Audience (for this presentation): ◦ Law Enforcement Training Officer
Objectives: ◦ Persuade law enforcement that having older driver
information in law enforcement training is essential◦ Offer the information that is important for law
enforcement officers to know Time:
◦ 15-30 minutes Success:
◦ The training officer that saw this presentation wanted the PowerPoint to use for a highway patrol officer class!
Your names and affiliations
Summarize facts about older drivers and their impact in your state
Highlight facts about driving evaluations in your state
Emphasize the importance of law enforcement’s knowledge of older drivers impact on safety in your state
Solicit the State Highway Patrol’s ideas about older drivers and how the your organization can assist.
78 Million Baby BoomersDriving is a privilege, but Baby Boomers act as if driving is a right. Learning to drive is right of passage; life changing event
Losing license is just as life changing
The Baby Boomers will affect the distribution of older adults
Driving & DemographicsDriving & Demographics• The number of older licensed drivers in the US is
expected to increase – from ~20 million today to ~40 million in 2020.
– Graph is for drivers 70 years and older
7.0
9.0
11.812.8
6.3
10.1
13.9
17.9
0
4
8
12
16
20
1990 2000 2010 2020 1990 2000 2010 2020
Males
Females
• Driving is and will remain the primary mode of transportation for older adults.• Driving represents the ability to maintain connections and contribute to the community.• Studies of older drivers show there may be a relationship between health, sense of autonomy, and ability to drive.• Loss of mobility can lead to depression, low life satisfaction, health problems, isolation, and loneliness.
Involves Performance
Skills Client Factors▪ 80% cognitive▪ 18% visual▪ 2% motor/sensory
Good drivers, but gradual changes in:▪ Vision▪ Visual scanning▪ Cognition▪ Attention▪ Physical fitness▪ Coordination▪ Response time increases
Less visual acuity Decreased speed in focusingPoor color discriminationIncreased sensitivity to glare
and bright sunlightReduced peripheral visionDecreased depth perception
Decrease in hearing abilityDecrease in strength and
flexibility Reaction time slowed
Cognitive changes Ability to retrieve information slows Divided attention decreases Difficulty dividing attention
Diabetes: affects vision, physical function, and cognition
Parkinsonism: physical abilities, later cognitive
Cardiovascular disordersSide affects of medicationsDementia
Crash Involvement Crash Involvement
FatalitiesFatalities
http://search.cga.state.ct.us/dtSearch_lpa.html
Drivers 75 years or older are involved in significantly more accidents and by 2025, more than 40% of all fatal crashes will be associated with age-related frailties.
In two-vehicle fatal crashes involving an older driver and a younger driver, the vehicle driven by the older person was nearly twice as likely to be the one that was struck.
In 46 % of these crashes, both vehicles were proceeding straight at the time of the collision. In 25 %, the older driver was turning left — 5 times more often than the younger driver.
• Men outlive their ability to drive by 6 years; women outlive their ability to drive by 10 years. Source: Foley, et al (2002)
• More than 600,000 people age 70+ stop driving each year.
• Question: When? How do I Question: When? How do I know?know?
• Older drivers begin to self-restrict – Women often stop prematurely
Act to Promote Driving Retirement
Act to Maximize Ability
Physically or Mentally
Competent
Perceived Competent
Appropriate
Perceived Incompetent
Inappropriaterestriction
Physically or Mentally
Incompetent
Perceived Competent
At Risk
Perceived Incompetent
Appropriate Restrictions
Individuals with cognitive deficits who do not always make the appropriate decisions with regards to driving modification or cessation because of lack of insight, poor judgment, and loss of reasoning ability (Adler & Kuskowski, 2003).
Studies have also shown that up to 25% of older adults continue driving after a physician recommendation for driving cessation (Dobbs, Carr, & Morris, 2002).
Individuals with dementia are at increased risk for unsafe motor vehicle operation
Becoming lost in familiar areas Incorrect turning & lane deviation Impaired signalingDecreased comprehension of
traffic signsUnaware of not being a
responsible driver
NIH - 1 in 7 over 71 years of age have some type of dementia (Plassman et al. 2007)
North Carolina Do the math for your state! In 2000, 969,048 over 65 138,435 with dementia 143 DMV offices 968 per office
Dementia - special issues with driving North Carolina - 11 Driving Specialists12,585 dementia referrals for
each evaluator 34.5 a day, 365 days a year. Need to have a system in place to
deal with these issues Need law enforcement’s assistance! Tickets are critical to the process
•Varies depending on state, setting, staff, training•DMV or licensing authority•Structured, “same for all”•Pass/fail •Medical review board
•Specialists in Driving Rehabilitation •Individualized•Screen or evaluate sub-skills•Performance in Context–On Road
Specialized trainingADED – Association for Driver
Rehabilitation Specialist 80% of DRS are occupational therapists CDRS – Certification administered by
ADEDAmerican Occupational Therapy
Association Specialty Certificate in Driving and Community
Mobility
Your definitionADL, IADL, work, leisure, education,
social participationCommunity mobility is under IADL
Rural communities: Driving is the only community mobility option
Occupational Therapists: Understand the critical demands of driving
Have science-based knowledge to understand progressive conditions and life changes affecting driving
Understand how community mobility affects quality of life
• Provide objective data regarding abilities required for driving
• Assure that abilities are within state regulations
• Relate abilities to skill performance of the actual driving task
• Help client and family think about driving safety for the present and future
Does Screening Licenses all driversOccupational therapy
evaluations required by law in North Carolina when medical functional concern
Occupational therapy evaluations require physician’s order
http://www.dmv.org/nc-north-carolina/department-motor-vehicles.php
Law Enforcement Officer: Based on observed driving behaviors. Initiates the request – medical review branch of DMV
Medical review staff meets May ask for a driving evaluation by an OT
Makes final determination
Educate about older adultsSupport their dutiesOffer resources Other ideas
Your name email Phone number
Parts of this presentation was developed by Dr. Anne Dickerson, PhD, OTR/L, FAOTA, East Carolina University