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“Our transportation decisions determine much more than where roads or bridges or tunnels or rail lines will be built. They determine the connections and barriers that people will encounter in their daily lives, and thus how hard or easy it will be for people to get where they need and want to go.”
—Elijah Cummings
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LEARNING OUTCOMES
By the end of this chapter, readers will be able to:
19-1. Relate the occupation of driving to community mobility and participation using the language of the International Classification of Functioning, Disability and Health (ICF).
19-2. Connect age-related physiological and disease-related changes with associated driving difficulties experienced by some older adults.
19-3. Understand the continuum of care, certification programs, and members of the interprofessional team for driving and community mobility.
19-4. Appraise the utility of clinical assessments used in driving rehabilitation programs for older drivers.
19-5. Evaluate the availability and effectiveness of various driving and community mobility interventions for older drivers.
19-6. Explain the psychosocial implications of driving cessation for the older adult.
19-7. Identify alternative methods of community mobility recommended for the older adult.
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Mini Case Study
Mrs. Florence Vasquez is a 72-year-old woman who is experiencing vision changes and peripheral neuropathy secondary to her chronic diabetes condition. These changes have limited her ability to drive. Specifically, she reports some fuzziness in her vision and says that it is increasingly difficult to see at a distance, such as reading upcoming signs, and while driving at dusk or in the dark. She has also noticed that occasional numbness in her feet makes using and switching pedals more difficult, causing a few “close calls” when attempting to use the brakes. Mrs. Vasquez primarily drives short distances around her town to complete the household errands and go to medical appointments for herself and her husband, who no longer drives. She also drives to visit friends’ homes, to take classes for seniors at a local university, and to attend Catholic Mass services. Occasionally, she drives a friend on an errand or volunteers delivering meals for a church outreach group. Mrs. Vasquez is accustomed to driving almost daily during a typical week but has cut out some of the evening activities due to her vision, and she feels worried that she might not pass her upcoming driver’s license renewal.
Provocative Questions
Based on this overview of Mrs. Vasquez’s current patterns of engaging in the community, what areas of occupational engagement would be most influenced if she is unable to drive?
What suggestions might you have for facilitating continued engagement in meaningful occupations, and participation in her roles as a spouse, friend, and volunteer?
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The ability to engage in activities and occupations out of the home is necessary to meet many of the demands of daily life, allowing individuals to get food and supplies, address health needs, socialize and interact, and fulfill family and worker roles. For older ...