Blog by Zeta Griffiths, Practice Manager extraordinaire
Photo : Zeta and Jenny (Director of Driving Well)
From an intake perspective the best advice I could give to any client would be, be involved in the process.
Our OT team is amazing, but they aren’t mind readers. A lot of the important information will come from you. For example…. What are your capabilities and limitations? Do you really have 20/20 vision, or might the Optometrist have a different opinion of your eyesight. The information that you gather for us before you actually meet your OT for the first time is invaluable.
Be prepared, make that appointment with your GP (make sure it’s a long one) and don’t leave without the paperwork we’ve asked you to get. Sometimes the GP thinks they know the process and can be a little stubborn, be patient and insistent and it will save you a second trip back to see them if you don’t come away with what we need.
Sometimes there are other things holding people back from getting everything organised. You may need a family member to take you for the appointments or you have scanner or fax limitations. Don’t get too hung up on how I’m going to get the paperwork back, I’ve got a whole bag of tricks up my sleeve. Get the process started and we’ll help you with the returns policy 🙂
I was once told I was being a pest by a lovely young man (98 years young) who needed an assessment. He didn’t have his paperwork and his assessment was quickly approaching. I would call him every second day, and ask if he’s made his appointments with the GP and Optometrist. He knew he needed to get them, but something was holding him back. On my last call to him I asked him what was really stopping him? His answer, “it’s time to stop and I just didn’t want to admit it. Not to mention Zeta, I though about what you said about all the money I’ll save when I get rid of the car and insurances etc and you know what, that’s a lot of beer!” We had a laugh and he gracefully retired from driving.
Everyone’s situation is different and our team would like to help you find your destination.
Check out these 5 helpful tips for partnering with us.
Our website explains in detail the process and forms needed for an OT driving assessment:
Email your referral to firstname.lastname@example.org for support with driving assessments and vehicle modifications.
When a person can’t use their lower limbs for operating brake/accelerator anymore (eg due to an injury such as lower limb amputation, or medical condition such as diabetes or multiple sclerosis), they will often be able to return to driving by using hand controls – this is where they have a lever that comes out from the steering column for braking, and then various different options for accelerating.
Two main types of hand controls: mechanical and electronic:
How do they work: “push-pat” – push the brake lever forwards for braking (braking is ALWAYS push forwards – because as humans we tend to put our hands out in front of us to stop us from falling), and “pat” it down for accelerating. This style has two rods that run down through the steering column, that connect to the pedals, so when you push the hand control, they activate the pedals.
For steering, a spinner knob is required to be able to operate the steering wheel safely with one hand. This is a requirement of all State Licencing Authorities, and a requirement of the governing guidelines AS/NZS 3954:2019 Motor Vehicle Driver Controls: adaptive systems for people with disabilities.
From left to right below:
Young fellow had his precious (and old) Ford Falcon, so had push-pat hand controls installed; close-up of push-pat hand control with electronic indicator panel, and close up of push-pat hand control with green toggle switch indicator.
Suitable for: these are a basic hand control that work well for older vehicles.
Problem: cars with knee airbags
How do they work: the brake lever is still connected to the pedals, so push forward on the lever activates the brake. This is typically positioned on the right hand side but can be trialled in some driving instructor vehicles on the left side. We usually like the stronger hand to operate the brake – stopping the car is the most important function in driving!
Then there are multiple options for accelerating – it depends on the person’s abilities such as dexterity, strength, sensory issues, any pain/fatigue. Common types are:
From left to right below:
Female driver using the trigger accelerator; male driver using the satellite accelerator; female driver using the overring accelerator; close-up of the Fadiel FSK2005 brake lever/trigger accelerator; close-up of the Fadiel e-radial accelerator; close-up of the satellite accelerator; close up of the Carospeed hand control system (left side operated); male driver using the trigger accelerator.
Higher level needs
For people with higher level disabilities (eg quadriplegia) who need a little extra help, then the next level of hand controls are full electronic input systems – such as the mini-wheel or joystick, and “Freedom” brake/accelerator units. These are available from Problem Management Engineering and Total Ability and require very intensive assessment and trials, and intensive training.
Getting back on the road with hand controls is a bit of a process, but so worthwhile. These steps will guide you through the process (bearing in mind the licencing process may vary from state to state – this is the QLD flavour)
1. Referral / intake
2) OT driving assessment: clinical and practical assessment, to trial various hand controls.
At intake, your OT driver assessor should be able to work out with you which type of hand controls you will be most suited to, and book a specialised driving instructor with these type of controls in their vehicle.
If we haven’t nailed the hand control choice, we will do further drives in the same vehicle/hand controls to get a bit more practice and confirm, or we may do further drives with different hand controls (same instructor/vehicle or different instructor/vehicle).
If we’ve worked out the right hand controls for you, we’ll discuss the recommended number of lessons – this will vary between 5 to 10 lessons, right through to 15 to 20, or even 30 to 40 for high level electronic gear, dependent on previous driver experience (some clients are teens / learners and have never driven before) and your progress.
3) Recommendations and paperwork
Once a decision on the hand controls is made, the OT driver assessor completes report/s and obtains quote for driving lessons from the chosen driving instructor, which is submitted to the insurer for approval.
When lessons are recommended, the OTDA will submit the OT driving assessment report and quote for the number of recommended lessons from the driving instructor provider, to the NDIA – “specialised driving training” is a quote required item, which needs to be approved by NDIA and added as a line item to your NDIA plan under Capacity Building: improved daily living (Specialised driver training 15_046_0129_1_3).
Once you have written approval from the NDIA, you are able to book your lessons directly with the driving instructor. (Note – as at February 2022, this is taking months to gain approval).
4) On-road re-assessment to review progress
For some clients, an OT on-road re-assessment will be completed part-way through their lessons, to check that everything is progressing as it should be, and gain the evidence to confirm that the modifications will enable the person to be a safe driver in the long term.
5) OT Driver Assessor to submit vehicle mods application
A vehicle modifications application is then completed and submitted to the insurer. This will typically include a suite of documents including:
NB: insurers have varying criteria about age and kilometres of the vehicle, which is considered to be “suitable” to modify. NDIS require no older than 5 years and no more than 80,000km – however, when minor modifications are being completed (including hand controls) which can be transferred to the next vehicle, they will usually accept this as long as the Safety Certificate is also provided.
Await approval of the vehicle modifications. (again, there may be lengthy wait times for NDIS Participants).
7) Installation, lessons, license/medical certificate review
8) Handover assessment
Note: in QLD, a Transport driving test is not required, however this is a requirement in other states. In QLD, we need to be confident that the client is driving at the QLD Transport driving test standard, and that if they did have to complete a test, that they are at passing level.
9) Further lessons as needed
Some clients will have another few lessons in their own modified vehicle to gain experience and confidence.
OT driver assessor will complete final on-road report and post-modification evaluation report – these will be sent to QLD Transport and the insurer.
A celebration is definitely in order after all this! And for Driving Well, the handover days are the absolute highlight for us, our “WHY FACTOR” – this is why we do what we do!
Brisbane vehicle modifiers:
Specialised driving instructors in Greater Brisbane region:
Check out our website www.drivingwell.com.au and get in touch if you need support with driving and/or vehicle access with a medical condition or disability.
#drivingassessment #handcontrols #vehiclemodifications #transport #independence #safety #driving #NDIS #occupationaltherapy #brisbane
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