Driver Training Services for Senior Drivers

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Reasons to participate in Driver Evaluation

Physical Changes
Normal physical changes with aging can include: difficulty walking or maintaining balance, slowed reaction time, loss of flexibility, or diminished strength. All these challenges may affect skills for controlling a motor vehicle.

Vision Challenges
90% of all decision making behind the wheel is related to visual processing. Macular degeneration, cataracts, diminished visual acuity, loss of peripheral vision, or impaired depth perception can impact visual processing while driving.

Ongoing Medical Conditions
Conditions such as arthritis, diabetic neuropathy, back or hip pain or other physical challenges limiting range of motion or strength may affect one’s abilities to look behind them when backing, steer, maintain lane position, or apply the gas or brake pedals appropriately.

Dementia or Alzheimer's Diagnosis
For individuals with dementia, Alzheimer’s disease, or who are showing signs of cognitive decline or memory loss, a driver evaluation is warranted as driving requires constant judgment and quick decision making behind the wheel.

A Recommendation to Stop Driving Has Been Made
A physician of family member of an aging individual may make a recommendation to cease driving. If the aging driver is unsettled or does not agree with this recommendation a comprehensive driver evaluation by an expert in the field of driver rehabilitation can aid in knowing if driving retirement is the best option.

Family Members Express Concern Regarding Safety
Family members may notice changes in driving skills of an older adult that lead to safety concerns. A comprehensive driver evaluation can provide input regarding how age related changes or medical challenges are impacting safe vehicle control and additional resources.

Additional resources

 

About Us

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Katie Fair:  (photo)

Katie Fair, MS, OTR/L, CDRS is the Driving Program Specialist at MedStar NRH Rehabilitation Network.  Katie is an occupational therapist and Certified Driver Rehabilitation Specialist with 15 years experience working in neurologic rehabilitation.  She was first introduced to driver rehabilitation as a student at Woodrow Wilson Rehabilitation Center in 2003. She started working in driver rehabilitation with MedStar NRH in 2014 and started a low tech driver rehab program at the MedStar NRH, Mclean site in 2017.  She obtained her Certified Driving Instructor credential in 2016 and her Certified Driver Rehabilitation Specialist credential in 2017. She is currently in a Doctorate program at Thomas Jefferson University where her capstone project is focusing on driving after concussion.

Ann Smith-Williams:  (photo)

***Need Ann’s BIO

Driver Training Services FAQs

What types of adaptive equipment do you have?
Sedan:

  • Electronic left food accelerator
  • Spinner knobs (tri-pin, single post, ring) with secondary control options
  • Electronic hand controls (left and right)
  • Adaptive signal/dash controls (right turn signal extension lever)
  • Variable sized steering wheel

Minivan:

  • Mechanical left food accelerator
  • Mechanical hand controls (left and right)
  • Option to drive from 6-way captain's seat or power wheelchair
  • Chest harness/cushions, pedal extensions
  • Variable effort steering
  • Ramp access

How many training sessions will I need?
May range from a few sessions to several weeks depending on your adaptive equipment or learning needs.  We will provided an estimate of anticipated training needs after your initial evaluation.

Is any of the driving evaluation covered by insurance?
Behind the wheel evaluation and training is not covered by insurance.  We may take your insurance information if we anticipate that you will need occupational therapy of physical therapy prior to starting the driver rehabilitation program.

Are their financial programs to help with the cost?
There are financing programs available for the cost of vehicle modification.  You will be provided with additional information during your initial evaluation.

Do you work with novice drivers?
We take novice drivers on a case-by-case basis depending on medical need.  The DC driving program can only take novice drivers from DC. The Virginia driving program can only take novice drivers from Virginia.  Maryland drivers can refer to the Division of Rehab Services (DORS) at 410-554-9365 or Tim Jones, CDRS at 301-682-9110.

Resources

To schedule our services, all clients should have a current driver’s license or permit.  A prescription from a medical doctor is needed prior to scheduling appointment. Your prescription should say OT/PT/Driver Rehabilitation.

Referral sources include but are not limited to: 

  • Medical doctor
  • Eye care specialist
  • Vocational Rehabilitation counselor
  • Independent Living Program counselor
  • The State Division of Motor Vehicles
  • Worker’s Compensation case manager
  • Veterans Affairs
  • Societies (ALS, MS, BI)

Clients must be seizure-free for at least at least 6 months (Virginia), 3 months (Maryland), 12 months (Washington, DC).

Forms

Virginia

Maryland

Washington, DC

Learn More About Our Resources

Driving With a Medical Condition

Please refer to your State Division of Motor Vehicles for specific medical policies:

Driver Rehab Evaluation

Step 1: Clinical Driving Evaluation (pre-driving)

You will participate in a full clinical examination. We will start by reviewing your medical and driving history. Our specialists will assess your physical abilities, cognitive functioning, road knowledge, vision, and reaction time and review your goals to ensure optimal results.

Step 2: Behind the Wheel Evaluation

The Behind the Wheel (On-Road) evaluation is completed in one of our specially modified vehicles. We use our company vehicles for this portion of the assessment for safety reasons, as they are equipped with dual controls, and have additional adaptive driving equipment that can be utilized as needed.

We will assess your driving ability and introduce equipment and/or techniques as appropriate that can assist in maximizing your driving performance. We have designed specific driving routes that gives us a clear snapshot of your abilities.

Step 3: Behind the wheel training

If necessary, additional training sessions may occur at the driver’s location, in their usual driving environment, assuring safe and independent execution of familiar and frequented routes. If a client requires adaptive equipment or techniques to drive, we will generally require additional training before we write an adaptive equipment prescription.

Step 4: Recommendations

Once the evaluation has been completed, we will discuss your entire assessment and share our recommendations with you, your family and your referring physician. In the best cases we can recommend that you return to driving without restriction.

Unfortunately, not everyone can return to driving, and sometimes our recommendation must be cessation from driving. This is difficult for anyone to hear. We will assist with counseling regarding alternative transportation options that will meet your new mobility needs as a non-driver. It is important that we make decisions and recommendations for your safety and for the safety of others using our roadways. It is always possible that your condition could change or technology advancement could improve your function. In that case we would invite you to return for reassessment at that time.

FAQs

What are specific areas that can affect my ability to drive?

  • Challenges in making multiple decisions simultaneously (multi-tasking)
  • Difficulty in judging traffic scenarios correctly and making correct responses to other roadway users
  • Slow processing that leads to delayed behind-the-wheel execution
  • Impaired memory for route navigation or for sequencing destinations
  • Visual challenges including double vision, visual suppression, or impaired perception of space
  • Impaired physical abilities such as tremors, tone, weakness or paralysis

Who can benefit from your services?

The program can help persons with a variety of disabilities including but not limited to: stroke, amputations of arms or legs, traumatic brain injury, multiple sclerosis, parkinson’s disease, spinal cord injury, arthritis, visual impairments, neurological impairments, decreased function due to aging, cardiac conditions, diabetic conditions, congenital disabilities.

License suspension

Virginia

If you receive a letter from the DMV stating that your license will be or has suspended and you need to enroll in a CDRS program, please call 703-288-8260 to schedule an appointment for a clinical driving evaluation.   If your appointment date is scheduled after the date of suspension, please let the scheduler know to send a letter of enrollment to the DMV Medical Review Board.

The DMV will send you a letter which you bring to your local DMV branch for a 3W restricted license, which allows you to drive ONLY with a CDRS (Certified Driver Rehabilitation Specialist).

You do not need the 3W restricted license for the clinical driving evaluation, but will need it for the behind the wheel evaluation or training.

 

Driving With Adaptive Equipment

Driving With Adaptive Equipment in Virginia:

Step 1:  Client and physician complete MED-2 forms (Sections A & F) and mail or fax to the DMV Medical Review Board.

Step 2: Driver completes a comprehensive assessment with an Occupational Therapist/Driver Rehabilitation Specialist to determine medical fitness and appropriate equipment.

  • The Driver Rehab Specialist sends report to DMV Medical Review Board for decision.  Once medically cleared, DMV will contact client with recommendations and issue a 3W license restriction which allows client to complete training using equipment with a driver rehab specialist. 
  • An assessment includes a clinical evaluation of physical, visual and cognitive skills to validate functional abilities and a behind the wheel evaluation to trial potential adaptive controls.  Evaluation vehicles have different hand control options and multiple steering orthotics.
  • An assessment concludes with a preliminary vehicle modification recommendation for anticipated vehicle modification needs.

Step 3:  Driver completes training with adaptive controls.

  • Training occurs in a Medstar company vehicle set up with equipment for the client’s specific needs.
  • Medstar vehicles have state required dual brakes, extra mirrors, and safety signage.
  • The driver practice skills needed for independent control operation such as acceleration, braking, parking, backing, etc.
  • Training also assures the person is making safe and independent decisions behind the wheel, judging space and time for merging, changing lanes, and parking, and incorporating disciplined visual scanning.

Step 4: Driver begins vehicle modifications and completes vehicle fitting.

  • Following training, a final vehicle prescription for adaptive controls is provided to the client and the client’s vehicle modifier.  The vehicle modifier will provide the client with a cost quote and order the equipment.
  • Once modifications are underway the client, Driver Rehab Specialist, and the vendor technician installing the adaptive controls will meet at the vehicle modifier’s shop to complete a vehicle fitting to assure that the controls are installed and positioned appropriately relative to the driver’s abilities. Adjustments will be made under the direction of our Driver Rehab Specialist. The vendor will require that they have the vehicle for a period of time prior to the fitting to allow for installation of the adaptive equipment.
  • Fittings are provided at the location of the chosen vehicle modification vendor.

Step 5:  Driver completes final training in the newly modified vehicle.

  • A final training session is completed in the client’s modified vehicle to ensure the client is proficient and comfortable navigating regular driving routes with the adaptive controls.
  • Final training includes a trip to the DMV for the client to complete a road test in his/her modified vehicle and obtain adaptive equipment restrictions on his/her license.  This is required for the client to be legally endorsed by the State of VA to use adaptive equipment.

Driving With Adaptive Equipment in Maryland:

Step 1: Client and physician complete necessary MVA paperwork, including the Physician/Health Care Provider Report and Consent form.

Step 2: Driver completes a comprehensive assessment with an Occupational Therapist/Driver Rehabilitation Specialist to determine medical fitness and appropriate equipment.

  • DRS sends report to MVA Medical Advisory Board for review and decision.  Once medically cleared, the MVA will contact client with a recommendations and issue a J license restriction which allows the client to complete training using equipment with a driver rehab specialist.
  • An assessment includes a clinical evaluation of physical, visual and cognitive skills to validate functional abilities and a behind the wheel evaluation to trial potential adaptive controls.  Evaluation vehicles have different hand control options, multiple steering orthotics, a left foot accelerator and pedal extensions of various lengths for trial. A wheelchair accessible vehicle is available for individuals who may need to drive from a power wheelchair.
  • An assessment concludes with a preliminary vehicle modification recommendation for anticipated vehicle modification needs.

Step 3:  Driver completes training with adaptive controls.

  • Training occurs in a Medstar company vehicle set up with equipment for the client’s specific needs.
  • Medstar vehicles have state required dual brakes, extra mirrors, and safety signage.
  • The driver practice skills needed for independent control operation such as acceleration, braking, parking, backing, etc.  Counsel regarding appropriate stowage of mobility devices such as a walker or wheelchair.
  • Training also assures the person is making safe and independent decisions behind the wheel, judging space and time for merging, changing lanes, and parking, and incorporating disciplined visual scanning.

Step 4: Driver begins vehicle modifications and completes vehicle fitting.

  • Following training, a final vehicle prescription for adaptive controls is provided to the client and the client’s vehicle modifier.  The vehicle modifier will provide the client with a cost quote and order the equipment.
  • Once modifications are underway the client, Driver Rehab Specialist, and the vendor technician installing the adaptive controls will meet at the vehicle modifier’s shop to complete a vehicle fitting to assure that the controls are installed and positioned appropriately relative to the driver’s abilities. Adjustments will be made under the direction of our Driver Rehab Specialist. The vendor will require that they have the vehicle for a period of time prior to the fitting to allow for installation of the adaptive equipment.
  • Fittings are provided at the location of the chosen vehicle modification vendor.

Step 5:  Driver completes final training in the newly modified vehicle.

  • A final training session is completed in the client’s modified vehicle to ensure the client is proficient and comfortable navigating regular driving routes with the adaptive controls.
  • Final training includes a trip to the MVA for the client to complete a road test in his/her modified vehicle and obtain adaptive equipment restrictions on his/her license.  This is required for the client to be legally endorsed by the State of MD to use adaptive equipment.

Driving With Adaptive Equipment in the District of Columbia:

Step 1:  Client and physician complete Medical/Eye Report Form and mail or fax to the DC DMV.

Step 2: Driver completes a comprehensive assessment with an Occupational Therapist/Driver Rehabilitation Specialist to determine medical fitness and appropriate equipment.

  • An assessment includes a clinical evaluation of physical, visual and cognitive skills to validate functional abilities and a behind the wheel evaluation to trial potential adaptive controls.  Evaluation vehicles have different hand control options and multiple steering orthotics.
  • An assessment concludes with a preliminary vehicle modification recommendation for anticipated vehicle modification needs.

Step 2:  Driver completes training with adaptive controls.

  • Training occurs in a Medstar company vehicle set up with equipment for the client’s specific needs.
  • Medstar vehicles have state required dual brakes, extra mirrors, and safety signage.
  • The driver practice skills needed for independent control operation such as acceleration, braking, parking, backing, etc.
  • Training also assures the person is making safe and independent decisions behind the wheel, judging space and time for merging, changing lanes, and parking, and incorporating disciplined visual scanning.

Step 3: Driver begins vehicle modifications and completes vehicle fitting.

  • Following training, a final vehicle prescription for adaptive controls is provided to the client and the client’s vehicle modifier.  The vehicle modifier will provide the client with a cost quote and order the equipment.
  • Once modifications are underway the client, Driver Rehab Specialist, and the vendor technician installing the adaptive controls will meet at the vehicle modifier’s shop to complete a vehicle fitting to assure that the controls are installed and positioned appropriately relative to the driver’s abilities. Adjustments will be made under the direction of our Driver Rehab Specialist. The vendor will require that they have the vehicle for a period of time prior to the fitting to allow for installation of the adaptive equipment.
  • Fittings are provided at the location of the chosen vehicle modification vendor.

Step 4:  Driver completes final training in the newly modified vehicle.

  • A final training session is completed in the client’s modified vehicle to ensure the client is proficient and comfortable navigating regular driving routes with the adaptive controls.
  • Final training includes a trip to the DMV for the client to complete a road test in his/her modified vehicle and obtain adaptive equipment restrictions on his/her license.  This is required for the client to be legally endorsed in Washington, DC to use adaptive equipment.

Services

Driver Training Services

Our Driver Training Program is the only fully accessible program in the Washington metropolitan area. The program helps people with disabilities and older drivers who wish to return to driving or learn to drive for the first time. The Driver Training Program staff is made up of licensed and registered occupational and physical therapists and rehabilitation engineers who are experienced in working with people with a variety of disabilities.

1. Clinical Driving Evaluation (pre-driving)
You will participate in a full clinical examination. We will start by reviewing your medical and driving history. Our specialists will assess your physical abilities, cognitive functioning, road knowledge, vision, and reaction time and review your goals to ensure optimal results.

2. Behind the Wheel Evaluation
The Behind the Wheel (On-Road) evaluation is completed in one of our specially modified vehicles. We use our company vehicles for this portion of the assessment for safety reasons, as they are equipped with dual controls, and have additional adaptive driving equipment that can be utilized as needed.

We will assess your driving ability and introduce equipment and/or techniques as appropriate that can assist in maximizing your driving performance. We have designed specific driving routes that gives us a clear snapshot of your abilities.

3. Report and Recommendations
Once the evaluation has been completed, we will discuss your entire assessment and share our recommendations with you, your family and referring physician. In the best cases we can recommend that you return to driving without restriction.

Unfortunately, not everyone can return to driving, and sometimes our recommendation must be cessation from driving. This is difficult for anyone to hear. We will assist with counseling regarding alternative transportation options that will meet your new mobility needs as a non-driver. It is important that we make decisions and recommendations for your safety and for the safety of others using our roadways. It is always possible that your condition could change or technology advancement could improve your function. In that case we would invite you to return for reassessment at that time.

4. Vehicle fittings
Vehicle fittings are an integral part of the vehicle modification process and are rendered to aid in the proper fit and placement of all controls relative to the client’s driving position and abilities.  Fittings assure the best interface between the driver, the vehicle, any assistive mobility devices utilized, and the driving controls.

Vehicle Fittings are provided for individuals who have successfully completed a driver evaluation, participated in driver training sessions to become proficient in the use of prescribed adaptive equipment and are having their personal vehicle modified with adaptive controls.

Fittings occur once a client’s vehicle is at a modification vendor’s shop for installation of prescribed adaptive equipment. Fittings occur at the modification vendor’s shop location.

5. Final Road Test Preparation
A final training session is completed in the client’s modified vehicle to ensure the client is proficient and comfortable navigating regular driving routes with the adaptive controls.

Final training may include a trip to the MVA/DMV for the client to complete a road test in his/her modified vehicle and obtain adaptive equipment restrictions on his/her license.

6. Driving Simulator
The Virage driving simulator provides an immersive driving environment with a 180 degree field of view, real car cockpit and motion platform.  It is used to measure a driver’s ability to control a vehicle and anticipate and manage risk in complex situations. It records driver performance, vehicle position, speed and reaction time for a variety of programmed traffic events.  Skills such as lane keeping, turning, hazard perception and collision avoidance are addressed in the different training modes.

We are currently using the simulator for patients who have driving goals, but may not be safe or ready for a behind the wheel evaluation or training.  Patients with stroke, TBI, Parkinson’s, age-related impairments can be assessed with the simulator.

Driver Training Services

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