In the Driver's Seat

Michael Northrup

People with medical conditions — or advanced age — that make driving a challenge are finding ways to stay safely in the driver’s seat through Cleveland Clinic’s Driver Evaluation and Rehabilitation Program.

“Maintaining low-risk driving skills is a challenge for older adults or any adult with multiple medical conditions,” says Barbara Messinger-Rapport, MD, PhD, Director of the Center for Geriatric Medicine at Cleveland Clinic. For people with heart disease or central nervous system problems, for example, the conditions themselves or the related medications can impair driving. “Also, as people age, they have more difficulty with visual contrast and slowed reaction time compared with younger adults,” she adds.

“It’s a huge thing for people to lose their independence,” says the program’s director, Patrick Baker, Certified Driver Rehabilitation Specialist. “I try to help people stay on the road.” Annually, Baker works with around 250 drivers with conditions such as Parkinson’s disease, multiple sclerosis, stroke, diabetes-related amputation or decreased vision.

When older people are in a car accident, they face greater risk for serious injury, says Dr. Messinger-Rapport. “Drivers ages 70 to 74 are twice as likely to die from accidents as those ages 30 to 59; drivers ages 80 and older are five times more likely,” she says. Using eye exams, computers and drawing tests, Mr. Baker assesses visual skills, strength and range of motion, cognition and reaction time. He helps drivers select and use adaptive equipment such as gas/brake hand controls and left-side gas pedals. “It takes a lot of training,” Mr. Baker explains, but nearly all program participants who install adaptive equipment remain behind the wheel. For drivers who need to stop driving, Mr. Baker breaks the news, sparing family and doctor-patient relationships from strain.