Still Driving? Innovative Program Assesses Senior Drivers

By Joanne Pallotta

BIDMC Correspondent


“Driving is freedom!” exclaims Herman Hamot.


The 90-year-old from Auburndale, Mass., has been behind the wheel for more than 65 years.


“Driving gives me a chance to do what I want to do,” he says.


But recently, Hamot’s son expressed concern about his father’s driving, so the senior Hamot made an appointment with Beth Israel Deaconess Medical Center’s DriveWise® program.


“Driving is a highly emotionally-charged issue,” says Lissa Kapust, LICSW, program director of DriveWise® and a clinical social worker in the Division of Cognitive Neurology at BIDMC.


With such a critical issue at stake, health care professionals and family members are often careful not to end driving privileges prematurely or to extend them beyond the point of safety.


“The question of driving, with its sense of self-esteem and independence, is an issue that brings family members, especially adult children, to their knees,” Kapust adds.


Kapust developed DriveWise® for BIDMC some 17 years ago.


“It became clear that we needed some kind of objective testing when the issue of if a patient is safe to drive came up,” she explains.


What is DriveWise®?


Kapust calls DriveWise® the gold standard of driving assessments. With a team of social workers, occupational therapists, and neuropsychiatrists, as well as a certified remediation driving instructor, this comprehensive driving assessment program evaluates judgment and performance, utilizing a thorough examination. At the end of the assessment, DriveWise® provides a recommendation to help in the difficult decision-making process about whether someone should continue behind the wheel.


“People are so identified with driving. Many of our clients feel that their ability to drive defines them,” emphasizes Kapust. “Even people with memory problems will never forget the day they were told they couldn’t drive.”


Who Benefits from DriveWise®?


DriveWise® is offered to anyone of driving age who may have, or is thought to have, a physical, psychological, or neurological issue.


“Problems that have led people to wonder if they are still safe to drive,” explains Kapust. She stresses that age and diagnosis alone do not determine driving safety. Rather, she says, recommendations are made on a case-by-case basis.


The Steps of DriveWise®


  • Initial Assessment: A meeting with a clinical social worker helps the participant and the DriveWise® team understand concerns and the role that driving plays in that person’s life. “How does driving fit into their lifestyle?” says Kapust.
  • “We’re anticipating what the impact will be if this person can no longer drive.”
  • Office Exam: This part of DriveWise®, conducted by an OT with specialized training, includes a number of cognitive tests that are both visual and reactive, written and computer-based.
  • On-the-Road Test: The standardized evaluation is 45 minutes on the road in a specially equipped vehicle with a driving instructor and an occupational therapist. Both are assessing driving performance and judgment.
  • Feedback Session: After the on-the-road test, the participant will return for feedback from the team.
  • Findings and Recommendations: At the very end of the program, the participant will be presented with a detailed letter, which summarizes the findings of the team. Kapust says the most important part for participants is the paragraph with the recommendation on whether or not to continue driving. The recommendation may come with restrictions.


Unsafe Drivers


If a participant is deemed unsafe to continue driving, support is provided and alternative forms of transportation are identified. In some cases, a patient might be referred to a remediation program and be re-tested at another time.


While DriveWise® is not affiliated with the Registry of Motor Vehicles, Kapust says the two sometimes collaborate to get an objective assessment on someone in question.


“Our responsibility is to both keep this individual safe, while also considering public safety,” says Kapust. “We try and remind people that driving is not a right, but a privilege.”


DriveWise® Cost


The DriveWise® program cost, including the driving instructor, is just under $500. In general, health insurance companies do not cover these costs, but participants are urged to contact their insurance company about their individual plans.


Herman Hamot completed the DriveWise® program and remains behind the wheel.


“The only recommendation is that I avoid driving at night,” which Hamot does. He says DriveWise® is an affirmation and a confirmation of his driving ability, and that it also brings peace of mind to his family.


Kapust calls Hamot an ideal participant for the program because of his family support and his motivation to follow the recommendations to continue driving safely.