Driving is a complex task that requires the integration of physical, sensory, and cognitive functioning by an individual to safely operate a vehicle. Although functional ability can and often does diminish as a person ages, the rate and ways in which that change occurs can vary widely among individuals. A 2001 U.S. Department of Transportation survey showed that older Americans travel extensively and rely on personal vehicles as heavily as do their younger counterparts. They make nearly 90 percent of all of their trips in a car. That reliance on personal vehicles among the rapidly growing population of adults ages 65 and older is expected to continue. In fact, in the coming years, older adults are expected to drive more miles each year and to drive for more years than the current cohort of older adults. Despite advances in the crashworthiness of today’s vehicles and improvements in road infrastructure, the fatality rate for older vehicle occupants, including drivers, has increased, while rates for other age groups have declined. A constellation of tactics will be required to enhance the safety of older drivers on the roads. Absent a concerted and coordinated effort to address the challenges faced by older Americans, the Insurance Institute for Highway Safety estimates that, if current trends continue, the number adults ages 65 and older who die in vehicle crashes could triple by 2030. The National Highway Traffic Safety Administration (NHTSA) and other leaders in the older driver research field have identified one of several critical elements that are needed to stem the current fatality trends among older adult drivers—unfettered access by consumers to valid and reliable evaluation and remediation, or retraining, services. The number of driving rehabilitation specialists who can provide those services, however, is inadequate to provide assessments and follow-up training to all who might be referred to them or who directly seek their services. In September 2003, NHTSA and the American Occupational Therapy Association (AOTA) signed a cooperative agreement under which AOTA would develop a report to provide a snapshot of current practices, operational barriers, marketing strategies, and lessons learned from a sampling of driving programs nationwide. AOTA sought to examine organizations that offer older adults and other individuals driving services in a clinical setting or in the car. AOTA also sought information about current driving programs in hopes of strengthening existing programs, of providing a better referral system for consumers and health professionals in search of driving services, and of expanding the number of programs for a burgeoning population of individuals ages 65 and older. Based on those issues, the project team crafted a set of research questions to ask existing programs. Those questions formed the basis for the survey instrument used to collect information from programs nationwide. The research team also conducted brief follow-up interviews with some driving programs and developed in-depth profiles of three programs that represent common occurring organizational structures for delivering assessment and retraining services. The survey was sent during the last week of January 2004 to 410 individuals who were part of the driving program database. Of those surveys sent, 317 were delivered by e-mail link, and 93 copies of the survey were mailed. Following dissemination of the survey, the research team discovered that, in some cases, several people from the same driving program received and completed the survey. In some other instances, only the program director completed the survey, even though it had been sent to three individuals listed in the database for a particular program. Overall, almost 4 out of 10 (39%) e-mail recipients of the survey completed the instrument versus less than 1 out of 4 (22%) of those receiving the mailed version of the survey. The research team notes that there is no way to determine with accuracy whether the driving programs responding to the survey represent a statistically valid sample of the types of programs in operation in the United States. In addition, the results of the brief program interviews and open-ended responses to some survey questions should be viewed with caution and as explorative in that they describe reactions of a nongeneralizable sample. (Author/publisher)
Abstract