because I’m thinking of my doctor visits, um, my doctor doesn’t ask about my vision, doesn’t ask about my reflexes and maybe that’s down the road a little bit. Maybe they will, you know, but I have been with many, many people over the years in their doctor’s visits and I can’t recollect a single one doing an eye exam or even checking those kinds of questions.
Terri Cassidy:
Yeah, it’s really interesting because I think of like from my sphere of being in the medical world, we think of somebody’s had a stroke. It should be their doctor that talks to them about, finding out if they’re safe to drive before they go back to driving. So maybe the medical professional in the sense of an acute injury or illness, so this person had a fall, had an injury. But when you say it like you’re saying it, it does seem like a big leap to ask the doctors to then be talking about driving. And so I think there’s potential there. Like I think there’s definitely room for that discussion. And I have, even in town, spoken with some of the doctor’s offices who’ve said “oh, yeah, maybe that’s something we should add to our general questions.” You know with the Medicare health, the physical, yearly physical there’s questions about just about everything else. You know, in terms of emotional state, and alcohol use and all of these different things, but there isn’t something specific to driving. So I think it would be really interesting. There has been some research around primary care physicians and how they could be, just tapping in and asking some of these questions and mostly what they came down to was that it was too much to ask a doctor’s office to perform a screening or some kind of test related to driving. They really found though, just having the physician’s office ask the question: “How’s driving going for you?” Like just even that would be a huge improvement over what we have going on right now. And I love the idea of normalizing that conversation so that you’re asked that every year. And so you’re not defensive when somebody asks you. It’s just an honest conversation of I’ve started to notice that sometimes I think I’m pressing the break and I’m actually pressing the gas. And that can relate back to sensation and that could be something the doctor could help you manage.
Cynthia Margiotta:
Right, so it would lead into so much more information for the doctor. So what kind of solutions are there for someone who has an injury and is having trouble with driving?
Terri Cassidy:
So I mentioned some medical diagnosis. So I mentioned a stroke and for example there are a variety of things that a driving rehab specialist can do with a client to help them get back to driving after something like a stroke. Some of that is going to be in an OT clinic so that might be part of outpatient therapy before somebody comes to see me. Really focusing on reaction time and multitasking and some of these pieces, these higher judgement pieces that we use all the time when we drive and we don’t really think about it. To me the other answer that though has to do with adaptive equipment. So for example, if someone’s had a stroke, and they, let’s say they can’t use the left side of their body. They can still do gas and break with their right foot, but they usually would have done their turn signal with their left hand. So there’s some equipment we can put in the vehicle to make it safer for that person to steer with one hand, to access their turn signal and to keep their attention on the road through that whole time. Or another example would be somebody who has an amputation. We do training for use with hand controls, so you don’t need to use your feet at all for accessing gas and break and steering. So there are some really great ways to keep people driving safely even after there have been some injury or illness changes.
Cynthia Margiotta:
Yeah. Wonderful. And are those expensive? Are those expensive adaptive types of equipment?
Terri Cassidy:
You know, expensive is a good question because it’s all relative. So for someone to get equipment, you know, hand controls can be about $2000. There’s also training involved with that. Evaluation involved with that. That could be another thousand dollars. To me, when you’re looking at that amount versus not driving, you know, so I think the expensive part is hard to answer. It depends on everybody’s particular situation. Driving a vehicle, owning a vehicle is expensive. Paying for insurance is expensive, you know. So it’s...
