What to Expect When You Are Referred to a Driving Rehabilitation Specialist?

As we age, our physical and cognitive capabilities can diminish. During an annual or other examination, your doctor may identify a need for further evaluation so you can remain a safe driver on the road. Driving Rehabilitation Specialists (DRSs) are trained to conduct these evaluations and to provide recommendations for how you can continue to drive safely for as long as possible.

A DRS will work with you to help decide how you can improve your driving; if other services to improve fitness would be useful; and if a comprehensive driving evaluation by a DRS would be useful. The DRS recommendation can include a scope of activities to assist the driver--from medication management by a caregiver and treatment by a physical therapist for mobility issues, to identifying adaptive devices for your car that will make driving easier and safer, seeking safety features when purchasing a new car, and planning for alternative transportation for those situations where you just aren’t comfortable behind the wheel.

A clinician can advise the older driver about reasons for needing an additional evaluation, its goals, the types of tests involved, and the typical costs, if not covered by insurance. Some programs may require a prescription, so it is necessary to understand local requirements and policies. A follow-up appointment is usually scheduled after the driver’s evaluation.

What Is the Role of a Driver Rehabilitation Specialist (DRS)?

A DRS is typically an occupational therapist specially trained to evaluate an individual's driving risk, especially individuals with medical conditions that may impact driving abilities. These conditions include arthritis, stroke, dementia, Parkinson's, and advanced age. They are typically affiliated with medical centers, rehabilitation facilities, driving schools, and state departments of motor vehicles. A DRS conducts a comprehensive evaluation to include on-the-road driving assessments. Their evaluations may result in changing the individuals driving habits, learning new methods of driving by adapting an individual's car with specialized driving equipment or exploring other transportation options. 

Their goal is to help you maintain independent driving through the use of specialized mobility equipment and/or training for as long as it is safe. Driving specialists are skilled in helping you determine when you may need to use assistive devices, such as larger mirrors, hand controls, or foot pedal extenders, or develop safer driving routes to decrease risk.

DRS-OTs have the science and medical-based knowledge to understand progressive medical conditions and life changes that can affect driving and take the time to understand the role that driving plays in your life and assure that, if necessary, you can experience a smooth transition from driving to alternative forms of transportation to maintain your independence and quality of life.

Who will do the Evaluation

Occupational therapists, healthcare specialists with training in driver rehabilitation, conduct comprehensive driving evaluations that consist of two parts: a) physical, visual and cognitive tests in an office or clinic, as well as b) a test behind the wheel of a car. The first group of tests focuses on abilities such as reaction time, sharpness of vision, judgment and planning and other skills required for making decisions while driving. The on-road part of the evaluation takes place in a vehicle equipped with safety equipment, such as an instructor's brake; this part identifies an older driver's strengths and weaknesses and ways to keep driving safely. If necessary, the evaluation may recommend using adaptive equipment.

There are many types of driving rehabilitation services—from those that involve only medical providers to driving schools.

You can find a DRS in your community at the AOTA locator and Certified DRS from the Association for Driver Rehabilitation Specialists (ADRS).

What do you do with your Evaluation Report

The DRS can make recommendations about strategies, specialized equipment, and training to improve your driving safety. If the evaluation results indicate the need for driving cessation, the DRS can help explain what the risks are and why driving may not be safe for you and others and help identify transportation options in the community.

At a follow-up appointment after the evaluation, the clinician can explain to you, your family member(s), and/or caregiver the results, along with recommendations about next steps—from mobility counseling and transportation planning to further evaluation by another health professional such as a neurologist, geriatrician, or psychiatrist.

Specific state requirements for older drivers may be found at licensing agencies listed at DMV USA.   The Primary care providers Guide, p.108, also lists licensing agency contact information by state, along with additional resources for locating license renewal criteria, reporting procedures, and medical advisory board information. A database of state license renewal cycles, vision requirements, and procedures can be found at: The Insurance Institute for Highway Safety and the Insurance Information Institute. This information should be checked for up-to-date changes in laws or requirement.