Programs to sharpen your driving skills

We have more reason than ever to be cautious on the road. The latest numbers from the National Highway Traffic Safety Administration show that traffic deaths have been steadily increasing in the United States among people ages 65 and older. While the numbers dipped slightly during the pandemic lockdown in 2020, they more than made up for it in 2021, jumping 14%. Whether you'll be on the road for a trip to the grocery store, a holiday gathering, or a warmer climate for the winter, you need to make sure you're driving as safely as possible. A few types of programs can help you do that.

Car-Fit evaluations

Once we reach a certain age, it can be difficult to reach the gas and brake pedals or see above the dashboard. This could be because you've gotten a little smaller with age or you're unfamiliar with the vehicle's high-tech tools that can tailor your fit.

A program called Car-Fit can help. It's a check-up from AAA, AARP, and the American Occupational Therapy Association, designed simply to help you fit better in your vehicle. You can attend an in-person Car-Fit event or watch a workshop online.

During a Car-Fit check-up, an occupational therapist will guide you through a list of 12 areas in your vehicle that require the proper fit, show you how to use equipment to make changes (such as buttons that can move the gas pedal or steering wheel), and make recommendations for adaptive equipment if you need it.

Cost: Free. Visit Car-Fit online (www.car-fit.org) for more information.

A driving "refresh"

A driving refresher course helps you stay up to date on the latest driving techniques, laws, and vehicle safety technology. It can also provide you with workarounds for challenges such as fighting glare at night or navigating around aggressive drivers.

You can take a driving refresher course online, in a classroom, or with a local driving instructor. To find a refresher course, just call your local AAA branch or visit AAA online (/ard). The AARP also offers a driving refresher course (/ads).

Cost: Less than $30 for online classes through AAA or AARP; $100 or more for local driving instruction. Taking a course may even save you money on your car insurance; call your insurance company to find out for sure.

A formal driving assessment

If you've noticed changes in your driving ability lately, consider getting a formal driving assessment. Ask your doctor to refer you to a hospital-affiliated program that includes both a clinical evaluation and a road test.

In the clinical evaluation, health professionals will ask about medical conditions you have, medications you're taking, and more. "We assess all of the things that affect your driving skills — your vision, cognition, range of motion, strength, coordination, sensation in your arms and legs, hearing, and medication side effects," says Amy Donabedian, an occupational therapist and certified driving rehabilitation specialist at Harvard-affiliated Spaulding Rehabilitation Hospital.

For the driving evaluation, you'll get in a car and demonstrate your ability on the road. A health professional and a certified driving instructor will go along for the ride. "We look at your control of the gas pedal, brake, and steering wheel," Donabedian says, "and we have a lot of questions we need to answer. Can you stay in your lane? Are you following the rules of the road? Are you aware of pedestrians, stop signs, and other cars? What's your reaction time? Can you park the car and back out of a space safely?"

After the road assessment, the team recommends steps to improve driving ability. "We may suggest that you take a driving refresher course or practice certain habits such as driving only during the day, at times when roads aren't congested, and driving with a spouse or friend who can be an extra set of eyes for you. Or it might be that you need driver rehabilitation, occupational therapy for grip strength, or modifications that make you more comfortable in the car — such as a dense foam seat cushion to improve your fit in the seat, or other adaptive equipment," Donabedian says. "The goal is to keep you on the road."

Cost: About $600 or more out of pocket. Medicare doesn't cover it.

Driver rehabilitation

Some hospitals offer programs that not only assess your driving ability, but also provide additional training to keep you behind the wheel. A certified driving rehabilitation specialist (usually an occupational therapist) will help you learn to use adaptive equipment if you need it, practice driving in challenging conditions, and develop safe driving habits. These programs are helpful for people who have a condition (such as neuropathy or Parkinson's disease) affecting their ability to drive and those who've had a stroke or another injury that affects driving.

Costs: About $100 or more per hour. Medicare doesn't cover it.

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