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