Question 1

In the Occupational Therapy Framework, driving is considered a(n):&#10;A) Activity of daily living&#10;B) Instrumental activity of daily living&#10;C) Client factor&#10;D) Role

Accepted Answer

Driving and community mobility as an instrumental activity of daily living (IADL) is recognized as critical to being able to participate in all other occupations (Dickerson, 2012), and as such, is considered an occupation enabler (Stav & Lieberman, 2008). Thus, older adults who cannot drive or who refrain from driving may have difficulty engaging in many of the fundamental activities for achieving productive aging.

Question 2

A fundamental reason why older adults value the ability to drive is:&#10;A) Generational influence&#10;B) Family values&#10;C) Lack of good public transportation&#10;D) No interest in ride sharing

Accepted Answer

The boomer generation grew up during a time when cars had just become readily available for most families. While only the wealthy had cars before World War II, in the 1950s and 1960s mass production made vehicles affordable, allowing families to move into the suburbs and expanding their social and physical environments. Every teenager counted the days to get their driver's license because the "car" was the social networking tool of this generation. In other words, the car was the equivalent to the smartphone today! Driving down the main street of any town in the "right" vehicle was comparable to posting the latest on Facebook or Twitter-making sure to connect with peers as well as seeing who everyone you were with or who had the best "wheels." Although telephones were available to communicate, they were often shared on "party lines," and teens had little privacy. The popular method of socialization was driving to local gathering places, whether it was a high school sports game, drugstore, diner, McDonald's eatery, concert, swimming pool, or the drive-in movie theater. With the expansion of the interstate highway system, families explored beyond their immediate communities, going on road trips (e.g., Route 66); taking vacations to the beach, mountains, or lake; traveling to extended family gatherings; or simply just enjoying Sunday drives. Thus, driving for the boomers is not just about community mobility (i.e., getting to where they want and need to go), but about the occupation of driving. Regardless of available alternative transportation, an older adult at risk of losing his or her ability to drive may not be just about losing just an option of community mobility. The older adult will be losing their highly valued occupation of driving "their car"-possibly equivalent to the younger person losing their phone privileges. Moreover, it is recognized that driving is crucial to engaging in other occupations, including work, education, play, leisure, and social participation, as well as most other IADLs (e.g., shopping, health management, money management, and caregiving) (Schold Davis, Dickerson, Dellinger, & Chodrow, 2016).

Question 3

Older adults tend be safe drivers due to which factor?&#10;A) Generational influence&#10;B) Family values&#10;C) Avoidance of driving during high traffic times&#10;D) Tendency to be cautious

Accepted Answer

It is important to recognize that older adults are generally safe drivers, overall having the lowest risk of collisions. Part of the reason for fewer crashes is the lower exposure to risk factors. Older adults tend to avoid driving during rush hour, at night, or on high-speed interstates. Additionally, research has clearly demonstrated that it is not "age" that leads to declines in driving, but the functional impairments associated with medical conditions that put older drivers at risk (Coughlin & D'Ambrosio, 2012; Dickerson et al., 2017).

Question 4

What aspect of older adult independence should be a legal right?&#10;A) Driving one's own car&#10;B) Community mobility&#10;C) Ability to perform ADLs&#10;D) A ramp to one's home for accessibility

Accepted Answer

Although driving is a privilege granted by the state, community mobility is a right for everyone. It is critical to understand that many of the ADLs and most of the IADLs are affected by whether someone is able to be mobile in their community. Table 13-1 outlines aspects of occupations, as identified by the Practice Framework (AOTA, 2014), that warrant consideration when addressing driving and community mobility of the client (Dickerson, 2016).

Question 5

Driving is a key IADL; however, some occupational therapy practitioners are hesitant to assess driving for which of the following reasons?&#10;A) Public transportation is often convenient and available&#10;B) Lack of confidence in making decisions about driving capability&#10;C) Cost and time required for driving evaluations&#10;D) Lack of assessment tools

Accepted Answer

When considering the IADL of driving, the identification process is not more complex, but it is more complicated. With driving, the potential risk is not just to the client and maybe the caregivers but also to the general public, as the negative result is a crash that often involves more than one person. While the fear of making a decision about driving is often the reason occupational therapy practitioners do not have the confidence to address driving (Dickerson, Schold Davis, & Chew, 2011), driving and community mobility is within the scope of occupational therapy practice and the ethical obligation of the practitioner to identify risk (Slater, 2012). Practitioners cannot make decisions about driving licensing, as only the state licensing agencies grant licenses. However, because occupational therapy practitioners observe functional performance and identify risk, they have been identified as the "go-to" profession for driver evaluation and rehabilitation (Society & Pomidor, 2016). Unless occupational therapy practitioners step up to address this IADL with all clients, it could be another practice area lost to other, less qualified service providers (who are without or have less medical training or education) who are already devising certificate programs that purport to be able to evaluate older adults effectively (Dickerson, 2012; Dickerson, 2014).

Question 6

Who can decide that an older adult no longer can retain a license to drive?&#10;A) Occupational therapist&#10;B) Physician&#10;C) State licensing agency&#10;D) Nurse practitioner

Accepted Answer

When considering the IADL of driving, the identification process is not more complex, but it is more complicated. With driving, the potential risk is not just to the client and maybe the caregivers but also the general public, as the negative result is a crash that often involves more than one person. While the fear of making a decision about driving is often the reason occupational therapy practitioners do not have the confidence to address driving (Dickerson, Schold Davis, & Chew, 2011), driving and community mobility is within the scope of occupational therapy practice and the ethical obligation of the practitioner to identify risk (Slater, 2012). Practitioners cannot make decisions about driving licensing, as only the state licensing agencies grant licenses. However, because occupational therapy practitioners observe functional performance and identify risk, they have been identified as the "go-to" profession for driver evaluation and rehabilitation (Society & Pomidor, 2016). Unless occupational therapy practitioners step up to address this IADL with all clients, it could be another practice area lost to other, less qualified service providers (who are without or have less medical training or education) who are already devising certificate programs that purport to be able to evaluate older adults effectively (Dickerson, 2012; Dickerson, 2014).

Question 7

Which group provides the evidence for making decisions about fitness to drive, particularly when related to screening and assessment?&#10;A) State licensing authorities&#10;B) Researchers&#10;C) Practitioners&#10;D) Consumers

Accepted Answer

Researchers provide the evidence for making decisions about fitness to drive, particularly when related to screening and assessment. With provided evidence concerning the validity and reliability of assessment tools, researchers assist in the establishment of appropriate constraints, limitations, and potential "cutoff" scores to be used by practitioners and/or licensing authorities. In best practice, researchers translate the research outcomes into practical criteria for an objective decision about fitness to drive. Researchers may be psychologists, occupational therapists, physicians, or other professionals with research degrees.

Question 8

Driving rehabilitation is a form of therapy that plans, develops, and implements services for individuals with disabilities in order for the individual to drive, typically following what rehabilitative approach?

A) Proactive
B) Maintenance
C) Remediation
D) Compensatory

Accepted Answer

Driving rehabilitation is a form of therapy-traditionally compensatory-that plans, develops, and implements services for individuals with disabilities in order for the individual to drive. Driver rehabilitation specialist (DRS) is a general term that encompasses a diverse group of providers. The requirements for the certification and education of a DRS are not based on being a member of a specific medical profession, nor is there is consistency between states. Providers who use the initials DRS have diverse backgrounds, including engineers, driving instructors, and health- care professionals.

Question 9

A typical outcome of a driving evaluation is which of the following?&#10;A) Compensation through training&#10;B) Use of a driving simulator&#10;C) Road assessment&#10;D) A report to state licensing authorities

Accepted Answer

Once completed, the outcomes of the evaluation may include one or a combination of the following implementation plans:
• Rehabilitation of underlying human components (e.g., increasing scanning abilities through specifically designed intervention)
• Compensation through training (e.g., driving simulator training, avoiding left turns),
• Compensation through adaptation of the vehicle (e.g., using hand controls or a steering knob for one-handed turning)
• Cessation of driving counseling and planning.

Question 10

Hand controls are an example of which type of driving rehabilitation intervention?&#10;A) Rehabilitation of underlying human components&#10;B) Compensation through training&#10;C) Compensation through adaptation&#10;D) Cessation of driving counseling and planning

Accepted Answer

Once completed, the outcomes of the evaluation may include one or a combination of the following implementation plans:
• Rehabilitation of underlying human components (e.g., increasing scanning abilities through specifically designed intervention)
• Compensation through training (e.g., driving simulator training, avoiding left turns),
• Compensation through adaptation of the vehicle (e.g., using hand controls or a steering knob for one-handed turning)
• Cessation of driving counseling and planning.

Question 11

In the process of addressing driving and community mobility, obtaining and reviewing data to determine the needs for evaluation is known as:&#10;A) Screening&#10;B) A driving simulator&#10;C) A driving evaluation&#10;D) An occupational profile

Accepted Answer

The answer of In the process of addressing driving and...

Question 12

When addressing driving and community mobility, the occupational therapist should follow which process?&#10;A) Screening prior to evaluation&#10;B) Use of a driving simulator to assess driving skills&#10;C) OTPF process&#10;D) Development of an intervention plan for driving remediation

Accepted Answer

The answer of When addressing driving and community mobility, the...

Question 13

The step in the process of the OT-DRIVE model when the occupational therapist determines the intervention plan considering the client's impairments on their potential for driving is:&#10;A) Readiness&#10;B) Intervention&#10;C) Verification&#10;D) Evaluation

Accepted Answer

The answer of The step in the process of the...

Question 14

Ms. Lee, a 76-year-old female, is taking time to thoroughly plan a trip across the country in her recreational vehicle. Ms. Lee is demonstrating the ability to perform which level of driving behavior?&#10;A) Strategic&#10;B) Tactical&#10;C) Operational&#10;D) Readiness

Accepted Answer

The answer of Ms. Lee, a 76-year-old female, is taking...

Question 15

Andrea tells you, the occupational therapy practitioner, that her mother got lost driving to the grocery store, a route she has taken many times. She asks your advice for next steps. The best next step is:

A) Encourage her to report this to her mother's physician
B) Recommend her mother take the bus from now on
C) Inform her that her mother should no longer drive
D) Complete a clinical observation checklist followed by a referral to a DRS for a specialized driving evaluation if indicated

Accepted Answer

The answer of Andrea tells you, the occupational therapy practitioner,...

Question 16

Rearview cameras are an example of which type of evidence-based technology in prevention of car crashes?&#10;A) Driverless car technology&#10;B) Antilock braking system&#10;C) Crash avoidance system&#10;D) Advanced driver assistance systems

Accepted Answer

The answer of Rearview cameras are an example of which...

Question 17

Older adults do not always adopt driving technologies that prevent motor vehicle accidents because they:&#10;A) Drive older cars without the technology&#10;B) Drive infrequently&#10;C) Are unwilling to pay for these services&#10;D) Lack trust in the technology

Accepted Answer

The answer of Older adults do not always adopt driving...

Question 18

Occupational therapists should encourage which type of technology for wayfinding?&#10;A) Driverless car technology&#10;B) Global Positioning System&#10;C) Crash avoidance system&#10;D) Advanced driver assistance systems

Accepted Answer

The answer of Occupational therapists should encourage which type of...

Deck 13: Driving and Community Mobility Introduction