1. Recognizing Warning Signs of the High Risk Driver
Cody Stovall OTR/L, CDRS
Work Plus Rehab Center
Jackson, TN
Senior Driver Summit Breakout 2016

2. Son I have been driving longer than you have been alive
Son I have been driving longer than you have been alive! I don’t know why the doctor sent me here! I have never had a wreck I’m a great driver!

3. Objectives Provide information about our program
Outline the clinical assessment of impaired older drivers and some common observations
Describe the purpose of the “Safe Roads for Seniors” initiative
Discuss warning signs and screening tools
Outline how you can become involved in Tennessee’s senior driver initiative and provide resources

4. Our program Established in 1998.
Perform other services such as outpatient PT/OT services for orthopedic or neurologic conditions
Who is evaluated…
Older drivers with cognitive decline
New drivers who might need adaptations
Seasoned drivers who have had traumatic events and might need hand controls or other vehicle modifications

5. What do we do? Clinical driver assessment Behind the wheel
Vision, short term, long term memory, multi-tasking, rules of the road, road sign recognition, muscle strength/range of motion
Behind the wheel
Safety during entire 45 min- 1hr drive time
Vehicle control
What is their speed?
Do they blame other drivers or vehicle for their mistakes?

6. Why are we here?
Madison County is #1 for Older Driver crashes in Tennessee
The purpose of the current research project “Safe Roads for Seniors” is to assess high risk senior drivers “fitness to drive” safely
Criteria for driver assessment/ grant funding:
Must be referred by physician
65 yrs or older
Live in 17 county region of West Tennessee

7. Why are we here? Educate about options that are in this state
Driver Evaluation programs
Work Plus Rehab Center Jackson, TN
Vanderbilt University Hospital Nashville, TN
LifeCare of East Ridge
Evaluations are fee for service….Medicare and private insurance do not reimburse
Most evaluations are >$500 for this 3-4 hour assessment which is not affordable for most of our clients

8. Assessment-Vision
Visual Acuity must be 20/40 in one eye to be able to drive (State Law)
Depth Perception…if impaired will have poor stopping distance…either in middle of intersection or 10 ft before stop bar for example
Road Sign Recognition…Sometimes difficulty with simple signs
Peripheral Vision…poor blind spot checks and usually has dents present on the vehicle

9. Assessment- Cognition
Oriented to Time, Place, Person, Situation
For example….Name, Date, Where they are, where they have been or are going
Short Term Memory
Problem Solving
Is Fatigue Noted?
Visual Perception…How well are their eyes communicating with their brain?

10. Signs of unsafe driving
Determining when someone can no longer safely drive requires careful observation by family and caregivers. The following list provides warning signs that it's time to stop driving:
Forgetting how to locate familiar places
Failing to observe traffic signs
Making slow or poor decisions in traffic
Driving at an inappropriate speed
Becoming angry or confused while driving
Hitting curbs
Using poor lane control
Making errors at intersections
Confusing the brake and gas pedals
Returning from a routine drive later than usual
Forgetting the destination you are driving to during the trip Read more:

11. Their Vehicle Dents, Scrapes, Different Paint Colors?
Can they explain the dents or did they know they were there?

14. Screening…Driver Orientation Screen for Cognitive Impairment
Ask ALL 9 Questions: Subtract one point for each incorrect response.
1. What is your date of birth?
Month, day, and year required; must match documents.
2. What is your full home address?
Address provided must match document; if not, prompt for
address listed on documents.
3. What state are we in now?
4. What city/town are we in now?
5. Without looking at your watch, can you estimate what time
it is now?
Answer provided must be plus or minus one hour of correct time.
6. What day of the week is it?
7-9. What is today’s date?
5 or more incorrect---Priority re-exam
Unsafe to drive; refer to department procedures for
alternative transportation and vehicle removal
3-4 incorrect---Regular or Priority re-exam
Potentially unsafe to drive; consider totality
of circumstances
0-2 incorrect---No Referral or Regular re-exam based on totality

15. Predicted Outcomes from SRFS
Identify trends and predict the number of senior drivers who will discontinue driving and need alternative transportation
Reduce costs because some patients will not meet the criteria for determination of “fitness to drive”
Reduce redundancy of efforts – Best Practices will provide statistical support for discontinuing assessments on certain patients with certain diagnosis’
Information from the research could be helpful in providing useful data to decision makers (insurance companies, policy makers)

16. What can you do to help?
DMV, law enforcement, family members can report a suspected impaired senior driver to the Department of Driver Improvement or family physician/neurologist
DMV and Law enforcement staff can receive requested training on identifying potentially at risk drivers
Participate in training to become a CarFit technician and/or coordinator to help seniors find the right “fit” in their cars
Work to start a community coalition to support efforts related finding alternative transportation options for seniors
Support the Yellow Dot program and ensure that senior drivers get the kit to register for the program

17. Cody Stovall OTR/L, CDRS
Questions?
Cody Stovall OTR/L, CDRS
Work Plus Rehab Center
343 Vann Drive, Jackson, TN
(731)
Thank you!!