Dad calls and lets you know that, instead of you driving him, he wants to drive you to a family event. You cringe, aware that, when Dad's in the driver's seat, you may be in for a harrowing ride. When the day comes, you reluctantly open the passenger door, fasten your seat belt and say a quick prayer.

Dad turns up the volume on the radio, which is playing a painfully off-key country song. You try to tell him he's hogging the road, but he doesn't hear you. He's entirely unaware that he's incurred significant hearing loss as he's aged.

What's a concerned son, daughter or spouse to do?

Taking away their keys and/or disabling the car are two extreme measures that can lead to conflict and bitterness. Yet they are sometimes necessary to protect the safety of a driver (and anyone else they may encounter while out on the road).

However, for less-impaired individuals, there is another option: driver rehabilitation and education.

A Different Kind of Driver's Ed

In Schenectady, NY, the Sunnyview Rehabilitation Hospital offers a Driver's Rehabilitation Program for motorists of all ages that assesses driver safety and independence through physical, visual and cognitive analyses.

Occupational Therapists (OTRs) who perform these evaluations are licensed by the state of New York as Certified Driving Instructors and Certified Rehabilitation Specialists (CDRS). Their vehicles are equipped with assistive devices and modified controls such as additional mirrors, left foot accelerator, hand controls and various wheel spinners (hub caps designed to keep wheels in place), according to Donna Stressel, OTR, CDRS, who runs the Sunnyview program. "Our program requires a doctor's prescription and is designed to support those who have medical conditions and disabilities that may interfere with their ability to drive safely," she says.

The evaluation focuses on the basics of safe driving. Therapists observe a person's motor skills, attention to detail and understanding of the rules of the road, but typically don't cover complex driving maneuvers such as parallel parking.

How Age Affects Driving Ability

Age alone doesn't automatically cause driving problems. Indeed, most people over 65 are safe drivers, according to Stressel. "People age at different rates, and some people 'age' faster than others," she says.

There are, however, some deficits that become more common with the advancing years.

Lack of visual acuity (clear vision) and hearing loss can impair a driver's ability to correctly assess changes in traffic patterns, see traffic signals and read road signs correctly. Hearing loss interferes with the ability to hear and interpret traffic sounds. Arthritic conditions cause joints and muscles to become so stiff and painful that turning one's head when backing up or quickly braking to avoid accidents can become difficult tasks to perform.

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Aging can also slow reaction time, and people who've sustained brain injuries due to accidents or strokes can develop memory and concentration problems. People diagnosed with Parkinson's disease experience diminished motor skills and may be unable to coordinate their movements quickly enough to avoid accidents. In addition, many older adults take medications that can cause them to experience dizziness, drowsiness or decreased attention while driving.

Keeping Seniors Safe

At Sunnyview, driving problems are identified and possible solutions are discussed with clients and families. Hand controls and other assistive devices may be recommended to keep a person safe while in the driver's seat. The therapists ensure proper placement of adaptive equipment within the vehicle and provide additional training on how to use it.

Should a person perform poorly during the assessments, therapists may advise the individual to stop driving. The suggestion may be for a temporary cessation—for instance, if the driver needs more time to recover from an injury or illness—or it could be a permanent ban. But those who shouldn't be driving aren't left abandoned. "When driving is considered to be unsafe, alternative transportation options are reviewed with clients and families in an effort to maintain independence within the community," Stressel says.

Because New York State doesn't have a mandatory reporting law, Sunnyview only alerts referring physicians of the results of a driving evaluation. However, licensed drivers are responsible for notifying the Department of Motor Vehicles about a medical condition that impacts on their ability to drive safely (Article 19-Section 506 of the New York State Vehicle Traffic Law). In situations where drivers are not mentally competent to comply with the self-reporting law, family members may be advised to complete the reporting process.

To find a certified driver rehabilitation provider in your area, search the Association for Driver Rehabilitation Specialists website.