Jacqueline Jones, Anne Dickerson, Hanna K. Flaten, Saddyna Belmashkan, Marian E. Betz; Driving Rehabilitation Specialists’ Perspectives on Older Driver Evaluations. Am J Occup Ther 2016;70(2):7002270010. https://doi.org/10.5014/ajot.2016.016915
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© 2021 American Occupational Therapy Association
OBJECTIVE. We explored driving rehabilitation specialists’ (DRSs’) perspectives on older driver evaluations.
METHOD. We conducted interviews with 26 DRSs across the United States who evaluate older drivers. Transcript analysis followed general inductive techniques to identify themes related to current systems and barriers to use.
RESULTS. Themes, by Social–Ecological Model level, were as follows: (1) individual occupational therapists’ commitment to mobility and safety, perceived responsibilities, and experience; (2) DRSs’ relationships with drivers, medical providers, and licensing bureaus; (3) the community surrounding the DRSs, including the health care system and transportation resources; and (4) societal factors, including DRS reimbursement, reporting requirements and liability coverage, and role of national organizations.
CONCLUSIONS. This qualitative study identified barriers to the development of an effective system for older driver evaluations. Future work should verify, refine, and expand these findings by targeting other stakeholder groups.
We need to somehow demystify what driver rehab is and make [people] feel like it’s doable. . . . [But driving rehabilitation] is not something that people right out of [occupational therapy] school can do right away. They need time to be able to work at their profession as it is, and learn how to work with people with disabilities and understand the disabilities more thoroughly[, and] then apply that to driver rehab.
I will get a call from the older driver or from a family member and then explain to them that insurance doesn’t cover it, but we’re hospital based, so we still require a physician’s order. So they call their physician and have [the physician’s office] fax a script to us.
I deal with farmers. They all live on highways. . . . So I can’t say, well, “You can drive in town, but don’t go on highways.” . . . Plus, there is no assistive transportation out in the country. For those folks, it’s really hard. They have to rely on family and friends and church.
the expertise of those with traffic safety and driver education backgrounds, because occupational therapists don’t come into this field knowing those two components. And driver educators and traffic safety professionals don’t come into this field knowing the diagnoses and medical side in terms of expertise.
Research and policy changes (including continuation of the Gaps and Pathways project) to augment the DRS workforce, particularly through partnerships with general practice occupational therapists and driving schools
Continued efforts to inform and engage practicing DRSs in the Gaps and Pathways project, models of reimbursement, and other aspects of the changing practice landscape
Enhanced communication with and education of other health care providers and the general public
Development and implementation of models for sustainability, including usable strategies for reimbursement.
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