Decision Tool for Clients with Medical Issues: A Framework for Identifying Driving Risk and Potential to Return to Driving

Abstract

This paper offers occupational therapy generalists and specialists a new framework by which to consider clinical evaluation data and an older adult's driving risk and potential to resume this previously learned skill. Based on Michon's model describing the hierarchy of driving levels, clinical questions identify the factors that may affect a client's fitness to drive. The first part is intended to support clinical judgment of whether a client needs a driving evaluation by a driver rehabilitation specialist. The second part offers a framework to organize clinical data that are already known and determine what other evaluation information is justified and necessary to make a driving recommendation. Methods and rational for use are discussed.

Crash avoidance in response to challenging driving events: The roles of age, serialization, and driving simulator platform

“…Deficits in visual scanning of busy driving environments are targeted as the main contributing factor (Braitman et al, 2008;Horswill et al, 2008;Staplin and Lyles, 1991). Recent studies as well as current models of older driver behavior all underline the fact that driving competency is multi-factorial and that the multiple factors involved interact with one another (Anstey et al, 2005;Dickerson and Bédard, 2014;Kamenhoff, 2008;Michon, 1985;Wood et al, 2008). However, the precise cognitive and motor components as well as their interactions have yet to be fully revealed (Bédard et al, 2008;Fildes 2008;Leproust et al, 2008;Wheatley and Di Stefano, 2008).…”

Transportation and Aging: An Updated Research Agenda for Advancing Safe Mobility

“…The evaluations are meant to be diagnostic and may result in licensing recommendations (Lane et al, 2014). Hence, a complex framework is required to ensure accurate determinations of fitness-to-drive (Dickerson & Bédard, 2014).…”

Driving Decisions: Distinguishing Evaluations, Providers and Outcomes

“…These practitioners perform skilled approaches specific to driving in the context of medical impairments, with recommendations to provide only the safest mobility outcome. Evidenced-based assessments of intrinsic factors of vision, cognition and motor skills in the context of the Michon Model of driving as outlined above are typically adopted [35]. While traffic signs, rules of the road and knowledge of traffic rules, along with in traffic driving skills are usually evaluated both clinically and within the actual driving situations, it is the specialized medical knowledge of health conditions including prognosis and compensatory potential that distinguishes the LDI and a non-medical DRS from the DRS with a medical degree (OT/DRS).…”