CARFIT Helping Mature Drivers Find Their Perfect Fit. Technician Manual

Transcription

1 CARFIT Helping Mature Drivers Find Their Perfect Fit Technician Manual CarFit is an educational program created by the American Society on Aging and developed in collaboration with AAA (American Automobile Association), AARP, and the American Occupational Therapy Association. Revised 1 January

2 Note to the reader: This manual is designed to be used by volunteer Technicians in studying for and preparing for a CarFit event. Although the manual can be used for review and as a refresher on what to do during a CarFit event, it is hoped that all Technicians will be familiar enough with the material that they will only need to refer to the manual as a resource during a CarFit event. Note to occupational therapy practitioners: The title occupational therapist is used throughout this manual as CarFit Technicians are from a wide range of backgrounds. Occupational therapists, occupational therapy assistants and occupational therapy students are represented by this single term. Revised 1 January

3 CARFIT PROGRAM OBJECTIVES BACKGROUND THE CARFIT EVENT TRAFFIC DIRECTION & CHECK-IN STATION CHECK-UP STATION OVERVIEW OVERVIEW OF THE CARFIT CHECKLIST...9 CHECK-UP INTRODUCTION..9 ITEM 1: DETERMINING HOW MANY PEOPLE DRIVE THE CAR..11 ITEM 2: VEHICLE SEAT BELT...12 ITEM 3: STEERING WHEEL TILT & HEAD RESTRAINT..14 ITEM 4: DISTANCE FROM BREASTBONE TO WHEEL ITEM 5: LINE OF SIGHT ABOVE STEERING WHEEL..20 ITEM 6: POSITIONING TO GAS PEDAL. 22 ITEM 7: POSITIONING TO BRAKE PEDAL ITEM 8: MIRROR USE ITEM 9: NECK MOBILITY FOR BLIND SPOT CHECK..28 ITEM 10; IGNITION KEY...31 ITEM 11: OPERATION OF VEHICLE CONTROLS CHECK-OUT STATION 35 ROLE OF OCCUPATIONAL THERAPIST. 35 ITEM 12: VEHICLE WALK-AROUND...36 Revised 1 January

4 CarFit SECTION 1: PROGRAM OBJECTIVES The CarFit program was designed to: Promote continued safe driving and mobility among older drivers by focusing attention on senior driver placement in their vehicle, Create an open environment that promotes conversations about driving, Provide information, education, and community-based resources to older drivers in a non-threatening, quick, and easily accessible manner. SECTION 2: BACKGROUND Who is CarFit The CarFit program was created by the American Society on Aging and developed in collaboration with AAA (American Automobile Association), AARP, and the American Occupational Therapy Association. Why a program like CarFit? People over the age of 65 are the fastest growing population in the United States. By 2030, over 70 million Americans will be ages 65 and older, of which ninety percent will be licensed drivers. Personal mobility is critical to healthy aging. Not only does it allow people the opportunity to age in place to grow older without having to leave their homes or communities the cessation of driving has been shown to contribute to depression, social isolation and a decline in overall health. Unfortunately, age-related changes can make it uncomfortable and unsafe to drive. The founding organizations, as well as various governmental agencies, professional associations, and private-sector organizations are taking steps to improve older driver safety and mobility. CarFit is an example of many different programs available to older drivers. Unlike other senior driver safety programs, CarFit focuses not on the abilities of the senior driver, but instead on their proper placement within their vehicle. Revised 1 January

5 What is CarFit? CarFit is a community-based program that provides the opportunity to assess older driver fit with their vehicle and provide safety information to seniors in a non-threatening arena. The primary purpose of CarFit is to convey safety information. It is not an evaluation. Therefore, the participant is not given a pass/fail message. The information shared is confidential, and no identifying information is given to law enforcement personnel or health care providers. The occupational therapist will share additional ideas to enhance driver safety based only upon the results of the CarFit check-up. How is a CarFit Check-Up done? CarFit is designed to operate in a variety of community-based settings, such as senior centers, and in conjunction with existing community-based programs, such as safe driver programs run by AARP and AAA. The core of the program is the CarFit event, which is staffed by trained CarFit technicians and health professionals (mostly occupational therapists) who work side-by-side and collaboratively with each participant. Older drivers are invited to drive in their own vehicles to the designated venue at an appointed time on the date of the publicized CarFit event. After going through Check-In, a trained CarFit Technician takes the senior driver through a CarFit Check-Up, which is structured around a carefully designed standardized Checklist combining observation and questionnaire-type items. Finally, the driver is directed to the Check-Out, where an occupational therapist or driver rehabilitation specialist will conduct a vehicle walk-around with the driver and will provide both specific and general information to help the participant achieve a better fit with his or her vehicle and continue to operate it safely. Each participant is provided resources and a copy of the checklist to review with his or her family or health care provider. Revised 1 January

6 SECTION 3: THE CARFIT EVENT OVERVIEW AND ORGANIZATION OF THE SITE Typically the site for a CarFit event will be a parking lot with at least one entrance and one exit. Ideally it will have shaded or covered areas for stopping points within the CarFit event. The number of lanes and stopping points will be based upon the number of participants scheduled for the event and the number of volunteers and occupational therapists available to conduct the event. For some CarFit events, organizers may choose to use an indoor facility because of concerns about the weather. Key Points: Every technician at a CarFit event must have a good working knowledge of the site, its layout, and its designated stopping places. Safe traffic flow is very important, and every volunteer must be constantly aware of the traffic flow during the entire event. A sample layout is included in the Staging a CarFit Event training manual. Here, the site is a parking lot with a separate entrance and exit. The designated entrance and exit for an event should be clearly marked with signage. On the day of the CarFit event, the volunteers setting up the site will create an organized path for drivers to enter and exit the parking lot. The CarFit site should be set up to allow for easy flow of traffic, with well-marked stopping places for the three major activities in a CarFit event: Check-In, Check-Up and Check-Out. Safety Point: The traffic flow should be designed so that drivers do not have to put their vehicles in reverse at any point during the event. In addition to strategic traffic flow through the event, several items will help ensure success and safety. Tents provide shelter from rain or sun. Tables provide an area to arrange paperwork Chairs provide volunteers a place to rest. Signs and traffic cones help mark the path for senior driver participants unfamiliar with the event. Vests and chock blocks can be used to increase the safety of your event. Revised 1 January

7 SECTION 4: TRAFFIC DIRECTION & CHECK-IN STATION The purpose of the Check-In Station is to collect basic information about each participant and have the driver sign the waiver form. As CarFit participants arrive at the CarFit event site, the Traffic-In Volunteer directs them to the Check-In Station. Traffic-In, Traffic-Out, and Traffic Flow Personnel, will: Direct traffic; and Be aware of pedestrians and moving vehicles in and around the site. It is recommended that one volunteer be designated for the Traffic-In flow, another for the Traffic-Out flow. If available, one or two additional volunteers can direct vehicles within the event being mindful of the moving vehicles at all times. NOTE: This position is optional. Volunteers do not have to attend the CarFit Technician training; they need only be oriented to specific jobs such as directing traffic flow prior to the CarFit event. At the Check-In Station, the Check-In Technicians are responsible for the initial greeting and paperwork. Participants will receive three pieces of information at this location, the Participant Data Sheet, Waiver Form and Checklist. Check-In Technicians should write down unique and matching participant ID numbers on the Participant Data Sheet and the Checklist. The Technician is also responsible for explaining the paperwork to the participant, and ensuring that each participant signs the Waiver Form. Here is a suggested introduction: Hello, thank you for coming to CarFit today. My name is and I am going to get a few pieces of information from you to start, if you don t mind. First, did you have an appointment today? [Allow participant to go through regardless of appointment.] Now, if you could fill out the following documents for me. The first allows us to gather more information about your driving habits; the second is a waiver form that indicates you are here voluntarily and all information is intended for educational purposes only. NOTE: If the driver refuses to sign the waiver form, they may not participate in the CarFit event. Revised 1 January

8 While the driver fills out the paperwork, the Technician should take note of whether and how the driver is using the vehicle s seat belt and mark the appropriate box at the end of the Checklist under Seat Belt Use; instruct the driver to keep the seat belt buckled unless instructed to do otherwise during the Check- Up. After the driver has filled out the paperwork, the Waiver Form is placed in a designated box for safekeeping at Check-In. All Waiver Forms should remain with the CarFit Event Coordinator. The Participant Data Sheet is stapled to the back of the Checklist, placed on a clipboard, and handed to the participant. Finally, the Check-In Technician should direct the participant to drive slowly to the Check-Up Station. Key Point: The Check-In Station should be located far enough into the site that if several vehicles are lined up to check in, they will be within the event site and not in the roadway. SECTION 5: CHECK-UP STATION OVERVIEW The purpose of the CarFit Check-Up Station is to examine the driver s positioning in their vehicle, field of view and knowledge and use of the vehicle s controls and offer safety recommendations. Working in two-partner teams, CarFit technicians complete this task by taking the driver through the first 11 items of a 12-point checklist in approximately 15 minutes. Areas of concern are notated by the technician by circling the flag corresponding with the item on the checklist. The occupational therapist or driver rehabilitation specialist can further discuss these issues with the driver at the Check-Out Station. Key Point: A flagged issue is not necessarily a safety concern. A Technician may mark a flag any time the issue is not easily resolved. Some flagged issues can be handled with suggestions or recommendations from the occupational therapist or driver rehabilitation specialist; others can be handled with various adaptive devices or aids that the therapist may suggest. If a formal driver evaluation is indicated, the occupational therapist can hand out material describing driving programs in the participant s community. Revised 1 January

9 Key Point: It is important that technicians remember they are educating participants and demonstrating adjustments to their vehicles. Only drivers may make adjustments to their vehicles, including returning seats, mirrors, etc to their original positions, if necessary. SECTION 6: OVERVIEW OF THE CARFIT CHECKLIST The CarFit Checklist is the main focus on the program. In this section, each item on the checklist is discussed in detail. A sample script is also provided. In conducting the Check-Up, it is imperative that each Technician be familiar with the Checklist and understands what to assess and what to mark on the Checklist, as well as how to respond to questions. In responding to questions, Technicians can always refer to the vehicle s manual for information about seat belts and other vehicle controls. Key Point: It is important to go through the Checklist in order, from start to finish, and to mark each item on the Checklist with a response, including the items that call for measurements in inches. Key Point: Technicians should refrain from any personal or social conversation with the driver. You should, of course, be friendly, but you must keep in mind that you only have minutes to cover the entire Checklist with each participant, so it is imperative that you begin quickly. CHECK-UP INTRODUCTION After the CarFit participant enters the Check-Up Station, the Technician will begin by directing the driver to pull up to the stopping place for the Check-Up. Once the vehicle has stopped, the Technician can move to the driver s window, and ask the driver to remain in the vehicle, with the gearshift in Park (or in Neutral if the vehicle has a manual transmission), the engine off, and the parking brake engaged. NOTE: The driver should remain sitting in his or her vehicle for the entire Check-Up. Once the vehicle has stopped, the Technician can introduce himself/herself, and provides a brief description of what will take place. Key Point: Begin quickly and set the tone for the rest of the Checklist procedure. Safety Hint: The Event Coordinator may elect to use vehicle wheel blocks (chock blocks) in the Check-Up Station to prevent vehicles from inadvertently moving forward or backward during the Check-Up. Revised 1 January

10 Technicians may choose where they would like to position themselves for greeting the driver and beginning the Checklist. Because of varying heights, mobility, and comfort, some Technicians may want to stand beside the driver door, some may squat with the driver door open, or, with the driver s permission, some may sit inside the vehicle on the passenger side. Technicians can make this decision on their own, depending upon their comfort level, and they can vary their approach from driver to driver. As a general rule, it is best to be at eye level with the driver of the vehicle while conducting the check-up. Direct the driver to move up to the designated stopping place. Safety Hint: Do not stand directly in front of the car when directing driver to a parking spot at the Check-Up Station. Stand to the side of where you want the driver to stop. If the driver is accompanied by family members or friends, suggest that the passengers wait in the designated waiting area away from the car. The Technician may be able to encourage the other occupants to get out by offering shade and refreshments. If they do not wish to get out of the car, go ahead and begin the CarFit Check-Up. Hello, my name is and I am from. Before we begin, I would like to ask you to do several things. First, please put the gearshift in park [or in Neutral if the vehicle has a manual transmission] and set the parking brake. Next, please roll the driver and passenger windows down. Finally, please turn off the vehicle s ignition and remain seated. The purpose of this CarFit Check-Up today is to examine your positioning in the driver s seat and look at your operation of all vehicle controls. This should take about 12 to 15 minutes. Based on how well you fit your vehicle, I may be able to offer tips and information that may interest you. If you are ready, let s begin. We will start with you sitting in the car just as you are right now. Revised 1 January

11 ITEM 1: DETERMINING HOW MANY PEOPLE DRIVE THE CAR Objective: To find out whether anyone else drives the vehicle, such as a spouse, and if so, whether the spouse is participating in the CarFit event today. If there are other drivers, remind the participant that each driver should make his or her own adjustments to the seat, steering wheel tilt, and mirrors before driving. If Yes, then proceed to item 2. Are you the only driver of this vehicle in your family? If No, then say: Usually when there is more than one driver in a car, there will be a difference in how each one sits relative to the steering wheel or adjusts the seat for comfort or visibility or adjusts the mirrors. You may need to make adjustments to your car each time before you start to drive. Is your spouse or partner participating in CarFit today as well? If they respond No, then explain: We encourage you or your spouse to contact the organization about information on when the next CarFit event will be held. Another option is for the driver to go through the same CarFit Checklist with the spouse at home. Emphasize that both drivers will need to pay close attention to the different adjustments and to what they should do as a predriving check when they get in the car after the other has driven. Revised 1 January

12 ITEM 2: VEHICLE SEAT BELT Objective: To determine whether the driver uses the vehicle s seat belt, uses it correctly, and has any problems in doing so. Key Points: Seat belts are used to keep the driver properly positioned in the event of a crash. Seat belts should be worn over the shoulder and low on the hips. If the driver places the belt behind the back or under the arm, injury may result. Key Points: It is important that each driver understand the importance of using the seat belt and how to use the belt properly. For drivers who do not use their seat belt because of difficulties, a variety of solutions may be available. This is a flag issue for which the occupational therapist on site can offer assistance at the Check-Out. Turn to the end of the Checklist where the Check-In Volunteer noted seat belt use, and look to see if the driver is now using the seat belt. If the driver is wearing the seat belt, then inquire whether this is a habit. If the driver does not have the seat belt on or says No, then ask why and write the response on the Checklist. Take this opportunity to make the driver aware of the safety benefits and encourage him or her to buckle their belt now and begin to use it from now on. Ask about whether the belt is comfortable or not, and write the answer on the Checklist form. I see you have your seat belt on. Are you in the habit of wearing it all of the time? Do you know that wearing a seat belt is extremely important in preventing injuries while driving? Research shows that people are more prone to serious, life-threatening injuries if they are not wearing a seat belt. The seat belt may in fact save a person s life. Does the belt feel comfortable to you? If the answer is No, ask the driver to Revised 1 January

13 explain what is not comfortable. Observe the position of the shoulder belt to the neck. Is it too high and digging into the person s neck? Is the seatbelt being used properly? If the belt is not being used properly, you can give the following instructions and information: If an adjustment is needed, the driver may not be aware of the slider track on the side pillar of many vehicles. The Technician may have to point this out. Safety Hint: The Technician is not to physically adjust anything on the vehicle. Only the driver can make any changes. In some cases, the driver may need to get out of the vehicle to make the adjustment. The proper way to wear a seat belt for an adult is for the lap belt to fit low and tight across the hips or pelvis, not on the stomach area. The shoulder belt should come over the collar bone, away from the neck, and cross over the breastbone; it should be snug across the chest. The shoulder belt should never be behind the back or under the arm. The shoulder belt can be adjusted on the side pillar to improve fit. Are you aware there is an adjustment you can make to the belt? Would you like me to show you how to adjust it? I can only demonstrate it but will guide you if you would like to try it at a different position that may be more comfortable for you. In some instances, adjusting the tilt of the back of the driver s seat can better position the seatbelt. Some vehicles may also have no adjustment for the seat belt. If the seatbelt does not adjust, make a note for the occupational therapist to see if anything further can be done to assist the driver. Revised 1 January

14 Ask the driver to unbuckle and rebuckle the seat belt. Make sure that the driver lets the belt retract all the way, so that he or she has to reach for the belt to begin the re-buckling process. Observe any problems with pushing the belt s release button. Make a note of any problems on the Checklist. Observe any problems with reaching for the belt behind the left shoulder, pulling the belt around the chest to the buckle, and pushing the clasp in to rebuckle. Please unbuckle the belt and let it go all the way back into the retracting mechanism. Now you may re-buckle the belt. If any problems are noted with use of the seat belt, circle No for this item on the Checklist so that the occupational therapist or driver rehabilitation specialist can offer some advice at the Check-Out. ITEM 3: STEERING WHEEL TILT AND HEAD RESTRAINT Objectives: 1) To determine whether the steering wheel is tilted at an appropriate angle enabling the driver for good forward vision, a good view of the dashboard instruments and indicators, and good control of the wheel. 2) To determine whether the driver s head restraint is adjusted properly. Key Point: Many drivers do not know how to adjust the tilt of the steering wheel to a comfortable and safe position or do not realize that the tilt of the wheel is interfering with good forward vision or wheel control. If the wheel is too high, it may interfere with the driver s forward field of vision or cause the driver to hold his or her shoulders high in a tiring position. If the wheel is too low, it may impede the person s ability to get in and out of the driver s seat or interfere with the driver s ability to see the dashboard indicators and instruments properly. A steering wheel tilted too low may also interfere with the driver s ability to move his or her leg back and forth Revised 1 January

15 between the gas and brake pedals. In this item you are simply looking at whether, in your judgment, the wheel tilt is too low or too high. Key Point: A properly positioned steering wheel should provide at least 2 inches of space between the top of the driver s thighs and the bottom of the steering wheel so that leg movement is not impeded, particularly the right leg s movement between the pedals. In addition, the driver should be able to reach the wheel easily, with arms slightly bent for comfort and shoulders relaxed. Safety Hint: The steering wheel must be positioned so that the airbag is directed towards the driver s chest, not at their face. Before the driver changes the steering wheel tilt, observe the current position of the wheel. If it is tilted too far up, it may impede the driver s forward line of sight and view of the speedometer and other dashboard readings. If it is too far down, it can make steering more difficult and may hit the driver s thighs. If adjustments are needed, you can assist the driver in finding a good position. If the wheel is too high or too low as described above, then ask: Note: Vehicles have different locations for the steering wheel tilt lever, so the driver may have to search for it. It is generally on the left side of the wheel behind the turn signal or underneath the steering wheel column. Now, let s take a look at your steering wheel. Are you clearly able to see the speedometer? Does the wheel have a tilt feature in your car? I noticed that your wheel seems to be [too high or too low], and you might find a different position to be better for seeing out the windshield and seeing your dash instruments. Would you like to try adjusting the steering wheel [up or down]? Revised 1 January

16 THE HEAD RESTRAINT Another common problem is that drivers are often unaware of the importance of the head restraint as a safety device that minimizes neck injuries in a crash or do not know how to adjust it properly. Key Point: The ideal position of the head restraint should be mid to above the ears and only 2 ½ inches or less from the back of the head to the restraint pad. Observe the position of the driver s head in relationship to the head restraint. If the head restraint is too low or too high, discuss the proper adjustment with the driver. DO NOT adjust the head restraint for the driver. The driver should make the adjustment if interested. This may require that the person get out of the vehicle, as it is often difficult to find the adjustment lever or button and operate it while facing forward in the driver s seat. (Note: Instead of the driver getting out of the vehicle to adjust the head restraint, you can make a note to have the OT address this during the vehicle walk around at the Check-Out Station.) The head restraint is very helpful in reducing neck injuries like whiplash in the event of a collision, particularly a collision in which you are rear-ended. It is important, though, that the restraint be at the proper height. The middle of the back of your head should hit the middle of the head restraint pad. If it is too low, your head may fall over the device, and if it is too high, it may not provide the proper support. If the device needs adjustment, say: I see that your head restraint could use some adjustment. If you would like, I could take the time now and show you how to adjust it. Would you like me to show you? Revised 1 January

17 ITEM 4: DISTANCE FROM BREASTBONE TO WHEEL Objective: 1) To determine whether the driver s breastbone is a safe distance from the steering wheel airbag. 2) To observe the driver s ability to operate the seat adjustment controls if necessary. Key Points: Many drivers do not understand how the airbag works, where it is, and what happens when it is activated. They also are unaware of a recommended minimum distance a driver should be from the airbag so that it can work properly and minimize any risk of harm due to sitting too close to a deployed airbag. Because space is needed for the airbag to inflate, drivers and passengers should sit at least 10 inches back from an airbag, wear the seat belt, and remove any excess slack in the belt. The Technician will be measuring the distance from the driver s breastbone or sternum to the center of the steering wheel by using a ruler or other measuring device. To avoid any uncomfortable personal contact, especially with female drivers, the Technician should give the ruler to the driver and ask him or her to hold it from their breastbone to the steering wheel. The Technician can then eyeball the measurement. A ruler is available in the Materials section on the CarFit website. (If a ruler is not available, an 8½ 11 inch sheet of paper can serve as the measuring device.) After you have made this measurement, be sure to record it on the Checklist in the space provided for Approx inches. If the Technician encounters any difficulty getting an accurate measurement, an approximate measurement is acceptable. If the driver s breastbone is less than the recommended minimum of 10 inches from the airbag, the Technician can guide them in adjusting the driver s seat backward until the driver is able to get at least 10 inches of clearance. The Technician may have to assist the driver in finding and operating the seat adjustment controls. It is important that you do not adjust the seat; let the driver make any adjustments. If a driver is adamantly opposed to moving the seat backward, don t press the issue. CarFit is an educational program only. Any adjustments are the driver s choice. (Circle the flag to prompt further discussion at the Check-Out Station.) If the driver has a difficult time reaching the pedals after adjusting the seat to get the minimum of 10 inches, this is a flag issue. Tell the driver to readjust the seat forward and indicate that the person at the Check-Out can address this issue later. Mark the Checklist accordingly, so that the occupational therapist or driver rehabilitation specialist can look at the issue and suggest possible solutions. Revised 1 January

18 Observe the distance from the steering wheel and airbag to the driver s chest. If the driver does not know where the airbag is, point it out. We are now going to look at the distance from the airbag to your chest. Do you know where your driver airbag is? The standard for safe use of an airbag is to maintain at least 10 inches from your breastbone or sternum to the airbag or the center of the steering wheel. Did you know that when the airbag is deployed in an emergency, the bag fills with air and moves out toward your face like a large balloon? It only stays inflated for ¾ of a second. The airbag provides a cushion to the driver as it deflates. The whole event occurs so quickly that drivers sometimes don t even realize what happened until the airbag is already deflated. Hand the ruler to the driver and guide him or her to measure between the sternum and steering wheel. Do not touch the driver s chest! If the distance is greater than 10 inches If the distance is less than 10 inches offer guidance on adjusting the seat Now let s check to see if you have a safe distance between sternum and airbag. Look straight ahead as you would normally while driving. Take this ruler [or measuring device] and place one end about mid-sternum or midbreastbone, and the other end on the airbag in front of you. Let me see what that measurement is. You are 10 inches or more away. That is good. You meet the recommended minimum measurement, so we don t need to do anything else. Remember this measurement, though, so that you can periodically check yourself. Can you see that you are less than 10 inches away from the airbag? The Revised 1 January

19 backward until the driver able to get the 10-inch reading. The Technician may have to assist the driver in finding and operating the seat adjustment controls for a more rearward placement. Do not adjust the seat yourself, but let the driver do it. government agency that regulates vehicle design and manufacturing tells us that it is unsafe to be closer than 10 inches to the airbag, as it could cause you serious injury. I would suggest that we move your seat back to get to that 10-inch mark. Would you like to try that now? Do you know how to operate your seat controls to move the seat backwards? If the driver has a difficult time reaching the pedals after adjusting the seat to get the minimum of 10 inches, then direct him or her to return the seat to its former position. Circle No for this item on the Checklist and indicate that the occupational therapist or driver rehabilitation specialist can address this issue at the Check-Out Station. If the driver has repositioned his or her seat and can still reach the pedals effectively, have the driver re-measure the distance. Then allow the driver to adjust the seat to their comfort level prior to moving to the next step. It looks like it may not be possible to obtain 10 inches from the steering wheel and reach your pedals. For now, let s move your seat back up to where you were comfortable and I will make a notation for the OT to make some possible suggestions at Check-Out. Let s re-measure that distance now. It looks like this is a better position for you, as it gives you the recommended distance from the airbag and still allows you to reach the pedals. You might consider moving your seat back to a distance such as this, but for now, please feel free to move the seat back to where it is most comfortable for you. Revised 1 January

20 ITEM 5: LINE OF SIGHT ABOVE STEERING WHEEL Objective: To determine whether the driver has the proper line of sight over the steering wheel for an adequate view of the road ahead. Key Points: A minimum distance of 3 inches above the top of the steering wheel is required for a good, straight line of vision for safety. If the driver already has a good line of sight, say so and indicate that it is important to maintain the 3-inch minimum. If the driver s line of sight is less than 3 inches above the wheel, suggest an adjustment to the seat to raise the driver higher. If adjusting the seat does not allow the driver both a good line of sight and proper positioning relative to the pedals, this is a red flag issue that the occupational therapist or driver rehabilitation specialist can address at the Check-Out. Have the driver look straight ahead. The Technician should position his/her eye level at the driver s eye level by bending, stooping, or squatting, then hold one ruler in a straight, horizontal line from the person s eye level toward the windshield. With a second ruler, measure the distance from the first ruler to the top of the steering wheel. Write this distance in the space provided on the Checklist. If the driver s line of sight is 3 inches or more above the wheel If the driver s line of sight is less than 3 inches above the wheel, a seat I am now going to take a look at your line of sight over the steering wheel. I need you to look straight out the windshield as you would normally if you were driving. Experts recommend that drivers have a line of sight at least 3 inches over the steering wheel. I am going to measure your line of sight now. Your line of sight is 3 inches or more above the wheel, so your positioning is good here. You might want to keep this 3-inch minimum in mind in the coming years, and if you find that your line of sight ever drops below that, you could try adjusting your seat or seek the advice of an occupational therapist or driver rehabilitation specialist to give you suggestions on how to correct it. Your line of sight is less than 3 inches above the wheel. I would suggest that Revised 1 January

21 adjustment upward may improve it. If the driver does not appear to know how to adjust the seat, take a minute to offer some guidance on adjusting the seat. The Technician may also check that the tilt on the back of the driver s seat is not too far back. Do not move the seat yourself, but let the driver do it with guidance. Make sure the driver doesn t adjust the horizontal seat position to reduce the airbag distance that you have just measured. If the seat does not adjust or adjusting it does not improve the line of sight while keeping the driver s feet within comfortable reach of the pedals, ask the driver to try adjusting the tilt of the steering wheel. Make sure that the driver doesn t adjust the wheel too low for good steering control. The bottom of the wheel should be at least 2 inches from the top of the driver s thighs and the driver should be able to see all dashboard indicators easily, with no obstruction of the view. If the seat and/or wheel tilt adjustment does not bring the driver s line of sight to 3 inches or more, circle No for this item, and the occupational therapist or driver rehabilitation specialist can address it at the Check-Out Station. we try to adjust your seat to see if this will help give you the 3 inches. Does your seat adjust up and down? If so, do you know how to adjust your seat up and down? Would you like to try that now? You can also adjust the tilt of the steering wheel, which may help why don t you try that? We are still short of the 3-inch mark. I will let the occupational therapist know at the Check-Out Station and perhaps he or she will have solution to this issue for you. If an occupational therapist or driver rehabilitation specialist is not available at the event, refer the driver to the list of local resources in the goodie bag. Revised 1 January

22 ITEM 6: POSITIONING TO GAS PEDAL Objective: To determine whether the driver can easily and efficiently, without reaching, depress the gas pedal. Key Points: Drivers should not have to fully extend their leg or use their toes to depress the gas pedal through its full range. If a driver is reaching in this way, it can be tiring and cause fatigue in the leg muscles. This section is designed to make the driver aware of good gas pedal use and a safe, non-fatiguing way of using the pedal. SAFETY CHECK: Make sure that the vehicle s engine is off! The Technician should get into a position where he/she can clearly see the driver s right foot. Observe the foot placement on the pedal. Can the driver easily press the pedal? Does the driver reach with his or her toes to get full pedal movement? If the driver needs to stretch his or her toes to reach the gas pedal or push the pedal If the Technician observes any problems with this task, circle No for this item so that the occupational therapist or driver rehabilitation specialist can offer a solution at the Check-Out Station. Now let s look at how well you can reach and depress the gas pedal. Place your right foot on the gas pedal and press the pedal. I notice that you are reaching out with your toes to get the pedal. This can be very tiring to your leg and foot muscles and can slow your foot s movement to the brake pedal. I will ask the occupational therapist to go over this with you at the Check-Out Station. It is possible we can find an appropriate seat adjustment for you to prevent you from reaching. Revised 1 January

23 If the vehicle has a standard transmission Repeat this several times. Note movement of the left foot to and from the clutch and the movement to depress and release the clutch. If a problem is seen, write in a comment so that the occupational therapist or driver rehabilitation specialist can offer a solution at the Check-Out Station. I notice that your vehicle has a standard transmission. Put your right foot on the brake, and use your left foot to depress the clutch all the way in is that difficult for you? You can release it now. ITEM 7: POSITIONING TO BRAKE PEDAL Objective: To determine whether the driver can reach the brake pedal and depress it fully, without difficulty, with the current seat position, and the ability to move quickly and efficiently between the brake and gas pedals. Key Point: Various aging conditions can affect a driver s range of motion and strength, in turn affecting the driver s ability to pick up his or her foot and move it quickly and efficiently to the brake pedal. The inability to quickly move the foot to the brake pedal in turn affects the driver s reaction time. While we are not measuring or even discussing reaction time in this item, we are looking at the quickness of the driver s movement, the driver s accuracy (the foot should land square in the middle of the brake pedal), and the driver s ability to fully depress the pedal. The Technician should observe whether the driver s foot lands square on the brake pedal and whether his or her movement was slow or uncertain. If the Technician feels there is room for improvement, this would be a flag issue for the occupational therapist or driver rehabilitation specialist to discuss at the Check- Out Station. Shoes or boots with thick soles, high heels or flip flops can impact the ability to achieve the proper position on the brake and gas pedals. If unsure, the technician should send to the OT for clarification. Revised 1 January

24 The Technician should get into a position where he/she can clearly see the driver s right foot. (Note: Some drivers will use their left foot to depress the brake pedal.) Observe the foot movement to the pedal and the driver s ability to depress the pedal fully. Watch for any signs of problems with this task, such as grimacing when depressing the pedal or reaching with the toes to fully depress the pedal. If the Technician observes any difficulty with this task, circle No for this item so that the occupational therapist or driver rehabilitation specialist can offer some recommendations at the Check-Out Station. Now I would like you, on my go-ahead, to simply put your foot on the brake pedal and depress the brake fully. OK, go ahead and depress the brake pedal. Do you have any problems with this task? The occupational therapist will offer you some ideas and recommendations at the Check-Out Station. Foot movement from gas to brake Safety Hint: Make certain the engine is turned off. Verify that the parking brake is on. In this exercise, the Technician is looking at how efficiently the driver can move his or her foot between the gas and brake pedals and whether the driver s foot lands squarely on the brake pedal. To indicate quickness, verbal directions will be quicker. Also, a slightly louder voice tone can often imply a quicker response here. Wait Now we are going to look at how efficient you are at moving your foot from the gas to the brake pedal. Having quick speed and landing well on the brake pedal is key to a quick stop. I would like Revised 1 January

25 about 3 seconds between commands. you to place your foot on the gas pedal, but do not depress it. When I say Stop, I would like you to move your foot as quickly as possible from the gas to the brake pedal. I will then direct you to return your foot to the gas pedal, and we will repeat this process three times. Do you understand? Let s begin. Observe the foot movement for smoothness, quickness, and accuracy of foot placement on the brake. If the Technician feels there is room for improvement (for example, if the driver misses the brake pedal or moves slowly over to the brake), circle No for this item, and the occupational therapist or driver rehabilitation specialist will address it at the Check-Out Station. Please place your foot on the gas pedal. Are you ready? STOP! Move your foot back to the gas pedal STOP! Move your foot back to the gas pedal STOP! Move your foot back to the gas pedal and relax. We are through with this section. ITEM 8: MIRROR USE Objective: To evaluate the driver s ability to use the rearview and outside mirrors effectively and to help the driver identify his/her blind spots. Many crashes among older drivers involve merging and lane changing. Proper mirror use or use of special mirrors can give the older driver the side and rear vision they require for safe driving. This Checklist item is simply to observe the driver s ability to see through the vehicle s mirrors and to make the driver aware of the importance of proper mirror use. If the driver is unable to obtain appropriate views through the mirrors before adjustments, this is a flag issue, and the occupational therapist or driver rehabilitation specialist can recommend solutions such as special mirrors at the Check-Out Station. Key Points: 1) In addition to the forward field of vision that we addressed earlier, it is important for the driver to have good side and rear views. Using the outside and rearview mirrors effectively requires that each mirror be Revised 1 January

26 properly adjusted. Many drivers have not been instructed on how to adjust their mirrors for many years, if ever. They may have gotten into the bad habit of not using one of the mirrors, or not using any of them. Perhaps they have a medical condition such as arthritis or a cervical fusion that prevents them from turning their neck far enough to see one of the outside mirrors. 2) If there is time, this is a great opportunity to demonstrate the enhanced mirror settings method of mirror adjustment (Appendix F). This method for setting your mirrors is also known as the BGE method, which stands for Blind Spot-Glare Elimination. Use of the enhanced mirror settings can minimize a driver s blind spots and reduce glare. Drivers who have attended a driver refresher course may be familiar with the enhanced mirror settings but may not have put it to use in their own vehicle. Be aware of time spent here and of any participants waiting in Check-Up lane. Remember that each driver will leave with a CarFit brochure that explains the enhanced mirror settings. This part of the Check-Up can run more smoothly and quickly if two Technicians, or a Technician and a volunteer, are working together one moving around the vehicle and the other speaking with the driver and providing clear directions. Check to see if the driver has a rearview mirror and one or two outside mirrors. If there is only a driver s side outside mirror, then the Technician will skip the portion that addresses the passenger side mirror. Make sure the driver has the rearview mirror properly adjusted so that the reflection frames the rear window. If it does not, ask the driver to adjust it. We are now going to look at your rearview and side mirrors. Do you feel that all of these mirrors are adjusted well for you? Did you know that many crashes for older drivers occur when they are lane changing or merging? To minimize blind spots and maximize visibility to the rear and side of your vehicle for lane changing and merging, neck mobility and mirror adjustment are very important. We will first check the adjustment of your rearview mirror. Does your rearview mirror frame your rear window? Revised 1 January

27 Walk to the rear of the vehicle and stand approximately 15 feet behind it. Hold 1, 2, or 3 fingers up just above the level of the trunk if it s a car and just above the lower part of the rear window if it s a minivan or sport utility vehicle. The Technician may have to walk back around to the driver door to hear the driver tell you how many fingers he or she saw, or he/she can ask the driver to hold up the number of fingers he or she sees. The Technician should mark the checklist accordingly. Now I am going to walk to the rear of the car and hold a number of fingers up. Please put your hands on the steering wheel as though you were driving, and when I ask you to identify how many fingers I am holding up, look only in the rearview mirror, without turning around, and tell me how many fingers you see. Note: If the driver does not have a right outside mirror, skip this question on the Checklist and mark N/A on the form. Walk to the right side rear bumper of the vehicle and stand 3 feet to the right of the car, facing forward. Hold 1, 2, or 3 fingers at the level of the car s right outside mirror. Now we are going to do the same thing but with the right outside mirror. How many fingers am I holding up? *If the driver is unable to see the Technician, it is a good indication that the mirrors are improperly positioned. The Technician should mark on the checklist whether or not the driver was able to be seen in the mirror PRIOR to adjusting it. This is a great time to emphasize the enhanced mirror settings as described above. This is worth devoting some extra time to, if the Technician feels comfortable demonstrating it and if the time is available. It appears we may be able to improve your mirror settings to reduce your blind spot. If you have a few minutes, I can explain to you an improved method of adjusting your mirrors that will help minimize your blind spots. Revised 1 January

28 Following steps for BGE, the Technician should first identify current blind-spots through walk-up from rear of car, adjust mirrors using BGE method, and then repeat the walk-up emphasizing the reduced blind spot to driver. Repeat on other side. (Note: Using changed mirror settings requires practice and familiarization Mirror adjustments should be done in gradual increments Begin slowly Home use of CarFit brochure that explains the enhanced mirror settings. I would encourage you to look at the mirror adjustment directions in the CarFit brochure when you get home and give it a try. It is an improved method of mirror settings and works very well when you get used to it. ITEM 9: NECK MOBILITY FOR BLIND SPOT CHECK Objective: To determine whether the driver is able to adequately check the vehicle s blind spots on either side of the vehicle. Key Points: Many collisions related to merging and lane-changing are the result of the driver s inability to check the vehicle s blind spots adequately. Many drivers do not have the good habit of checking their blind spots, and some think that they adequately check the blind spots by looking in the rearview and outside mirrors. For this item, the Technician will first determine whether the driver can adequately turn his or her neck to make a direct visual check of the blind spots on the left and right sides of the vehicle. Second, the Technician will remind drivers who do not have the good habit of checking their blind spots of the importance of doing so before merging and lane changing. If turning the head to make a direct visual check of the blind spots is a problem for the driver, the Technician can first ask if he or she has used the enhanced mirror settings method of mirror adjustment. If not, this is another good time to demonstrate the effectiveness of the enhanced mirror settings. It is important that the driver understand that the enhanced mirror settings method does not Revised 1 January

29 eliminate the need for further checking of the blind spot areas. Some drivers just do not have adequate mobility of their head, neck, or trunk to perform this vital task for safe driving. Various special aftermarket mirrors are available that allow drivers to see into the blind spot area without looking over their shoulder. If the driver lacks the mobility for an adequate check of the blind spots, this is a flag issue. The occupational therapist or driver rehabilitation specialist will determine which type of aftermarket mirror would be most suitable at the Check-Out Station. If the Technician demonstrated the enhanced mirror settings to the driver, indicate that on the Checklist. The Technician should Position him/herself on the driver s side of the vehicle about even with the back of the rear passenger s seat. Step 5 6 feet to the left and face forward. Have the driver look in the left outside mirror and ask if he or she sees the Technician in it. If the driver says yes, take another step to the side and ask again, until the driver no longer can no longer see the Technician. We will now check your neck movement from side to side for checking your blind spots. I am going to stand in the blind spot of your vehicle and first make sure that you cannot see me in your left outside mirror. Once I know that I am in your blind spot area, I will ask you to turn your head and tell me how many fingers I will be holding up. Again, I need you to place your hands on the steering wheel and leave them there throughout this check. The Technician is now standing in the blind spot, and the only way the driver will see the Technician is to turn his or her head and/or trunk to look at this area. It is important for drivers to understand that they do not have to look far backward over their shoulder, but just far enough to see the blind spot area where the Technician is standing. Hold up a number of fingers at the level of the outside mirror or slightly higher. Some drivers will release their hands from the steering wheel while turning Now that I know that I am in your blind spot area, please look straight ahead until I instruct you to turn your head OK, ready? Please turn your head and identify the number of fingers that I am holding up. Now, how many fingers was I holding up? Revised 1 January