On the road again

By Michaela Gibson Morris

Daily Journal

Robert Thompson of Tupelo is looking forward to a short drive for coffee.

It's been nearly nine months since the retired Milam school principal, sidelined by a stroke in October, has been able to make the trip to join his former colleagues for coffee and fellowship on Wednesday mornings.

“It's just so much trouble,” to get his wife, Chris, to get him up, help him dress and drive him there, Thompson said.

However, Thompson will soon be back in the driver's seat. He has completed an evaluation and occupational therapy process with North Mississippi Medical Center Outpatient Rehabilitation Center.

His car should be outfitted with adaptive devices to work around his stroke-weakened left side. A spinner knob will let him turn the wheel safely with one hand. A turn signal extender will move the control to his stronger right side, making it even safer for him.

“It came back naturally,” said Thompson, who went through several practice sessions with occupational therapist Melinda Lamon to familiarize himself with the adaptive equipment.

Key to independence

Getting people ready to get back on the road after an injury or illness is one of the most rewarding parts of the rehab center's driving program.

“It's the biggest symbol of independence,” said occupational therapist Melinda Lamon, who performs the driving evaluations and helps train patients with the different adaptive equipment.

In addition to helping patients with disabilities drive, the program also handles driving evaluations ordered by physicians to check particularly how well aging minds and bodies are handling the demands of driving safely.

The American Medical Association recommends drivers between the ages of 75 and 80 be evaluated by an occupational therapist, said Judy Crump, director of outpatient rehab.

Medicare and some insurance often pay for the driving as part of occupational therapy evaluations and treatment.

The occupational therapists make recommendations, but they can report potentially dangerous drivers who are determined to get behind the wheel to the Department of Public Safety, which could revoke their license.

“We take it very seriously,” Crump said.

NMMC Outpatient Rehab has recently been able to expand their driving evaluation and training programs.

“We just got our own car with all the equipment,” and no longer have to share a car with the inpatient Rehabilitation Institute, Crump said.

No ordinary car, the vehicle is equipped with a number of adaptive devices like spinner knobs and cuffs to help with steering, and left foot extensions to adjust the gas pedal.

The passenger seat is equipped with a brake and an occupational therapist sits so she can reach the wheel and the accelerator in an emergency.

Rehab driving

In many cases for people recovering from injuries and illness, where there's a will, there can be a way to drive.

“All you have to have is two functioning extremities,” along with good vision, quick reaction times and solid judgment, Crump said.

Adaptive equipment can help people overcome strokes, spinal cord injuries and amputations and drive again.

“Most are able to drive with therapy,” Crump said.

Many of the adaptations are fairly reasonable, although they should be installed by specialized mechanics, Lamon said. The spinner knobs cost about $100. Left foot accelerators cost about $300 to be installed. Hand controls are more expensive.

Not just the road

Driving safely is about more than being able to turn a steering wheel and push an accelerator.

“It includes a lot of pretesting before we get on the road,” Lamon said.

Therapists do vision screening and use a simulator to test how long it takes a person to use the brake or accelerator, Lamon said. The average time is half a second; even a second is too long.

They also look at cognition and the ability to recognize signs and follow directions.

“Multitasking is a key work,” Lamon said.

Drivers have to be able to scan the whole environment, drive defensively and listen to the radio, Lamon said.

The therapists also emphasize the importance of being able to get in and out of a car independently as a purely practical matter.

“They need to be able to do the whole thing,” Lamon said.

Smart driving

The driving evaluations are not necessarily a pass/fail test.

In some cases, the therapists recommend restrictions, such as driving only during the day, at low traffic times or in familiar areas, especially for older drivers.

The Department of Public Safety also has a designation that can restrict drivers from highways and other roads where the speed limit exceeds 45 miles an hour, Lamon said.

In some cases, she will recommend drivers turn off the radio, cell phone, don't eat and avoid involved conversations so they will have no distractions.

However, there are times, especially in patients with dementia, that the recommendation has to be no driving.

“For people with cognitively progressing conditions,” like dementia, “there's no therapy,” Lamon said.