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"With full-span lives the norm, people may need to learn how to be aged as they once learned to be adult."

—Ronald Blythe (1979, p. 22)


By the end of this chapter, readers will be able to:

  1. Describe the national statistics on older adult drivers and the types of motor vehicle violations most commonly performed by older adults.

  2. Define driving as an occupation using the Occupational Therapy Practice Framework.

  3. Explain the age-related physiological changes and disease-related changes associated with driving difficulties among older adults.

  4. Identify the clinical assessment and interventions used in driving rehabilitation programs for older drivers using evidence-based practice.

  5. Discuss the psychosocial implications of driving and the inability to drive.

Clinical Vignette

Mr. Olsen is a 72-year-old executive who has some arthritic changes in his right leg. He has driven to work for the past 20 years and plans to continue to do so. However, he notes that the pain and stiffness in his leg make it more difficult to move quickly from the gas pedal to the brake. He has no other physical limitations, and he is cognitively quite sharp. He wears bifocals, and his corrected vision is 20/20.

Because of the arthritis in his leg, he keeps a greater distance between himself and the next vehicle, realizing that it takes slightly longer for him to react and brake for sudden stops.

  1. On the basis of the information here, do you believe that Mr. Olsen is safe to continue driving? Why or why not?

  2. What suggestions might you have for making Mr. Olsen a safer driver given his current physical status?

Although there are alternative means to move about in the community, 90 percent of older adults prefer accessing the community via the private automobile (Rosenbloom, 2004; Stav, 2008). Driving is a valued occupation as it is crucial to continued independent living and maintaining ties to society (Stav, 2008). Many older adults work past retirement age, engage in volunteer work, or stay involved in organized community activities (Kartje, 2006; Stav, 2008). They assume multiple roles, such as a spouse, caregiver, grandparent, friend, worker, or volunteer, all of which dictate the needs of the older driver (Kartie, 2006).

In this chapter, the meaning of driving for older adults, its contribution to meaningful occupational profiles, and the skills needed to be able to drive safely are considered. Evaluation of driving and interventions to support driving are reviewed.

Overview of National Statistics on Violations, Crashes, and Fatalities

According to the most recent report by the National Highway Traffic Safety Administration (NHTSA; 2013), there were 35 million licensed drivers aged 65 and older in the United States, representing a 21 percent increase from 2002 to 2011. The total number of licensed drivers increased only 9 percent during the same time period. It is projected ...

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