Enabling people with limitations or impairments to participate in everyday life is the role and passion of most occupational therapists (OTs). OTs achieve this outcome by enhancing an individual's ability to participate, by modifying the environment, or by adapting the activity to better support participation. For most adults, driving is an essential part of life.
An OT helps individuals return to work or to a sense of normalcy. An OT has an effect on peoples’ health and well-being, creates structure and time organization, and brings meaning to life, culture and personally to each patient or client.
When individuals experience a life-changing physical or mental condition – temporary or permanent – returning to driving can be a huge boast to their well-being.
Driving is one of life’s more complex processes, involving a range of physical, cognitive and visual abilities.
During the rehabilitation process, a patient often needs to develop confidence in their abilities to resume the task of driving. A realistic, interactive driving simulator gives clients the ability to practice driving in a safe and realistic driving environment.
Driving involves many of the service approaches occupational therapists use to treat patients including:
- Teaching new ways of approaching the task of driving
- Breaking down the driving process into achievable components
- Determining if vehicle adaptations are required and what recommendations might be appropriate
- Assessing a person’s overall driving skills and fitness
- Helping an individual increase their driving confidence
- Providing guidance to family members and caregivers
Occupational therapists can use a driving simulator as a therapeutic activity to improve an individual's occupational performance and increase function in activities of daily living. The some of the motor, visual and cognitive abilities required to drive can be transferred to walking around the house or apartment.
The driving simulator is used to evaluate brain functions relating to driver fitness and other complex Instrumental Activities of Daily Living (IADL). It can be considered “the treadmill for the brain” and may be used for assessment, treatment and practice of visuo-spatial and attentional skills and abilities. The scenarios are developed for specific medical conditions, with the underlying purpose of entailing features in the scenario that specifically map to perceptual, cognitive, and motor-control performance abilities to sensitively detect impairments of brain functioning such as memory, visual processing speed, divided attention, judgment and so forth. This will produce functional outcomes and allow for the development of individualized patient care pathways.
Driving simulation provides clinicians –physicians and therapists – with a modern system to evaluate perceptual, cognitive and motor-control abilities. Assessment of these abilities will help guide medical decision-making for further testing, functional outcomes, interventions or advice for other complex tasks and occupations (besides driving) that rely on sort term memory, divided attention, visual processing speed, spatial orientation and situational awareness. Driving simulation is a system level, functional test which combines component functions into an integrated, dynamic performance test to see how well patients perform and react “under the pressure of time.”
Clinics are not required to have an existing driving evaluation program to leverage this system and technology. The administrators or therapists doo not have to be Certified Driving Rehabilitation Specialists. Therapists who assess stroke, dementia and traumatic brain injury, for example, will find that impairments of memory, attention and perception will be quickly identified by impairments in driving skills and abilities associated with these brain functions. If driving is one of the patient’s stated goals, then information gained by using the simulator can be used for deciding the need for further testing such as a behind the wheel road test or for practice and more formal treatment regimens during neuro-rehabilitation.
The turn-key CDS clinical driving simulator is based on an actual car – a Ford Focus – giving all parties some face validation. The CDS Scenarios suite of virtual drives provide the OT and the patients a variety of driving situations including residential, suburban, urban, rural, industrial and freeway as well as various lighting (bright sunlight to dark nighttime) and weather conditions (clear, foggy, snowy). The virtual driving scenarios range from simple, adaptation drives and limited complexity to transitional drives that involved multiple real-world driving settings and various environmental factors. There are enough of them to avoid the clients from memorizing them. The driving scenarios are designed in accordance with AASHTO, MUTCD and ADED best practices for delivery of driver rehabilitation services.
The administrative interface is intuitive – the OT can begin running practice drives immediately. The OT has the ability to play-back the patients’ practice drives, allowing the OT to point out to the patient the positive and negative behaviors and for the patient to learning and gain additional insight.
A suite of virtual drives involving a variety of common driving situations allows OT to see their patients in a series of driving environments, from the simple to the complex.
The need for access to intervention services is increasing. As individuals and professionals use self-assessments and professional screening tools that associate impairments with driving risk, passenger safety intervention will be required to minimize the functional impact of these risk factors on driving safety. The intervention sought from driving rehabilitation specialists is expanding from evaluating for driving potential for persons with disabilities to an ever-increasing emphasis on addressing the question of “when a person should stop”. Decisions about driving are exceedingly complex.
Therapists are typically committed to considering all options of remediation and adaptation/compensation before concluding that driving cessation is the necessary recommendation and the focus turns to alternative means for continued mobility and community involvement. The difficulty is determining when that point occurs. As researchers in aging continue to develop evidence clarifying the cut-points for decisions and compensation techniques, this information needs to be shared to ensure incorporation into occupational therapy professional development. There is also a need to increase the capacity for occupational therapy programs to provide evaluation and intervention services. Working at the level of the client, the occupational therapist can be the key link between research and practice of assessment and rehabilitation and the researchers and practitioners addressing alternative transportation issues.
Whether you work in an acute care hospital, inpatient rehabilitation facility, outpatient clinics, rehabilitation centers, skilled nursing facility, home health, specialist assessment centers, just about every patient can benefit from some driving practice as part of their rehabilitation process.
A simulator can be provided on a loan to see how the product can be integrated into the care you offer. The administrators will be able to see how the operation can provide a competitive advantage for your facility, yield extra billable time and help improve the bottom line. The patients and their families will appreciate the extra care you provide, offering a unique and needed service for those involved in the rehabilitation process.
Whether your patients are recovering from a stroke, spinal cord injury, head or traumatic brain injury, orthopaedic surgery, eye surgery, a realistic driving simulator can benefit you, your facility and your patients.
The client data collected by the system is stored locally and remotely as optional backup and data sharing measures. This allows DriveSafety to push software updates, new driving scenarios and to help remotely diagnosis technical problem should they arise. It also allows DriveSafety to pull driving performance data for trend analysis, predicative analysis and benchmarking. The data repository adheres to HIPPA requirements for security. Client identity consists of age, gender, medical condition, and related driving data, no additional client information is required or recorded.
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