Consensus statements on driving for persons with dementia.

The presence of dementia can have a profound effect on a person's capacity for driving, and will lead to eventual cessation of driving and reliance on alternative transportation options. This paper offers evidence and discussion that affirm eight consensus statements related to drivers with dementia and the impact of dementia on the driving task. These statements offer guidance for occupational therapy practitioners when addressing driving and community mobility, a valued instrumental task of daily living.

Individualized assessment of driving fitness for older individuals with health, disability, and age-related concerns.

OBJECTIVE: Driver licensing agencies are faced with an increasing population of drivers who are seeking to maintain driving privileges whilst coping with functional changes associated with health, disability, or aging-related issues. Some of these changes impact upon the motor, sensory, and cognitive capacities essential for safe motor vehicle operation. The driver assessment process, as provided by occupational therapists and other professionals trained in the techniques of driver rehabilitation, can provide objective data to identify driver strengths and limitations and options available to increase mobility independence via consideration of adaptive mobility equipment, vehicle choice, driver training, or alternative transportation if necessary. This article provides an overview of the driver rehabilitation specialist's assessment and training process, with an analysis of the key issues related to this form of assessment and the need for further research. RESULTS/DISCUSSION: The basic driver rehabilitation process is outlined including examples of common deficits, assessment considerations, and intervention approaches. The clinical and on-road assessment procedures are described, with illustrations of the reasoning process that leads to a determination of the person's overall driving competence and rehabilitation recommendations. A review of the literature is provided that examines the currently available documentation that supports this assessment and rehabilitation process. CONCLUSION: The article concludes with a review of current literature that examines the claim that detailed clinical and on-road assessment, as provided by driver rehabilitation specialists, is currently the best method for assisting drivers with complex health, disability, or aging-related issues to resume or retain driving privileges.

Driving and community mobility.

Attention to driving and community mobility is a growing area of concern due to the implications across the life span, association to occupational engagement, and relevance to other organizational entities (see Appendix B). The skills, knowledge base, and scope of practice of occupational therapy enhanced by additional training in driver rehabilitation place the profession of occupational therapy in the forefront of driving and community mobility services. The focus on injury prevention, engagement in occupation, and the intervention strategies used in driver rehabilitation and community mobility services are consistent with the Philosophical Base of Occupational Therapy (AOTA, 1995) and, therefore, warrant attention in all areas of occupational therapy practice.