Mary slipped into the car seat, gripped the steering wheel and pressed the gas pedal.
But she was really nervous. She was in her 80s and recovering from a stroke. She hadn’t driven a car in more than a year.
No worries. This wasn’t a “real” car, it was the new Visage Clinical Driving Simulator at Albany Medical Center. Borrowing technology from video games, the simulator has three large screens with a 180-degree view of different driving environments, from city streets to mountain roads; weather conditions like fog and snow; and random surprises, like a pedestrian darting into the street or a deer leaping across a road.
In the three months that the simulator has been operational, two specially trained occupational therapists have been using the device to evaluate the driving skills of a wide range of patients.
“To me, it’s been a lifesaver. It’s going to give me incentive to recover even more,” says Mary, a retired nurse and resident of Delmar who agreed to talk to The Daily Gazette if we would not use her last name.
It took Mary a few sessions to relax into the video experience, which she described as “very exciting and very challenging.” After a report on her performance was sent to her primary physician, Mary got the green light for limited driving that avoids highways and heavily trafficked roads.
With the launch of Albany Medical Center’s Driver Rehab Program, patients in the Capital Region now have two options for checking their driving skills. Sunnyview Hospital and Rehabilitation Center in Schenectady has provided driving rehab since 1987 and offers one of the most comprehensive programs in the state.
“We do not use a simulator. Our on-road assessment and all our driver training is out in a vehicle,” says Donna Stressler-Tice, director of Sunnyview’s driver rehab program and a nationally recognized driver rehab expert.
Sunnyview’s three cars, which go out on city streets, rural roads and highways in the Schenectady area, have dual controls, with gas and brake pedals for the therapist. “Sunnyview is a driving school and all of our occupational therapists that work in driver rehab are also driving instructors,” says Stressel-Tice. “We’ve been trained in how to control the vehicle from the passenger’s side. While we don’t have a steering wheel, we are fully capable of taking over that vehicle if we need to.”
Along with Stressel-Tice, Sunnyview has three other occupational therapists who are certified driving rehab specialists.
“There are only about 12 of us in the state,” she says. “There are some states that don’t have any. We are certainly fortunate to have that many.”
As the U.S. population ages, there aren’t enough of these specialists to meet demand, especially in rural areas, she says.
In 2019, Sunnyview did 430 on-road evaluations and 650 hours of driver training.
At both Albany Med and Sunnyview, an evaluation begins with a referral from a doctor or nurse practitioner. Then there’s a clinical assessment.
“We’re looking at the entire gamut,” says Carrie Meher, one of two driving specialists at Albany Med. “Visual perception skills, reaction speed, sensation in the feet or hands, range of motion, coordination, cognition, memory, problem solving.”
Anyone who has a disability or injury or illness that inhibits their ability to drive may benefit, Meher says. “Sometimes as we age our hearing or vision or reaction speed decreases. Those patients may benefit from a referral. Or someone who has any type of traumatic injury, like loss of a limb.”
Patients with multiple sclerosis or Parkinson’s disease, both progressive disorders, could come in for periodic checkups, she says. They also work with Alzheimer’s and dementia patients. “There’s such a wide range of cognitive impairment. There are some patients that would be able to drive on a limited basis.”
Meher knows that patients are often worried about losing their driver’s license. And sometimes the report that is sent to the doctor does confirm that a patient is not able to drive safely.
“But being occupational therapists, our goal is promote independence. And sometimes it’s modified. In driving, that might mean adaptive equipment or driving during certain times of the day or certain days of the week or a limited route. In general, our whole goal is to make sure people are safe.”
As for Mary, the determined stroke survivor, she plans to be back on the road in the new year.
“I’m going about it very slowly,” she says. The first step is backing her car in and out of the garage and up and down the driveway. Traveling around in her neighborhood is next.
“I want to be able to drive and do it safely,” she says.
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