Screening Tool Helps Caregivers Identify At-Risk Older Drivers

The University of Florida has launched a free online tool to help caregivers and family members identify drivers aged 65 and older who may be at risk of driving problems.

Caregivers or family members who have been a passenger in a vehicle driven by an older adult within the past three months can complete the Fitness-to-Drive Screening Measure. After completing the questionnaire, users receive a rating profile of the older driver, recommendations that can be shared with health professionals, and links to resources, such as availability of alternative transportation options.

While an on-the-road evaluation, conducted by an occupational therapist who is a certified driving rehabilitation specialist, is ideal for assessing an older adult’s driving ability, it’s not accessible to everyone because of the cost and the limited number of professionals who can administer the test, says Sherrilene Classen, PhD, MPH, the tool’s lead developer.

“We know from our research and others’ that drivers do not give valid self-reports,” says Classen, an associate professor of occupational therapy at the University of Florida College of Public Health and Health Professions. “Most everybody thinks they are driving better than they actually are. Because we don’t have the evaluators to assess the 36 million older adults who may potentially at some stage require a driving evaluation, we went to the next-best step, which is involving their caregivers or family members.”

In studies to determine the accuracy of caregiver and family members’ assessments, researchers compared their evaluations of older drivers with professional evaluations of the same older drivers and found that the caregiver and family members’ ratings were consistent and reliable.

The online questionnaire takes about 20 minutes to complete. Four short videos provide step-by-step instructions for each section. Users respond to questions about the older adult’s driving history and are asked to rate performance on 54 driving skills, such as staying within lane markings, turning left across multiple lanes when there is no traffic light, and merging onto a highway. On the basis of the responses, the screening tool classifies the older driver in one of three categories: accomplished driver, routine driver, or at-risk driver.

An accomplished driver rating indicates there are no immediate concerns, and the driver should consider being screened on an annual basis. Routine drivers may be fit to drive, but there are signs of difficulty with driving in challenging or complex traffic situations. At-risk drivers are advised to stop driving until they speak to a health care provider. A summary report includes specific recommendations that can be printed and shared with a health professional.

“The results give the physician or the occupational therapist a profile from which they can see the driver’s competencies and problem areas,” says Classen, also director of the University of Florida Institute for Mobility, Activity, and Participation. “We hope this tool helps facilitate conversations about driving issues.”

In many cases, older drivers who exhibit difficulties can continue to drive with the assistance of several different interventions. Occupational therapists can offer training on skills such as visual scanning of the roadway and can help drivers plan routes to avoid potential hazards. Assistive devices, such as seat pads that raise the driver and improve his or her line of sight, can address physical changes that affect driving. Sometimes a referral to another health provider, such as an ophthalmologist who can diagnose and treat a vision condition, can solve the problem.

“We have a range of options to keep people on the road longer and safer, and in the case of folks who cannot drive or are no longer fit to drive, we are able to provide them with a community mobility plan, including alternative transportation options and travel training, so they stay integrated in their communities,” Classen says.

The Fitness-to-Drive Screening Measure can be accessed at http://fitnesstodrive.phhp.ufl.edu.

— Source: University of Florida