Copperas Cove occupational therapist helps with driving assessments
By BRITTANY FHOLER
For the average student learning to drive, there are several options for driving education, whether it’s a driving school or being taught by a parent.
But, for people who need modifications or for older adults are facing the choice of whether to continue driving or not, there is an option called Home and Driving.
Occupational therapist Megan Frazier saw a need in the Central Texas area for driving evaluations for senior citizens and those who were facing uncertainty of whether they were fit to drive.
Frazier said she was approached frequently by family members and caregivers of patients at the skilled rehab and nursing home where she worked, who were concerned about how to determine whether their loved one should retire from driving.
Frazier said there wasn’t many resources in the area, so she began researching and obtained additional training.
“It is within the scope of practice for occupational therapists to address driving, so I spent the next year learning more about what assessments to provide to help with that, and I also went and became a Texas Driver’s Education teacher as well,” Frazier said.
A little less than two years ago, Frazier zto start her own private practice and founded a home-health based agency, Home and Driving.
Through Home and Driving, she sees clients for driving related services as well as aging place related services, where she does home safety and modification evaluations.
Frazier initially started seeing medically complex patients and older adults to determine are they fit to drive.
Over the last year, she has branched out more to address teens with driving needs, such as teens with autism, ADHD or other learning disabilities who may not fit well into a traditional driving school.
Frazier also helps those who need adaptive tools to help them drive, such as a left foot accelerator, hand controls or steering modifications.
Since opening in October 2018, Home and Driving has seen more and more clients.
Frazier explained that she has had to go out and educate the community on her business.
“A lot of it has been education on my part because people don’t know we even exist, or that it’s a need even,” Frazier said.
She focuses on educating the general population as well as medical providers and has garnered referrals from other therapists.
Last Saturday morning, Frazier spoke at a Zoom conference for the Age of Texas, talking about driving retirement.
“We look at it as it’s a plan for people who are working towards the point where they can no longer drive, because we’re all going to live past that age where we’re no longer safe to drive, and it can be physically, it can be mentally. It’s different for everybody,” Frazier said. “However, having that plan in place- driving retirement shouldn’t be kind of that end result, that end decision point. A lot of people say, ‘Well you’re going to take away my keys.’ No, I’m not necessarily going to take away your keys, but you’re starting to have these problems.
Let’s start limiting the things you do on a normal basis.”
Examples of these limits include not driving at night, not going to downtown Austin or not driving on I-35, she said.
The Hartford Guide for Mature Market Excellence has a list of warning signs online, at www.thehartford.com.
Some of the warning signs Frazier looks for involve a pattern of behaviors, such as getting lost, getting honked at or being pulled over more frequently, as well as slower driving and taking longer to make decisions or avoiding certain routes due to difficulty.
A caregiver might notice more dings and dents in the car or damage to the mailbox or garage door, Frazier added.
When it comes to making the decision to consider driving retirement, there is often reluctance.
“If it’s not a particular driver but it’s a family member, a question I usually ask is, ‘Would you put your kids in the car with your loved one?’, and that’s one of those questions that kind of hits home personally because if I don’t want to put my children in the car with my parents, that’s probably telling that they aren’t safe to be driving, and we’re just not ready to admit it yet,” Frazier said.
As an occupational therapist, Frazier looks at behaviors related to daily living- bathing, dressing, toileting, medication management and cooking.
“If a person can’t safely operate a stove, they probably shouldn’t be driving a car,” she added.
To evaluate a driver, Frazier will do a clinical assessment at a patient’s home, before they go for a drive in their community, taking their normal roads and routines to determine whether they are safe or not.
Frazier encourages people to call her at 254-290-3333 to determine whether to set up an appointment or not. During this phone call, Frazier will talk with the person about their individual needs.
“The reason somebody would want to start driving with a disability, need to change or stop is very personal for every person, so the easiest way is just to call,” Frazier said.
Frazier said that in cases of driving retirement, she will want to have open communication with her client’s doctor, especially if the retirement is due to cognitive function.
With the COVID-19 pandemic, Frazier has had to make some slight adjustments to how she does business. From mid-February to early May, Frazier did not see any clients. Social distancing is impossible to do in a car, she added.
She spent her time coming up with policies and procedures for how best to adapt once she decided to accept clients again.
Now, Frazier sees one patient a day to allow time to thoroughly clean the Home and Driving vehicle between clients. She wears her own mask and requires face masks of clients. She also screens for COVID symptoms and checks 24 hours ahead of time to make sure as well.
Even with these changes, Frazier said she has been very busy.
“[Driving] really hits home for independence, and people realize that so it’s one of those things that is really important to people to maintain and so they wanted to get in the car, and we just followed the social distancing and the masking,” Frazier said.
Home and Driving is the only business of its kind in the Fort Hood area. St. David’s, in Austin, offers a hospital-based program and is the next closest.
Throughout the state of Texas, there are about six total programs that offer services similar to Frazier’s, she said.
“The good thing about what occupational therapists who specialize in driving is is we provide objective measures is really what it comes down to, on either what people need to work on or where they’re struggling,” Frazier said.
The purpose of these services is not to take away keys, but rather to make it safe for the driver. Frazier added that she does not have the authority to take away someone’s keys, though. That authority lies with the Texas Department of Public Safety who relies on a medical advisory board to render an opinion or recommendation on the “ability of an applicant or license holder to operate a motor vehicle safely or to exercise sound judgment on the proper use and storage of a handgun,” according to the Texas Department of State Health Services website.
Home and Driving is a private pay service, and Medicare does not reimburse them because “Medicare does not feel that driving is an essential skill needed,” Frazier said.
The average cost for an evaluation is $350 to $500. For a younger adult that needs training or a client that needs adaptive equipment, the cost can be $125 to $250 per hour.
For more information, readers can visit www.homeanddrivving.com.