#16 Tips for Older Drivers and Their Families

Aging with Altitude

Terry Cassidy, Occupational Therapist and owner of Health Partners specializes in the evaluation and support for older drivers. The week of December 7 is Older Driver's Awareness week and an ideal time to learn more about safe and comfortable drivers to take into their senior years. To see more about the week's activities visit

https://www.aota.org/Conference-Events/Older-Driver-Safety-Awareness-Week.aspx

Aging with Altitude is recorded in the Pikes Peak region with a focus on topics of aging interest across the country. We talk about both the everyday and novel needs and approaches to age with altitude whether you’re in Ft. Lauderdale, Florida or Leadville, Colorado. The Pikes Peak Area Agency on Aging is the producer. Learn more at Pikes Peak Area Agency on Aging.

Transcript:

This is Studio 809.

Cynthia Margiotta:

Hello everyone. This is Area Agency on Aging, Aging with Altitude Podcast. Welcome to all of you. This is where we provide answers, assistance, and advocacy for our elders. Thank you for joining us today. Our topic today is Older Driver Safety Awareness Week that’s coming up in a couple of days, yes?

Terri Cassidy:

Starting December 7th.

Cynthia Margiotta:

So let’s get that in our heads. I’m your host, Cynthia Margiotta. I’m a geriatric social worker and a volunteer with the Pikes Peak Area Council of Governments Area Agency on Aging. That’s a mouthful. And CEO of a program called PEARLS Program of Colorado. With me today is Terri Cassidy. Thank you for being here today, Terri. Thank you. She’s got all these wonderful letters after her name so I’m gonna just tell you what they are. The first one is OTD. What is that?

Terri Cassidy:

Doctorate in Occupational Therapy.

Cynthia Margiotta:

And then the second one is OTR/L.

Terri Cassidy:

And that’s just licensed and registered occupational therapist in the state of Colorado.

Cynthia Margiotta:

There’s no “just.”

Terri Cassidy:

No just.

Cynthia Margiotta:

No just. And the third one is CDRS.

Terri Cassidy:

Certified Driver Rehabilitation Specialist.

Cynthia Margiotta:

And that’s a mouthful girlfriend. I like the letters. OK, she’s here to talk to us today about Older Driver Safety Awareness Week. Terri has her doctorate in occupational therapy and is a certified driver rehab specialist, as she mentioned. As the owner of Health Promotion Partners, she empowers people to take positive action toward their health and well-being. She and her team provide driver evaluations and home evaluations to help older adults stay independent and connected with our community. Wonderful, wonderful. So let’s get started with some of the questions. I have a million of them. What is Older Driver Safety Awareness Week?

Terri Cassidy:

Yes. Well, thank you, Cynthia. I’m excited to be able to be here and talk about this topic. Older Driver Safety Awareness Week has such a long title, partially because it’s trying to explain what it is. It was started through the American Occupational Therapy Association really to have a set time to raise awareness to this topic. Just safety of older drivers really in a way that’s non-threatening. That’s really just about a topic that people don’t like to talk about, maybe. So trying to bring some attention from different sectors. So starting with AOTA, but there’s a lot going on even statewide with the Colorado Department of Transportation, nationally with AARP and other partners to promote this week. It’s always the first full week of December so this year is December 7th through the 11th to encourage people to think about and talk about older driver safety.

Cynthia Margiotta:

That’s a very important thing. There’s so many out there and it would be helpful, yes?

Terri Cassidy:

Yes.

Cynthia Margiotta:

So what do you do as a driver rehab specialist?

Terri Cassidy:

So in my role as a driver rehab specialist, I do driving evaluations and driver training. As an occupational therapist is really the background that I bring to this driving perspective. So particular to older drivers, I might see somebody when there is some concern or question either by the family, sometimes by the physician, sometimes by the client themselves. Am I still doing well with driving? Is this still something I should be doing? And so we do see clients and we do an evaluation here in the clinic and then also out on the road to give people feedback about maybe how age related changes are or are not affecting their driving. For some people that’s just giving them a really good baseline of this is what’s going on now so that if there’s concerns in the future, they could come back.

Cynthia Margiotta:

And this office is so easy to get to. You’re just off of Filmore and on Beacon which is not far from I-25 in Colorado Springs.

Terri Cassidy:

Yes. I’m glad that you were able to get here today.

Cynthia Margiotta:

Yeah, me too.

Terri Cassidy:

Something I like a lot about this space is our, we have a very accessible parking lot so it’s a good place for a driving program.

Cynthia Margiotta:

I even parked in it. Not so straight in the line.

Terri Cassidy:

Oh I didn’t look at your car.

Cynthia Margiotta:

Don’t look, don’t look, don’t look. I backed into a parking spot. What are some trends related to older drivers?

Terri Cassidy:

Well, I would say just for starters that when we’re talking for me, talking about driving evaluations, or even in general, for older driver safety. To me it’s not so much about age. I’m really looking at function overall. So for anybody that we’re talking about driving with, I don’t see that you know, a certain age means yes or no in terms of driving or anything like that. Like we’re really looking at physical skills, visual skills, cognitive skills is what makes up a lot of that. And older drivers tend to be more safe drivers. They tend to have less risky driving behaviors, tend to drive less at night, less overall miles. However, the data does show that over the age of 75, the fatality rate for individuals over 75 increases quite a bit compared to drivers of any other age. Except new drivers kind of mirrors that. So the concern becomes, you know, are there just changes that are happening that are affecting ability to drive and there is also an issue of frailty adding to the increased fatality rates. So somebody who’s 80 who’s involved in a crash is more likely to have more injuries, potentially life threatening injuries than a 40 year old person involved in that same crash. So there’s a couple of factors going on there, but I think overall older drivers have good driving habits, safe driving habits. We just want to find ways to keep them safe.

Cynthia Margiotta:

That makes a lot of sense to me. How do we, you know, what’s the biggest barrier to having discussions with folks about older drivers? Those barriers that, you know, I’m fearful of losing my driver’s license. She’s going to take my driver’s license away.

Terri Cassidy:

You said it. I mean that’s basically. You know, it’s a type of topic, and like I said in the beginning, people don’t always like to talk about this subject. Once you bring it up, so when I’m out talking to people, it doesn’t matter the population of people I’m talking to, everybody has a personal story about a relative, a family member, a friend where driving was iffy or where that person successfully decided on their own to stop driving. It’s a type of thing that everybody can relate to, but it’s touchy. Because, I think the biggest reason that it goes so far into our own identity and our independence of being able to drive. So if your child comes to you and says, “I have some concerns, dad, about your driving.” I think it can be hard to not take, get defensive around that discussion. So I would say the barrier is almost this stigma around removing driving, or stopping driving and really, what I would love to see is that our focus, or our value is on being engaged in the community, continuing to do things that are important to you. If you’re the driver or the passenger, it’s ok. You know, how can we just keep people involved in what they’re doing. But sometimes we get really stuck on the who’s in the driver’s seat.

Cynthia Margiotta:

Yes, yes. I have known multiple women who haven’t driven in 20 or 30 years because the husband, or even sometimes the wife, has to be the driver. You take their driver’s license away and it’s almost, and I can’t, you know, it’s for people, I guess for women to understand because it’s generally men who are very sensitive about losing their driver’s license. The closest I can think of to coming to that is you take away a woman’s home, her ability to care for her home. Because the generation we’re talking about, you know, women’s homes were their jobs. And you take that away from them, maybe they would understand a little better about their husband’s feeling about losing their driver’s license. Am I off?

Terri Cassidy:

Yeah, I appreciate that because I think it does go back to the person’s role. And so, you know, in your example, talking about the husband as the primary driver, that’s his role. And when we’re talking about changing that it’s a big deal. So yeah, no, that’s a good analogy of taking, shifting, or changing that person’s role there.

Cynthia Margiotta:

We don’t like losing our roles.

Terri Cassidy:

It’s true. It’s true and I think any ways we can help redefine our roles as we age, but hold on to, kind of figure out what the most important piece of that is, but on the surface it’s a discussion people tend to shy away from.

Cynthia Margiotta:

Yeah. Oh yeah. What are some good ways to make sure you’re a safe driver?

Terri Cassidy:

So, yes. There’s a great quote. I think it’s a Dave Barry quote that says, “Everybody feels they’re an above average driver.” Something along those lines. Everybody thinks they’re a safe driver. It’s just kind of our mentality. But things change in our bodies as we age and so sometimes it’s worth having those things checked up. In terms of being a safe driver, it’s not just important for your own self-perception. I felt safe during that drive, but doing kind of just routine medical visits. That’s going to affect your safety as a driver. Vision is a huge one, so getting an eye exam, talking to your eye doc about driving. Certainly, just medical routines, typical health examinations, things like that. There are some self-assessments of driving that are available online. I know both triple A and the AARP have those on their websites that people could fine. They’re just asking you questions about your driving. I feel like when it comes to family members, a good question is do you feel comfortable having your children in the car with your loved one. You know, so I think sometimes if you’re the older adult who’s interested in being like, how am I doing? How’s my driving going? Asking people who have driven with you. Just being, opening up to that feedback a little bit of do you feel comfortable driving. Usually, it comes the other way. Usually comes after the fact where people are saying, they’re finding out about it for another reason.

Cynthia Margiotta:

So what you’re saying really, I guess I can equate that to people who have not had glasses. And they get their very first pair of glasses. And they look out the car window. I’ve heard this story from lots of people. And they say oh my gosh. I can see the leaves on the trees.

Terri Cassidy:

Right. I’ve had that experience, yes.

Cynthia Margiotta:

Right. It’s a shock because an older driver thinks they’re being safe, being careful, but maybe they’re driving, maybe they’re weaving a little bit. Or they aren’t using their blinker in time. You know, a hundred things, right. So that’s what I can equate it to that might help listeners to hear gee yeah, I remember when I first got glasses.

Terri Cassidy:

Yeah, and that idea of oftentimes things change slowly so we don’t notice the change. Vision is a great example of that. Of your vision, and something we see a lot is trouble with contrast. So a lot of people maybe their night vision isn’t as good anymore, but they don’t notice it because they’ve just gotten used to it slowly over time. And that’s where I do feel an outside, objective opinion or evaluation can be really helpful.

Cynthia Margiotta:

Yes, that way we can’t blame the kids. We can’t blame the doctor. We can blame that lovely lady, Terri.

Terri Cassidy:

Yes! Absolutely.

Cynthia Margiotta:

It’s all her fault. OK. So driving concerns about an older family member have long been considered a family issue. Shouldn’t this topic just be addressed by family members?

Terri Cassidy:

Yeah, and that kind of gets back to the barriers question and I feel like that has in the past been a big, just part of our culture of, in a different time. Let’s say where people say “Oh, Mr. So and So is not safe behind the wheel. We know what his car looks like and we just try to avoid it” for example.

Cynthia Margiotta:

Yes, yes. I remember that person.

Terri Cassidy:

But our world has changed and sped up and there’s, there’s too many cars on the road to keep track of which ones to stay away from. And I think that, you know the research that’s been done in terms of focus groups, talking to older adults about who do you, who would you want to bring up problems with driving, or concerns that could potentially could affect your driving. The answer has tended to be spouse. Although for a certain percentage the answer is definitely not spouse, so that’s kind of a tricky one. The other person that ranks high is the doctor. So a lot of individuals feel like my doctor will tell me if I’m not safe enough to drive.

Cynthia Margiotta:

Whoa, yeah. Wait a minute.

Terri Cassidy:

It doesn’t necessarily happen that way.

Cynthia Margiotta:

Yeah.

Terri Cassidy:

But I think that’s a perception of, you know, they’re looking at my health. They’re going to look at these decisions with me. And that’s where, you know, a lot of my education is to the medical community. Say hey people are looking to you for making these decisions, here’s some suggestions on some ways that we can do this together.

Cynthia Margiotta:

How could a doctor do that? I don’t understand how they could. Seriously I don’t because I’m thinking of my doctor visits, um, my doctor doesn’t ask about my vision, doesn’t ask about my reflexes and maybe that’s down the road a little bit. Maybe they will, you know, but I have been with many, many people over the years in their doctor’s visits and I can’t recollect a single one doing an eye exam or even checking those kinds of questions.

Terri Cassidy:

Yeah, it’s really interesting because I think of like from my sphere of being in the medical world, we think of somebody’s had a stroke. It should be their doctor that talks to them about, finding out if they’re safe to drive before they go back to driving. So maybe the medical professional in the sense of an acute injury or illness, so this person had a fall, had an injury. But when you say it like you’re saying it, it does seem like a big leap to ask the doctors to then be talking about driving. And so I think there’s potential there. Like I think there’s definitely room for that discussion. And I have, even in town, spoken with some of the doctor’s offices who’ve said “oh, yeah, maybe that’s something we should add to our general questions.” You know with the Medicare health, the physical, yearly physical there’s questions about just about everything else. You know, in terms of emotional state, and alcohol use and all of these different things, but there isn’t something specific to driving. So I think it would be really interesting. There has been some research around primary care physicians and how they could be, just tapping in and asking some of these questions and mostly what they came down to was that it was too much to ask a doctor’s office to perform a screening or some kind of test related to driving. They really found though, just having the physician’s office ask the question: “How’s driving going for you?” Like just even that would be a huge improvement over what we have going on right now. And I love the idea of normalizing that conversation so that you’re asked that every year. And so you’re not defensive when somebody asks you. It’s just an honest conversation of I’ve started to notice that sometimes I think I’m pressing the break and I’m actually pressing the gas. And that can relate back to sensation and that could be something the doctor could help you manage.

Cynthia Margiotta:

Right, so it would lead into so much more information for the doctor. So what kind of solutions are there for someone who has an injury and is having trouble with driving?

Terri Cassidy:

So I mentioned some medical diagnosis. So I mentioned a stroke and for example there are a variety of things that a driving rehab specialist can do with a client to help them get back to driving after something like a stroke. Some of that is going to be in an OT clinic so that might be part of outpatient therapy before somebody comes to see me. Really focusing on reaction time and multitasking and some of these pieces, these higher judgement pieces that we use all the time when we drive and we don’t really think about it. To me the other answer that though has to do with adaptive equipment. So for example, if someone’s had a stroke, and they, let’s say they can’t use the left side of their body. They can still do gas and break with their right foot, but they usually would have done their turn signal with their left hand. So there’s some equipment we can put in the vehicle to make it safer for that person to steer with one hand, to access their turn signal and to keep their attention on the road through that whole time. Or another example would be somebody who has an amputation. We do training for use with hand controls, so you don’t need to use your feet at all for accessing gas and break and steering. So there are some really great ways to keep people driving safely even after there have been some injury or illness changes.

Cynthia Margiotta:

Yeah. Wonderful. And are those expensive? Are those expensive adaptive types of equipment?

Terri Cassidy:

You know, expensive is a good question because it’s all relative. So for someone to get equipment, you know, hand controls can be about $2000. There’s also training involved with that. Evaluation involved with that. That could be another thousand dollars. To me, when you’re looking at that amount versus not driving, you know, so I think the expensive part is hard to answer. It depends on everybody’s particular situation. Driving a vehicle, owning a vehicle is expensive. Paying for insurance is expensive, you know. So it’s all of these pieces, yeah. It needs to be weighed for each person’s situation.

Cynthia Margiotta:

Right, right, but it’s out there. And it’s great. And you have those contacts.

Terri Cassidy:

Yes.

Cynthia Margiotta:

And so people going through your program, if they discover they need some adaptive equipment, you could put them in touch with the correct person.

Terri Cassidy:

Yes, yes. We can help with that whole process.

Cynthia Margiotta:

That’s great. That’s great. So what should I do if I’m concerned about a family member’s driving?

Terri Cassidy:

And this I’m going to go back to the idea of start the conversation. You know, so often people are concerned, but they’re, don’t want to mention it. And I feel like a lot of times just coming from a place of concern, and not necessarily making any decisions, but just saying that I noticed that, you know, whatever it is. Give concrete examples if possible. But just first, bring up the topic. Say I’m a little bit concerned about this, what do you think? Maybe next time when we go to your doctor, we see what your doctor thinks. Because a lot of timed that is how it comes to the doctor’s attention is family members bringing up at the doctor’s appointment, which I think is appropriate and it helps kind of have more people give input to a decision. Because there’s all kinds of personal things that come up in these family discussions so getting more and more toward objectivity, I think is really helpful in those discussions as well, but I would say having that discussion, having an open mind. There are some great tools online to be done proactively. There’s like a driving contract that someone would sign with their children and the children saying things that I’m worried about with your driving. I’m going to let you know and also give you every opportunity to fix it, or to prove me wrong basically. And the older adult saying I agree to this process. I’m probably not explaining it great, but there are some driving agreements that can be a nice thing to do before there is anything going on that you’re worried about.

Cynthia Margiotta:

Nice, nice. Do you also have them here in the office?

Terri Cassidy:

I have access to them. They are mostly online. So yeah. I can give you guys that info.

Cynthia Margiotta:

That would be good for folks. You know, who’ve come to your program and visit with them as well. Maybe there’s no problem now, you’ve done the plenty, no problem, but here’s something you and mom can talk about and come to conclusions what works for you in your family.

Terri Cassidy:

And that’s a great point because the majority of people that we see, do pretty well. So I don’t want to make it seem like send them to Terri and that’ll be the end of their driving. I would say 80% we see, the recommendation is to continue driving. Maybe with some equipment. Maybe with some restrictions. Maybe just with some training. But we are always talking about the fact that we as a society are living longer, and it will become more and more common for us to outlive our ability to drive. So, it’s going to happen to all of us. And so the more we can be prepared and be thinking about these things, the easier it’ll be.

Cynthia Margiotta:

Absolutely, good for you. So you know, there’s a big problem with losing your driver’s license and I think that’s probably a national issue. I really don’t know but losing connectivity with the things outside of our home is a fear. So, if someone needs to stop driving, how can they stay engaged with their community?

Terri Cassidy:

And that’s a great, a great topic. A great piece of this and really a great question to be asking because that, like I was saying earlier, that’s really the key. So a lot of times, you know, if it’s somebody we’re seeing here we will try to facilitate that process. There are some really good tools online as well for family discussions of like write down where you go on a weekly basis and then have some input into the best ways to get there. So sometimes, a lot of times the family members are willing and able to help with a ride to the hair dresser, the ride to the doctor where maybe they want to be there anyway as an extra set of ears. There’s a lot of community rides in terms of neighbors going to church anyway and it’s easy to bring you. So some of that is done best kind of with family discussions and kind of circles of support. There’s also ride services that are available. There’s quite a few things available in Colorado Springs. So services such as Silver Key, such as Envida. There’s things through, I think Fountain Valley Senior Center does transportation. There’s a variety of transportation alternatives and it’s just really helpful to learn more about those because there are different requirements for different ones although we’re seeing more collaboration which is encouraging to me. So as different transportation providers collaborate, it cuts down your wait time because the next bus coming by can pick you up and take you on the way. So there’s some good things happening in our community that way. Other options that are maybe less familiar, but can be really helpful are these ride sharing services like Uber and Lyft because a lot of things I hear, people want their transportation on demand. They don’t want to have to schedule two weeks ahead for a ride somewhere. And it works for a doctor’s appointment, but maybe not for some other things. There’s a great service called Go Go Grandparent and it’s essentially like a concierge service for Uber and Lyft. So you don’t have to have a smart phone. You can call from a landline. I could call and arrange a ride for my mom. It’s still going to be an Uber driver that comes and picks her up, but the communication and the payment piece of that is, doesn’t all have to be done through an app. So that can be a good bridge.

Cynthia Margiotta:

And that’s Go Go Grandparent?

Terri Cassidy:

Yeah, yeah.

Cynthia Margiotta:

I like it.

Terri Cassidy:

Yeah, and it’s nationwide. It’s growing which is cool. So that’s a good one to check out. The other thing I’ll say around this is, I think it’s really helpful to learn about some of these services before you need it and that’s always a really difficult thing. For example, we might see somebody here for a driving evaluation and the recommendation is that they drive to their familiar locations within five miles of home, but the once a year doctor’s appointment on the other side of town, let’s start finding some alternatives for that. So maybe they figure out Silver Key and use Silver Key for that ride. Just bits and pieces so I don’t feel like you have to be completely giving up your car to start exploring some of these other options.

Cynthia Margiotta:

Right. I mean just listening to you I can think of, you know, maybe you have a friend who’s still driving. You can set up your doctor appointment to match their doctor appointment or be right there if they’re willing and take them to lunch.

Terri Cassidy:

Yes, and I think that’s a thing a lot of people don’t want to be a burden, of course. And I think some of that is a shift in how we think about things, and there’s things you could do for them. Take them to lunch, bake them cookies, you know, there’s things you could do reciprocally that you both feel good.

Cynthia Margiotta:

So December 7th is around the corner. The beginning of the week. Can you tell us just a little bit about the different themes for Older Driver Safety Awareness?

Terri Cassidy:

Yes, so each day has a different theme. I’m just going to kind of read through them here. There will be more information available online as well. So Monday the theme is “Anticipating Changes That Can Affect Driving.” And that kind of relates back to some of the changes that we’re saying could happen slowly that you don’t really notice. Tuesday is “Family Conversations,” which as we’ve alluded to here can be a really, a huge topic. Wednesday is “Screening and Evaluations with an Occupational Therapist.” And some of that could happen at an outpatient clinic, not always a full driving program. For example, in town there are a couple of occupational therapists who will do kind of a screening to give you some information there. Thursday, “Interventions that Empower Drivers and Families.” So really around adaptive equipment and what types of things can help somebody stay safer longer. And then Friday, “Staying Engaged in the Community with or Without a Car.” So these topics are really put out there with the hopes that other people will pick them up and start talking about them. So I think there will be a lot on social media during that week, but kind of related to each theme each day.

Cynthia Margiotta:

Right. Wonderful. So how can someone stay or get in touch with you through Health Promotion Partners? Phone numbers, email?

Terri Cassidy:

Sure. Phone always works great so Terri Cassidy, Health Promotion Partners. My number is 719-231-6657. Our website is HealthPromotionPartners.com. And then email, it’s [e-mail]. And I’m happy to talk to anybody even if it’s just questions and wondering about their specific situation. Happy to take those calls.

Cynthia Margiotta:

Wonderful, and thank you so much for your time, Terri. This has been very enlightening. I appreciate it.

Terri Cassidy:

Thank you. It’s been a pleasure.

Cynthia Margiotta:

So that’s the show. And thanks to all of you for being with us today. Until next time, take good care of yourself and your loved ones.

Terri Cassidy:

Thank you, Cynthia.

Hi, this is Dave Gardner. I just want to make sure you know that during these unusual times peakradar.com/virtual brings local arts and entertainment right into your home. From local music to gallery tours, to classes in dance, yoga, writing, and more. Our community is still creative and invites you to join in at peakradar.com/virtual