AOTA's Older Driver Safety Awareness Week seeks to raise awareness and increase education about the aging driver's options (products, programs, and services). Each day of the week, AOTA spotlights a different aspect of older driver safety.
Upon completion of a comprehensive driving evaluation, occupational therapy practitioners trained in driving rehabilitation make any necessary suggestions to make driving safer or more comfortable. Often times, these suggestions go beyond minor mirror or seat adjustments and may involve the use of adaptive equipment or vehicle modification.
"Through an evaluation, drivers can get solutions such as driving equipment and adaptations that provide them with the support they require to stay on the road safety and confidently," says Elin Schold Davis, OTR/L, CDRS.
Pamela Toto, PhD, OTR/L, BCG, FAOTA, an occupational therapist who is board certified in gerontology, recalls the impact of introducing an array of adaptive equipment to older adults at a rural senior center during an educational in-service.
"Driving is an essential activity for many older adults who wish to maintain their independence," she notes. "After allowing them to test our swivel seat, leg-lifter, seat cushion, and Handybar, they wanted to buy our items from us on the spot. For many of those seniors in that rural community, the only way to get to the center was by car, and those adaptive items would enable them to do so with greater ease and safety."
Physical challenges can often be compensated for by equipment, adding to a driver's safety and confidence. If neck turning is limited or painful, a wide-angle mirror may offer a solution. If foot pedals are harder to manage when diabetic changes have resulted in partial amputation, hand controls can offer a safe alternative.
Examples of adaptive equipment include:
- Low-effort steering: Modification to the power steering system that reduces the effort required to turn the steering wheel, which is helpful for those with painful arthritic shoulders and limited flexibility.
- Ribbon attached to seatbelt: A simple adaptation that allows the driver or passenger to pull the seatbelt across the body without twisting and reaching behind the shoulder.
- Hand controls: Adaptive equipment allowing drivers to control the accelerator and brake functions with their hands.
- Handybar: Removable grab bar that hooks onto the door latch to give the driver something to hang on to when transferring into and out of the vehicle.
- OnStar: Subscription system using wireless and GPS technology to offer navigation services in case the driver becomes lost, emergency services assistance (including an automatic alert to first responders in the event of a crash), and other safety options.
- Extra or extended mirrors: Add-on or replacement mirrors to help broaden peripheral vision and expand the field of view to minimize head turning.
- Swing-out seat: A replacement seat with a swivel base that extends the seat beyond the car threshold so drivers don't have to maneuver around the steering column to get in and out.
- Siren detector: An electronic device that detects the high-decibel sound waves of an ambulance or fire truck and alerts drivers who have a hearing impairment.
- Bioptics: A system in which a small telescope is attached to prescription eyeglasses that allows a driver with very low vision to be able to drive by glancing briefly and intermittently through the special lens. Note: Locate a specially trained low vision specialist trained in bioptics and driver rehabilitation before considering this option. Laws for licensing drivers using bioptics varies by state.
- Tire pressure sensors: Electronic sensors that let the driver know when air pressure is low, which can help prevent a flat tire from a slow leak or loss of vehicular control due to under-inflation.
- Traction control sensors: Add-ons to an antilock brake system that can improve traction when the driver is accelerating too quickly or on a wet surface.
- Back-up camera: A wireless system that projects the view from the rear of the car onto an LED screen that can be mounted on the dashboard or windshield so the driver doesn't have to turn around to see what is behind the vehicle.
- Seat cushions: Round swivel seat cushions turn 360° to help drivers and passengers rotate in and out of the vehicle. Other types of cushions can help relieve back pain. Safety Alert: Any cushion may also pose a safety risk. The cushion placed on the driver's seat could compress in the event of a crash, creating space that allows the driver to "submarine" or slip forward under the now loose seatbelt.
- Foot pedal extensions: Professionally installed pedal extenders allow better, more comfortable reach of the accelerator and brake pedals without causing the driver to position the seat dangerously close to the steering wheel.
Adaptive equipment can also help caregivers who are transporting passengers. Schold Davis recalls a woman in her 80s struggling with the realization that she needed help caring for her husband with advancing Parkinson's disease. They feared becoming homebound because she was afraid of dropping him while helping him in and out of their car.
"The couple invested in a swing-out passenger seat, reducing the demands of her husband's assisted transfer to within her capabilities," Schold Davis said. "Not only could they resume afternoon visits to the lake, but the prospect of maintaining their residence in their home was once again a possibility."