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Friday: Taking Changes in Stride

AOTA's Older Driver Safety Awareness Week seeks to raise awareness and increase education about the aging driver's options. Each day of the week, AOTA spotlights a different aspect of older driver safety. Another aim of AOTA's Older Driver Safety Awareness Week is to promote understanding of the importance of mobility and transportation to ensure that older adults who need to limit driving or cannot drive will remain active in their communities.

When an older adult learns that he or she can no longer drive safely, it can be difficult to imagine an active and engaged in life without the familiar option of driving. Many believe this change equates to a loss of independence. However, older adults who need to limit or stop driving have two choices—they can either find another way to get to the places they want to go, or they can stop leaving their homes.

"Without driving, older adults have been found to participate in less out-of-home activities," says Peggy Barco, MS, BSW, OTR/L. "Without driving, it has been found that individuals can risk social isolation, depression, and may lack a sense of control over their lives." This needs to change!

Losing one's ability to drive does not have to mean losing independence. "One thing we can do is plan for the day when we can no longer drive, and work together as a community to find ways to ensure that all individuals have a fulfilling life by continuing to participate in those activities and occupations that are meaningful to one's quality of life—with or without driving," says Barco.

Older adults may be surprised to discover that several options may be available to support their goals of getting around in their communities. They can consider trading favors in exchange for rides from friends, family members, and neighbors (e.g., offer to sign for packages for a neighbor who is at work during the day in exchange for a ride). Some grocery stores, places of worship, malls, and other organizations offer transportation services. They can also explore whether volunteer driver programs, taxi services, or paratransit options would work for them.

Occupational therapy practitioners play an important role in helping older adults who can no longer drive find other ways to participate in activities and occupations. "The occupational therapy practitioner is involved in working with the client in the present, as well as being an advocate for change in the community for the future," says Barco.

Alternative transportation options aren't always realistic for older adults because the same things that prevent them from driving can also be barriers to community mobility options. "Van services, cabs, and coordinating friends and family members for trips involve complex scheduling issues that require a high level of executive function and cognitive abilities, which maybe be declining in the older adult," says Barco. "Other options such as walking to a bus require adequate physical stamina, balance, and sensory skills, which can also show decline in older adults." For some, the impairments that led to the decision to stop driving (e.g., declining vision, strength, flexibility, or memory) also make some forms of public transportation options unsafe or inappropriate.

Occupational therapy practitioners can determine whether public transit is feasible for the older adult and can focus on ways to overcome any barriers. If public transit is not an option, they can share information about businesses offering transportation or delivery services. They can also help older adults formulate schedules of their important activities and assist in arranging transportation with family members and friends. Finally, they can develop health and wellness programs that focus on maintaining cognitive abilities and physical strength to help older adults obtain or maintain the ability to use alternative transportation.

Families are encouraged to explore transportation options, availability (hours of service and geographic limits), and support services before driving cessation to facilitate thinking about potential issues and solutions. Occupational therapy practitioners can counsel families and individuals before and after driving cessation. "We need to work with the whole system—the client, family and friends, and community resources—to help identify ways that older adults can maintain their participation in activities outside of the home without driving," says Barco.

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