Note: In 2011, AOTA identified this and many other topics as emerging niches in occupational therapy. Today, many of these topics have become mainstream. Learn more about the 2011 Emerging Niche series here.
Why emerging? The number of people age 65 and older in the United States is expected to double in the coming years, increasing from 35 million in 2000 to an estimated 72 million in 2030.1 An increasing aging population and the fact that Americans love cars—the country has more passenger vehicles than licensed drivers2—has put the topic of older driver safety in the national spotlight. Older drivers are reluctant to give up what they see as their independence, but occupational therapy can help.
Get Involved! Nearly 15 years ago, Wendy Stav, PhD, OTR/L, SCDCM, FAOTA, was working in an acute rehab unit and heard reports from colleagues about clients with impairments who intended to drive after their discharge. Stav was taking a graduate class in ethics at the time, and she thought it was unethical to put the clients’ neighbors and families at risk by not addressing their potential driving issues. A few years later she wrote and received a grant from her state’s Department of Transportation to create a community-based driver assessment center, and she has been practicing, researching, and advocating for safe community mobility ever since.
Stav has seen an increased recognition and respect for the role of occupational therapy in addressing driving issues, but she believes there is still work to be done to ensure a strong foothold. Stav recommends that occupational therapy practitioners who are interested in working with older drivers seek out a mentor to ask questions and receive guidance. “There are a substantial number of barriers in the driving rehabilitation practice area,” she says. Stav’s recent research shows that those barriers include fiscal support, infrastructure, physical environment, and institutional culture.3“Make every effort to gain support from individuals who allocate funding to develop programs as well as lower level managers who determine staffing distributions and daily operations,” she suggests.
Driving and community mobility are vital areas of occupational engagement, according to Stav, and occupational therapy practitioners are the only professionals who possess a tremendous amount of knowledge in the areas of occupational analysis, occupational performance, clinical reasoning, and other issues that are necessary for addressing driving and community mobility. Some may see the topic of driving as “taboo” because the possibility of driving cessation is sensitive and life-altering, but Stav reminds practitioners that they deal with and discuss many other sensitive and potentially life altering issues. “[Safe driving] is no more sensitive than discussing the transition to supervised living,” she says. “There is nothing taboo about addressing driving, and your clients’ family members will appreciate your honesty and support.” All practitioners working with older adults should look at the skills needed for driving and offer ideas for these clients to either drive safely through rehabilitation, make modifications with a program such as CarFit, or explore alternative community mobility options.
Federal Interagency Forum on Aging-Related Statistics (2010). Older Americans 2010: Key indicators of well-being. Retrieved May 19, 2011, from
U.S. Department of Transportation, Federal Highway Administration. (2008). Highway Statistics 2008: Licensed drivers, vehicle registrations, and resident population. Retrieved June 16, 2011, from
- Stav, W., Weidley, L. S., & Love, A. (2011). Barriers to developing and sustaining driving and community mobility programs. American Journal of Occupational Therapy, 65(4), 38–45.
Emerging Niche in All Practice Areas