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Bill Klaproth (Host):  Eisenhower’s rehabilitation services department offers a number of interesting programs including a driving program and a low vision program. So, let’s learn more about driving assessments and rehabilitation for low vision with Kathryn Scheuring and Occupational Therapist at Eisenhower Health. Kathryn, thank you so much for your time today. so, let’s start with the driving program. How do people learn they need a driving evaluation? Is that usually a recommendation from their doctor and what does it mean when a person is told they need a driving evaluation?

Kathryn Scheuring, MS, OTR/L (Guest):  Yes. So, a driving evaluation is normally something that’s brought up by the patient’s doctor. And usually it comes because the patient has had maybe a health scare or has been in the hospital for a long period of time and the doctor is concerned about the patient being able to return to driving safely. Or sometimes if he is just worried about cognitive changes over time especially in older adults, just to have a check to see how the cognition and how reaction speed is affecting a person’s ability to drive.

We also have evaluations that may come about from a patient’s doctor if they do in fact have a large accident or in fact the DMV or police have taken away their license.

Host:  Okay, got it. So, then what types of skills are you assessing in a driving evaluation? What are you looking for in these patients?

Kathryn:  So, with the driving evaluation, we are primarily looking at cognition and reaction speed. So, we want to make sure that cognitively they are still able to understand the rules and regulations of the road in the state of California, they are still able to demonstrate good reaction speed meaning if something unpredictable happens while they are driving in the simulator; can they take their foot off the gas, place it on the brake within a suitable amount of time to be able to stop or initiate a stop. We also look at things like balance and making sure that people can get in and out of the vehicle without falling. If they have walkers or other assistive devices; making sure that they can also stow those away independently and then of course, checking their vision to make sure they are within the regulations of California to be able to maintain their driving.

Host:  Right and how long does this evaluation take?

Kathryn:  The evaluation can take up to three hours, that’s the allotted time that is given. But most people finish in about an hour and a half.

Host:  Okay and can a family member refer a loved one for a driving evaluation and who should be getting these evaluations?

Kathryn:  The family member can refer them however, all referrals here at Eisenhower Health have to be sent in via a doctor and it can be any doctor, primary care doctor or cardiologist. It doesn’t matter. So, if a family member is concerned or they would like to have their loved one have an evaluation; they would just ask their doctor and the doctor would then send over a referral and then our rehab department would call to schedule the patient.

Host:  Got you. All right good to know. So then what is the difference then between a driving evaluation or assessment and driving rehabilitation?

Kathryn:  The driving evaluation is primarily to test a driver’s skills as of this moment. A driving rehabilitation is more for people who have undergone some sort of large health problem, maybe a stroke, maybe a traumatic brain injury and they are relearning the skills to be able to drive. So, that would happen over a series of probably about ten sessions and then once that it is felt that the patient was able to retest, they would then have a driving evaluation. The rehabilitation focuses more on regaining the skills that are needed to drive and the evaluation is only a one time pass or fail type assessment that a doctor is looking for to determine if the patient is suitable to continue to drive.

Host:  Right. That makes sense. All right so let’s move on to the low vision program. So, Kathryn what is low vision?

Kathryn:  So, low vision is primarily related to a progressive eye condition, glaucoma, cataracts, macular degeneration or sometimes any sort of neurological deficit that has caused vision to be taken away from the older adults.

Host:  So, then what’s the purpose of the low vision program? Is it possible for people to improve their vision through the program or is this a matter of retraining to work with the vision that remains?

Kathryn:  So, low vision rehabilitation is primarily focused on functional independence with the remaining vision. So, most people with low vision diagnoses are slowly going to lose vision via macular degeneration or cataracts or diabetic retinopathy so this is something that they are going to have to learn how to manage and how to be as functional as possible. So, we don’t emphasize the vision – the visual acuity getting any better but more so as learning what vision you do have left and how to compensate to continue to do the tasks that you love to do.

Host:  So, many people fear losing their sight. Are there ways to help people stay connected and active with the things they love to do even if they have low vision?

Kathryn:  Absolutely. So, low vision rehabilitation is a great way to start because you do learn about kind of what is going through, what kind of process you are going through, what the eyes are doing and how to compensate for what you’ve lost with tips and techniques, assistive devices. They have a lot of low vision devices or aides now that help older adults compensate for the vision loss via magnifiers or portable video magnifiers. Doctors are also very trained right now, optometrist or ophthalmologist to refer to other low vision areas like the Braille Institute or other visual services in the valley to be able to talk to you about what vision loss means, what to expect and then ways to keep yourself healthy and kind of check in about the process.

Host:  So, if someone suspects they or a loved one has low vision; who should they talk to?

Kathryn:  Well first you want to make sure that if any low vision is suspected without a diagnosis; you want to talk to your ophthalmologist because ophthalmologists specialize in low vision eye diseases. And therefore they can tell you exactly what is going on with your eyes and then once they have kind of an idea of what is going on; then you would ask the doctor to refer you to appropriate services even if it’s just for learning new information about what you are going through. And then the doctor can make the determination and give advice as needed.

Host:  So, the first step is seeing your ophthalmologist then?

Kathryn:  Absolutely.

Host:  Okay so is the program by referral only or can people call with questions and make an appointment directly?

Kathryn:  People can always call with questions and we can go through the process of kind of what to expect however, everything is billed through insurance for low vision rehabilitation and therefore it requires a doctor’s referral.

Host:  Got you. Kathryn this has been really insightful and informative. Thank you for your time.

Kathryn:  Thank you.

Host:  That’s Kathryn Scheuring, an Occupational Therapist at Eisenhower Health. To learn more about Eisenhower’s rehabilitation services, all you have to do is call 760-773-2033, that’s 760-773-2033. And if you found this podcast helpful, please share it on your social channels and be sure to check the entire podcast library for topics of interest to you. This is Living Well with Eisenhower Health. I’m Bill Klaproth. Thanks for listening.