Occupational Therapy Driver Assessment – What and Why?
Driving is an important part of our lives and identity – facilitating freedom and independence. Driving, however is a complex task and requires the following skills:
- Physical ability
- Thinking skills
Any deficit in any of those abilities as a result of injury, illness or ageing can impact on our ability to drive.
I Will Know When to Stop Driving: Sometimes, and sometimes not. Sometimes people are not aware of their changing abilities particularly regarding cognition (as seen in Dementia, Parkinson’s Disease). When our abilities change we may need guidance from our family, friends, doctors or health professionals about how our health is impacting on our ability to start, resume or continue driving. Driving is a privilege not a right and it is the driver’s responsibility to ensure they are medically fit to drive. Failure to identify when they are unfit to drive may result in putting lives at risk, and result in serious legal and financial outcomes including loss of insurance cover.
Ensuring a person is medically fit to drive is governed nationally by Austroads – Assessing Fitness to Drive (a publication which outlines medical conditions and the licencing requirements for private and commercial licences). In Queensland, drivers over 75 years old must carry a Medical Certificate for Motor Vehicle Driver Form (completed by the driver and GP).
Who are OT Driver Assessors: As an Occupational Therapist, our main goal is to enable and support people to maintain their independence. In particular Occupational Therapy Driver Assessors (OTDAs) help to identify when our abilities required to drive are impaired. Research has shown that performing an Occupational Driver Assessment (OTDA) is the Gold Standard in assessing a person’s ability to drive. An OTDAs has not only completed a degree in Occupational Therapy but also postgraduate studies in Driver Assessment. An OTDAs is aware of the importance of driving for the person and try to keep the whole assessment process as simple and stress-free as possible.
What is an OT Driver Assessment: Prior to an OTDA, the assessor requires a medical report outlining medical conditions, medications and that the person is medically fit to undertake the test. The person must have a valid Driver’s Licence or Learners Permit. The OTDA consists of 2 parts: Off-road and On-road assessments. These are normally completed on the same day (but can be done separately if required) and are done at the person’s home or in the OT’s clinic.
Off-Road Assessment: This part looks at the person’s medical background, driving history, vision, physical ability, decision-making and judgement skills relevant to driving and road law knowledge. This part can take up to 2 hours.
On-road Assessment: The on-road assessment occurs in the driving instructor’s dual controlled car. This means the driving instructor has controls on his side (left passenger side). The car can be manual or automatic depending on what the person normally drives or what is required based on the person’s medical condition. The person will be in the driver’s side, the driving instructor will be in the left front passenger seat and the OTDAs will be in the rear left passenger seat writing down the occurrences that happen on the drive. The driver will be given time at the beginning of the on-road assessment to become familiar with the vehicle they are being tested in. This part takes up to 1 hour.
Possible Outcomes: At the end of the assessment the OTDAs will give feedback on the how the person’s medical condition/s impact on their ability to drive safely according to legal and driving safety requirements. There are a number of possible outcomes these include:
- The driver is fit to drive and no further intervention is required
- The driver is fit to drive with certain restrictions such as limited distance from their home, driving in daylight hours only or driving an automatic vehicle only
- A series of driving lessons with a qualified driving instructor to regain confidence, learn compensatory skills or upgrade driving skills
- Driving lessons to gain competency in driving with specialized vehicle modifications such as a spinner knob, left foot accelerator or hand controls. These modifications must be endorsed on the person’s drivers license.
- Cancellation or suspension of a driver’s licence to await a person to recover further from illness or injury
- Unfit to drive with licence cancellation
Reporting: The OTDAs writes a comprehensive report which is sent to the referring doctor, the person and the licencing authority. This part takes up to 1 hour.
Ongoing OTDA: An on-road re-assessment may be required to assess a person’s progress after a series of driving lessons. Further OTDA may be requested if a person has a progressive medical condition such as Multiple Sclerosis, Dementia, Parkinson’s Disease or Muscular Dystrophy.
Why Is It So Expensive? This is a question I often get. Please note that a full OTDA comprises of 3 hours face-to-face and 1 hour of report writing. This does not include travel time or the cost of the driving instructor. The cost of the OTDA is not covered by Qld Transport or any other driver licencing authority. Rebates (not fully covering costs) may be obtained through Medicare or private health insurance. Costs may also be covered by the NDIS (if in the person’s budget), HomeCare Package (depending on level and approval by the provider). DVA may cover costs if the person is eligible such as their medical condition is supported by DVA and they are needing vehicle modifications.
Katt McDonald, Occupational Therapy Driver Assessor
T: 0417 913 354