Bozeman Deaconess
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Comprehensive Evaluations Available to Determine Driver Safety

March 28, 2012

“The number one reason people come to me for a driving evaluation is family concern,” says Sarah Thelen, OTR/L, occupational therapist at Bozeman Deaconess Hospital. Since 2008, Thelen has taken special interest in driving assessments in this emerging clinical subfield of occupational therapy. Comprehensive driving evaluations focus on determining a patient’s ability to safely operate a vehicle.

When family members can’t dissuade an aging parent to quit driving, they often accompany the parent to a doctor’s visit and bring up the topic. “I require a physician’s referral prior to initiating the assessment,” Thelen explains. “With the exception of new drivers, I see all ages of patients with the majority being elderly. Our patients suffer from dementia, strokes, head injuries, spinal cord injuries, amputations, Parkinson’s, MS, visual deficits and other age related deficits.”

Once a physician’s order is obtained, strong evidence and research-based assessments are completed in a three-part evaluation. The evaluation begins with an in-clinic visit looking at physical performance, cognition and visual-perceptual skills. That’s followed with state-of-the-art driving simulator assessment on-site at the Western Transportation Institute’s Diving Simulator Laboratory at MSU. The patient sits in the front quarter cab of a Saturn sedan with fully functioning controls. Five rear projection plasma displays provide 170 degrees of horizontal field of view. “I use specific research-based hazards to test the driver’s reaction time, peripheral vision and hand-eye coordination,” Thelen says. “I can test potential harmful scenarios in the simulator that can’t be assessed in a car safely. This simulator can give me insight as to how a patient will do during behind-the-wheel testing. Finally, if deemed safe, our patient is taken out in a hospital owned vehicle equipped with a passenger side brake.” Patients requiring adaptive equipment due to physical disabilities can be trained to use vehicle hand controls including a right hand turn signal, extended mirrors and various steering wheel knobs as appropriate. Ongoing behind-the-wheel training using compensatory strategies is provided for drivers exhibiting potential for improvement.

Many drivers are anxious when being asked to prove their driving skills. Thelen says she is very sensitive to this fact. “I take to heart that driving can be the last source of independence for many drivers. For many people driving is crucial to self-worth.” She asks the drivers to let the objective data of the test speak for itself and lets them know right away if there are issues. “That way they have a chance to correct the error. It’s not such a shock when they get their report.” She discourages family members from coming to the test, thus taking the pressure off of loved ones. Responses from drivers vary; some drivers joke with her, others make excuses. The objective data obtained from the assessment offers concrete examples of a person’s deficits and it helps when explaining concerns with driving safety.

At the completion of all the evaluations, Thelen faxes thorough, objective results to the ordering physician.

For more information about the driving evaluation program at Bozeman Deaconess Hospital ask your physician for a referral or call Sarah Thelen at 585-1002.
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