Developing and Delivering Educational Presentations

Report
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Audience (for this presentation):
◦ Law Enforcement Training Officer
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Objectives:
◦ Persuade law enforcement that having older driver
information in law enforcement training is essential
◦ Offer the information that is important for law
enforcement officers to know
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Time:
◦ 15-30 minutes

Success:
◦ The training officer that saw this presentation
wanted the PowerPoint to use for a highway patrol
officer class!
Your names and affiliations
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Summarize facts about older drivers and their
impact in your state
Highlight facts about driving evaluations in
your state
Emphasize the importance of law
enforcement’s knowledge of older drivers
impact on safety in your state
Solicit the State Highway Patrol’s ideas about
older drivers and how the your organization
can assist.
 78 Million Baby Boomers
 Driving is a privilege, but Baby
Boomers act as if driving is a right.
 Learning to drive is right of passage;
life changing event
 Losing license is just as life changing
The Baby Boomers will affect the distribution of older adults
Driving & Demographics
• The number of older licensed drivers in the US is
expected to increase
– from ~20 million today to ~40 million in 2020.
– Graph is for drivers 70 years and older
Males
Females
20
16
11.8
12
13.9
12.8
10.1
9.0
8
17.9
7.0
6.3
4
0
1990
2000
2010
2020
1990
2000
2010
2020
• Driving is and will remain the primary mode of
transportation for older adults.
• Driving represents the ability to maintain
connections and contribute to the community.
• Studies of older drivers show there may be a
relationship between health, sense of autonomy,
and ability to drive.
• Loss of mobility can lead to depression, low life
satisfaction, health problems, isolation, and
loneliness.
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Involves
 Performance Skills
 Client Factors
▪ 80% cognitive
▪ 18% visual
▪ 2% motor/sensory
Good drivers, but gradual changes in:
▪ Vision
▪ Visual scanning
▪ Cognition
▪ Attention
▪ Physical fitness
▪ Coordination
▪ Response time increases
Less visual acuity
Decreased speed in focusing
Poor color discrimination
Increased sensitivity to glare and bright
sunlight
 Reduced peripheral vision
 Decreased depth perception
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Decrease in hearing ability
Decrease in strength and flexibility
 Reaction time slowed
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Cognitive changes
 Ability to retrieve information slows
 Divided attention decreases
 Difficulty dividing attention
Diabetes: affects vision, physical
function, and cognition
 Parkinsonism: physical abilities, later
cognitive
 Cardiovascular disorders
 Side affects of medications
 Dementia
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Crash Involvement
Fatalities
http://search.cga.state.ct.us/dtSearch_lpa.html
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Drivers 75 years or older are involved in
significantly more accidents and by 2025, more
than 40% of all fatal crashes will be associated
with age-related frailties.
In two-vehicle fatal crashes involving an older
driver and a younger driver, the vehicle driven by
the older person was nearly twice as likely to be
the one that was struck.
In 46 % of these crashes, both vehicles were
proceeding straight at the time of the collision.
In 25 %, the older driver was turning left — 5
times more often than the younger driver.
•
•
•
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Men outlive their ability to drive by 6 years;
women outlive their ability to drive by 10
years. Source: Foley, et al (2002)
More than 600,000 people age 70+ stop
driving each year.
Question: When? How do I know?
Older drivers begin to self-restrict
– Women often stop prematurely
Act to Maximize Ability
Act to Promote Driving Retirement
Physically or
Mentally
Perceived
Competent
Appropriate
Competent
Perceived
Incompetent
Inappropriate
restriction
Physically or
Mentally
Perceived
Competent
At Risk
Perceived
Incompetent
Appropriate
Restrictions
Incompetent
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Individuals with cognitive deficits who do not
always make the appropriate decisions with
regards to driving modification or cessation
because of lack of insight, poor judgment,
and loss of reasoning ability (Adler & Kuskowski, 2003).
Studies have also shown that up to 25% of
older adults continue driving after a physician
recommendation for driving cessation (Dobbs,
Carr, & Morris, 2002).
Individuals with dementia are at
increased risk for unsafe motor vehicle
operation
 Becoming lost in familiar areas
 Incorrect turning & lane deviation
 Impaired signaling
 Decreased comprehension of traffic
signs
 Unaware of not being a responsible
driver
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NIH - 1 in 7 over 71 years of age have some
type of dementia (Plassman et al. 2007)
North Carolina Do the math for your state!
 In 2000, 969,048 over 65
 138,435 with dementia
 143 DMV offices
 968 per office
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Dementia - special issues with driving
North Carolina - 11 Driving Specialists
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12,585 dementia referrals for each
evaluator
34.5 a day, 365 days a year.
Need to have a system in place to deal with these
issues
 Need law enforcement’s assistance!
 Tickets are critical to the process
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•Varies depending on state, setting, staff, training
•DMV or licensing authority
•Structured, “same for all”
•Pass/fail
•Medical review board
•Specialists in Driving Rehabilitation
•Individualized
•Screen or evaluate sub-skills
•Performance in Context–On Road
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Specialized training
ADED – Association for Driver
Rehabilitation Specialist
 80% of DRS are occupational therapists
 CDRS – Certification administered by ADED

American Occupational Therapy
Association
 Specialty Certificate in Driving and Community Mobility
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Your definition
ADL, IADL, work, leisure, education, social
participation
Community mobility is under IADL
 Rural communities: Driving is the only community
mobility option
 Occupational Therapists:
 Understand the critical demands of
driving
 Have science-based knowledge to
understand progressive conditions
and life changes affecting driving
 Understand how community mobility
affects quality of life
Provide objective data regarding
abilities required for driving
• Assure that abilities are within state
regulations
• Relate abilities to skill performance
of the actual driving task
• Help client and family think about
driving safety for the present and
future
•
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Does Screening
Licenses all drivers
Occupational therapy evaluations
required by law in North Carolina
when medical functional concern
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Occupational therapy evaluations
require physician’s order
http://www.dmv.org/nc-north-carolina/department-motor-vehicles.php
Law Enforcement Officer: Based on
observed driving behaviors. Initiates
the request – medical review branch
of DMV
 Medical review staff meets
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 May ask for a driving evaluation by an
OT
 Makes final determination
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Educate about older adults
Support their duties
Offer resources
Other ideas
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Your name
 email
 Phone number
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Parts of this presentation was developed by Dr. Anne Dickerson, PhD,
OTR/L, FAOTA, East Carolina University

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