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Friday, February 21, 2014

Driver Rehab: Helping To Keep Seniors Safe On The Road

As baby boomers approach older age, they and their children are increasingly seeking out driver rehabilitation specialists. (Brenda Anderson/Flickr)

As baby boomers approach older age, they and their children are increasingly seeking out driver rehabilitation specialists. (Brenda Anderson/Flickr)

The National Institutes of Health predicts that by 2030, almost 1 out of every 5 Americans — some 72 million people — will be 65 years or older. According to the National Highway Traffic Safety Administration, there are about 35 million licensed drivers over 65. That’s up 20 percent since 2003.

Interestingly, these drivers don’t pose the most danger. That honor goes to teens and people over 75. But as baby boomers approach older age, they and their children are increasingly seeking out driver rehabilitation specialists.

Anne Hegberg, a driver rehabilitation specialist at Marianjoy Rehabilitation Hospital in Wheaton, Illinois, joins Here & Now’s Robin Young with details.





A new study from the Insurance Institute for Highway Safety found today's elderly drivers less likely to be involved in, injured in or killed in automobile accidents than previous generations. And older drivers today have access to driver rehab specialists. Now, there's long been an association of driver rehab specialists for people with disabilities. Now there's a focus on rehabbing the elderly as well, and it's supported by and often covered by insurance companies or Medicare.

Anne Hegberg is a senior clinician and driver rehab specialist at Marianjoy Rehab Hospital in Wheaton, Illinois. She's at the studios of WDCB Public Radio in Glen Ellyn, Illinois. So Anne, what are you working towards when it comes to the elderly as a rehab specialist?

ANNE HEGBERG: What we're trying to do is keep people on the road as safe as possible. AAA says that people outlive their ability to drive safely by seven to 10 years. So rather than have it be one day you're driving, the next day you're not, we're trying to get it so it's more of a continuum.

YOUNG: People can go online with AAA or AARP and they can take online screening assessments of themselves or of a parent. If somebody needs rehab, which your facility offers, they can get a doctor to do it because very often it will be paid for by Medicare or Medicaid. So check all of that out. But what do you do?

HEGBERG: It's about a two, two and a half hour evaluation. The first part is in the clinic where we get the background information, past medical history, driving history. Then we check their vision, and then we're looking at their range of motion, their strength, coordination. That's just the first part. Then the second part is going out in the car and driving. We do have to use our car because it's got the instructor brake on it, and it also has a light on the passenger side so we can tell if they're activating the brake light.

Sometimes people will compensate by starting to drive with two feet but they kind of rest their left foot on the brake all the time so you're following them. They always have the brake lights on. So then we have a set evaluation route where we take them out driving. If they say they never go on the expressway, we're not going to take them on the expressway.

At the end, then we always sit down with the family and the client, talk about strengths and weaknesses and what our recommendation is: they're fine to drive, they should limit their driving, or that they should retire from driving.

YOUNG: Well, what if they're somewhere in the middle, maybe limited but have some rehab? How do you rehab a driver who, let's say, is forgetting to look when they change lanes?

HEGBERG: Well, sometimes what works the best is doing it in their home area where they're familiar and working on some compensatory strategies as far as routing so they're not going on identity traffic. And then the other thing is it depends on why they're not looking to the left when they lane change. A lot of the older never had driver's education so they never learned that. So if they're cognitively intact, that's something they can learn. If it's a memory problem, then that's a little tougher.

YOUNG: And then, of course, there's the physical. Some insurance companies have online exercises you can do to get your neck moving a little more so that you can turn and look over your shoulder. You know, quite something that people are trying to come up with ways to keep seniors driving because - because why? I mean, why not just try to get as many people off the road?

HEGBERG: Well, it's their independence. When you have to stop driving, the rate of depression goes up, isolation. They're not going to get to the doctor as often if they can't drive. They've always met their friends for the last 40 years at the coffee shop every Monday.

YOUNG: You mentioned the depression. I mean, insurance companies being behind this signals that they understand that there are some other costs that come from people not driving, the cost of depression, for instance. And what do you think about how else we might assess seniors? Illinois is right now the only state that requires a test for older drivers.

Many other states require them to renew their license in person rather than online. In their recent report on older drivers, the National Highway Traffic Safety Administration wrote that there's insufficient evidence of the reliability of any sort of driving assessment or screening test.

HEGBERG: Yeah. We spent a good two, two and a half hours with a person, so I feel real comfortable. When I'm training new people to do my job, I always say, you know, they're like, well, the person wasn't that bad. And I say, well, would you put your child in the backseat with them? And that kind of, oh, yeah. But at the state level, you know, it might be under 10 minutes that can be a problem.

YOUNG: Yeah. Anne Hegberg, senior clinician and driver rehab specialist at Marianjoy Rehabilitation Hospital in Wheaton, Illinois. Anne, thanks so much. Fascinating.

HEGBERG: You're very welcome. Transcript provided by NPR, Copyright NPR.

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