By Letha Mosley PhD, OTR/L, FAOTA
In 2012 there were over 36 million individuals age 65 years or older who were licensed drivers in the United States (Centers for Disease Control, n.d.). While some older adults tend to avoid driving due to a decline in physical, cognitive, or perceptual skills others may continue to drive with impairments rather than give up their keys and feel dependent on others. For individual and societal safety, it is extremely important for older adults to have accurate knowledge of their driving skills, confidence in driving ability, safe driving performance, and/or use of community resources to be able to engage in daily occupations and activities necessary for independence or a high quality of life (Stav & Lieberman, 2008). However, there are a limited number of programs that provide the scope of services that can assess their skills and provide avenues for sustaining some level of control and independence in their ability to navigate within their communities. To address this problem, the UCA Department of Occupational Therapy is working to strengthen education, research, direct services, and networking related to driving and community mobility within Arkansas.
Driving and community mobility is defined as “planning and moving around in the community and using public or private transportation, such as driving, walking, bicycling, or accessing and riding in buses, taxi cabs, or other transportation systems” (AOTA, 2014, p. S19). Occupational therapists (OTs) have a primary role in evaluation and treatment in driving and community mobility for individuals across the lifespan with varying abilities and conditions (AOTA, n.d.). A systematic review indicated that five interventions used by OTs have a positive effect on improving older adults’ driving performance; these included patient and family education, cognitive and perceptual training, therapy to enhance physical fitness, simulation training, and behind-the-wheel training (Golisz, 2014). The UCA OT Master’s program provides students with educational experiences with each of the aforementioned interventions and, with current efforts to move to doctoral education, will provide more in depth training to increase the competence and confidence of OT practitioners in addressing the growing needs of Arkansans. Although several barriers such as limited fiscal, physical, and infrastructure resources has prevented the development of driving programs in some health facilities in Arkansas, the UCA OT department has acquired resources that can be used in collaboration with local practitioners and health facilities to offer free or low cost services for the community. The most recent purchase was the Virage VS-500 3-Screen Driving Simulator (pictured). In collaboration with local practitioners, the VS-500 has been used as one component of a driving evaluation for clients. Occupational therapy students within the program get the opportunity to experience simulated driving on the VS-500 from a client’s perspective as well as learn to operate the evaluation and/or treatment components of the driving simulator to identify potential problems that may need to be addressed prior to a client engaging in a behind-the-wheel or on-the-road assessment. Under the guidance of Drs. Mosley, Moore, and Stearns, four graduate students will be engaging in research from 2016 to 2017 using the VS-500 and determining how different non-invasive interventions influence clients’ physiological responses to the driving simulation. The ultimate goals for the UCA OT program related to driving and community mobility are to: 1) prepare graduates with the skills, confidence, and commitment to address driving and community mobility, especially as related to adults and older adults; 2) serve as a collaborator or resource to practitioners in the state who may not be afforded the opportunity to have a driving simulator in their clinic but who want/need to use this as a form of assessment and/or treatment; and 3) close the gaps and provide a pathway or network for physicians and other practitioners to refer clients to the scope of driving and community mobility services available within the state or surrounding areas. For further information about driving and community mobility, feel free to peruse the American Occupational Therapy Association’s Older Adult Driving and Community web page at: http://www.aota.org/olderdriver or contact Dr. Mosley at firstname.lastname@example.org .