Technician Manual
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.
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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.
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CARFIT…………………………………………...……………………………1
1. PROGRAM OBJECTIVES……………………...………………………….4
2. BACKGROUND……………………………………......…………………..4
3. THE CARFIT EVENT………………………………..…………………...6
4. TRAFFIC DIRECTION & CHECK-IN STATION…………..…………7
5. CHECK-UP STATION OVERVIEW………………………..……………8
6. 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…………….……....17
ITEM 5: LINE OF SIGHT ABOVE STEERING WHEEL…………….……….20
ITEM 6: POSITIONING TO GAS PEDAL…………………………….………22
ITEM 7: POSITIONING TO BRAKE PEDAL………………………….……...23
ITEM 8: MIRROR USE…………………………………………...……….……..25
ITEM 9: NECK MOBILITY FOR BLIND SPOT CHECK……………….…….28
ITEM 10; IGNITION KEY……………………………………………….……..31
ITEM 11: OPERATION OF VEHICLE CONTROLS………………….………32
7. CHECK-OUT STATION…………………………………………………35
ROLE OF OCCUPATIONAL THERAPIST………….…………………………35
ITEM 12: VEHICLE WALK-AROUND………………………………………...36
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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.
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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.
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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.
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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.
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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 CheckUp.
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.
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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 12–15 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.
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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.
What To Do
Direct the driver to move up to the
designated stopping place.
What To Say
Hello, my name is ____________ and I
am from _____________. Before we
begin, I would like to ask you to do
Safety Hint: Do not stand directly in
front of the car when directing driver to several things. First, please put the
a parking spot at the Check-Up Station. gearshift in park [or in Neutral if the
Stand to the side of where you want the vehicle has a manual transmission] and
driver to stop.
set the parking brake. Next, please roll
the driver and passenger windows
down. Finally, please turn off the
If the driver is accompanied by family
vehicle’s ignition and remain seated.
members or friends, suggest that the
passengers wait in the designated
waiting area away from the car. The
The purpose of this CarFit Check-Up
Technician may be able to encourage
today is to examine your positioning in
the other occupants to get out by
the driver’s seat and look at your
offering shade and refreshments. If they operation of all vehicle controls. This
do not wish to get out of the car, go
should take about 12 to 15 minutes.
ahead and begin the CarFit Check-Up.
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.
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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.
What To Do
What To Say
Are you the only driver of this vehicle
in your family?
If “Yes,” then proceed to item 2.
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.
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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.
What To Do
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.
What To Say
I see you have your seat belt on. Are
you in the habit of wearing it all of the
time?
What To Do
If the driver does not have the seat belt
on or says “No,” then ask why and
write the response on the Checklist.
What To Say
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.
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.
What To Do
Ask about whether the belt is
comfortable or not, and write the
answer on the Checklist form.
What To Say
Does the belt feel comfortable to you?
If the answer is “No,” ask the driver to
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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:
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.
What To Do
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.
What To Say
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.
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.
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.
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What To Do
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.
What To Say
Please unbuckle the belt and let it go all
the way back into the retracting
mechanism.
Now you may re-buckle the belt.
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.
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
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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.
What To Do
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.
What To Say
Now, let’s take a look at your steering
wheel. Are you clearly able to see the
speedometer?
If the wheel is too high or too low as
described above, then ask:
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]?
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.
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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.
What To Do
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.)
What To Say
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?
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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.
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What To Do
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.
What To Say
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.
What To Do
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!
What To Say
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.
If the distance is greater than 10 inches
…
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.
If the distance is less than 10 inches …
offer guidance on adjusting the seat
Can you see that you are less than 10
inches away from the airbag? The
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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.
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.
If the driver has repositioned his or her
seat and can still reach the pedals
effectively, have the driver re-measure
the distance.
Let’s re-measure that distance now.
Then allow the driver to adjust the seat
to their comfort level prior to moving
to the next step.
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.
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Technician Manual
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.
What To Do
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.
What To Say
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.
If the driver’s line of sight is 3 inches or Your line of sight is 3 inches or more
above the wheel, so your positioning is
more above the wheel …
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.
If the driver’s line of sight is less than 3
inches above the wheel, a seat
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Your line of sight is less than 3 inches
above the wheel. I would suggest that
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Technician Manual
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.
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?
What To Do
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.
What To Say
You can also adjust the tilt of the
steering wheel, which may help … why
don’t you try that?
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 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.
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Technician Manual
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.
What To Do
What To Say
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.
Now let’s look at how well you can
reach and depress the gas pedal.
Place your right foot on the gas pedal
Observe the foot placement on the
and press the pedal.
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 …
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.
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.
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Technician Manual
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.
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.
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 CheckOut 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.
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Technician Manual
What To Do
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.)
What To Say
Now I would like you, on my go-ahead,
to simply put your foot on the brake
pedal and depress the brake fully.
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.
OK, go ahead and depress the brake
pedal. Do you have any problems with
this task?
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.
The occupational therapist will offer you
some ideas and recommendations at the
Check-Out Station.
What To Do
What To Say
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
Revised 1 January 2008
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
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Technician Manual
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
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Technician Manual
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.
What To Do
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.
What To Say
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.
Make sure the driver has the rearview
mirror properly adjusted so that the
reflection frames the rear window.
We will first check the adjustment of
your rearview mirror. Does your
rearview mirror frame your rear
window?
If it does not, ask the driver to adjust it.
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Technician Manual
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.
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.
The Technician should mark the
checklist accordingly.
What To Do
What To Say
Note: If the driver does not have a
right outside mirror, skip this question
on the Checklist and mark N/A on the
form.
Now we are going to do the same thing
but with the right outside mirror.
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.
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.
Revised 1 January 2008
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.
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Technician Manual
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
ƒ Mirror adjustments
should be done in gradual
increments
ƒ Begin slowly
ƒ 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
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Technician Manual
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.
What To Do
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.
What To Say
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.
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.
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.
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.
Hold up a number of fingers at the level Now, how many fingers was I holding
of the outside mirror or slightly higher. up?
Some drivers will release their hands
from the steering wheel while turning
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Technician Manual
their head; just remind them to keep
their hands on the steering wheel while
they are looking, and try again with a
different number of fingers.
If the driver cannot turn his or her neck
or head to complete this task, circle
“No” for this item, and the
occupational therapist or driver
rehabilitation specialist can address this
issue at the Check-Out Station.
What To Say
Now we are going to check your right
outside mirror in the same way, so I will
move to the right side now …
What To Do
Next, check the other side.
Note: If the driver does not have a
right outside mirror, skip this question
and mark N/A on the form.
Walk to the right side of the vehicle.
The Technician should position
him/herself on the passenger’s side of
the vehicle about even with the back of
the rear passenger’s seat. Step 5–6 feet
to the right and face forward. Be sure to Can you see me at all in your right side
check and make sure that the driver
mirror?
cannot see you in the right outside
mirror.
Now turn your head and identify how
many fingers I am holding up.
Once the Technician knows he/she is
in the blind spot …
If the driver cannot see the Technician’s
fingers, is it because of limited neck
mobility for turning and looking over
the shoulder? Does the driver appear to
also be turning his/her trunk to
compensate for limited neck rotation?
If there are any problems, circle “No”
for this so that the occupational
therapist or driver rehabilitation
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Technician Manual
specialist can provide information on
special mirrors or other compensatory
techniques at the Check-Out Station.
ITEM 10: IGNITION KEY
Objective: To evaluate the driver’s ability to properly use the ignition key.
Key Points: Every driver must be able to use the ignition key. Some very simple
solutions are available for drivers who have difficulties with these tasks. For this
item, the Technician is only observing whether there are any difficulties or
complaints of pain or discomfort. If there are, this is a flag issue, and the
occupational therapist or driver rehabilitation specialist can give the driver
information about adaptive devices at the Check-Out Station.
What To Do
If the key is in the ignition switch, ask
the driver to remove it. If the key is not
in the ignition switch, ask the driver to
put the key in the ignition and then
remove it.
What To Say
Let’s now look at how you turn the
engine on. Could you please remove the
key from the ignition?
Observe as the driver is doing this.
Make a note if the driver has a difficult
time reaching the ignition switch with
the key, removing the key from the
ignition switch, or holding onto the key
from hand weakness, pain, or
deformity.
Do you have problems doing this?
What To Do
Next, ask the driver to turn the key.
Note the same details as above, but also
watch carefully for any difficulties in
turning the key. For example, the driver
may have to move his or her trunk to
get closer to the ignition switch because
of limited reach. The driver may
grimace if this task causes pain or may
What To Say
Now, please check that the car is in
Park [or in Neutral if the vehicle has a
manual transmission], then go ahead
and stick the key back into the ignition
and start up the engine. Do you have
problems using the ignition key to turn
the vehicle on?
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Technician Manual
use both hands to turn the key. Circle
the flag if the driver has any problems
holding the key, reaching the key to the
ignition switch, putting it in the ignition
switch, or turning the key to turn the
engine on.
Thank you. Please set the ignition to the
Adaptive devices are available to assist
auxiliary position, turning the engine
with this task. If the Technician notes
any problems, circle “No” for this item, off.
and the occupational therapist or driver
rehabilitation specialist will address this
issue at the Check-Out Station.
ITEM 11: OPERATION OF VEHICLE CONTROLS
Objective: To determine whether the driver has any difficulties operating selected
secondary controls of the vehicle (such as wipers, turn signal, and horn), setting
and releasing the parking brake, and turning the steering wheel.
Safety Note: In some vehicles these controls do not work with the engine
off, so the Technician may have to ask the driver to set the ignition to the
accessory position, while keeping the engine off. Always make sure the
parking brake is on and the vehicle is in Park (or Neutral if the vehicle has a
manual transmission).
Key Point: The Technician is checking that the driver is able to operate various
vehicle controls safely and efficiently. Adaptive devices are available to assist
drivers with turning the steering wheel or operating secondary controls such as the
turn signals, and horn. If the Technician notes any problems in this section, these
are flag issues, and the occupational therapist or driver rehabilitation specialist will
address them at the Check-Out Station.
(Note: The vehicle’s owner’s manual will describe where these are located and
how they work.)
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Technician Manual
What To Do
Please ask the driver to set the ignition
to the accessory position, while keeping
the engine off.
What To Say
Turn signals
Note: This is a wonderful opportunity
to notify the driver if any headlights or
taillights are not in working order.
Stand beside the driver door and
observe the driver use the turn signal
lever while instructing him or her to
turn the left turn signal on. Make a note
of any problems observed in the
driver’s reaching for the turn signal
lever or turning the signal light on.
Now we are going to check some other
secondary controls in your car. Let’s
first look at your turn signals.
Do you have any problems operating
the turn signals? Please put on your left
turn signal.
Now cancel the left turn signal and turn
Observe the driver operate the right
turn signal lever and make a note of any on the right turn signal.
problems.
Thank you. You can turn that signal off
now.
Headlight switch
Now turn the headlights on … Good.
While standing at the driver door,
Now please turn on your high beams
observe the driver reaching for and
operating the headlight switch and then … and now turn them off … Good,
now go ahead and turn off the
turning the high beams on and off.
Note any difficulties the driver has with headlights.
this task.
If the vehicle is equipped with daytime
running lights, the driver will not need
to turn the lights off.
Emergency flashers
While standing at the driver door,
observe the driver reaching for and
operating the emergency flashers. Note
any difficulties the driver has with this
task.
Revised 1 January 2008
Now turn on your emergency flashers.
You can turn them off now.
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Technician Manual
What To Do
Parking brake
What To Say
We are now going to look at the
operation of the parking brake.
Observe whether the parking brake is
operated by hand or by foot.
Safety Hint: Parking brakes that have
not been used for over a decade may
become stuck.
Write down any problems the driver
has and if you had to provide any
instructions.
What To Do
Turning the steering wheel
Note: The engine will need to be on in
order for power steering to operate.
While doing this task, the driver only
needs to make one full turn of the
wheel. For safety, make sure that the
driver does not turn the wheel all the
way to its stopping point. Further,
technicians should not stand in front of
the vehicle.
Note any difficulties with steering
technique in terms of smoothness,
quickness, grasp on the wheel rim, or
range of reach. Some drivers have
learned compensatory ways to steer,
such as the new recommended method
of sliding the steering wheel through
the hands while they are positioned at 4
o’clock and 8 o’clock. You may observe
Revised 1 January 2008
How do you operate the parking brake
to put it on? How does the vehicle let
you know if the parking brake is on?
Can you apply your parking brake? Is
this difficult for you?
What To Say
We have one last task to do inside the
vehicle. I am going to ask you to simply
turn the steering wheel. Do you have
any problems with steering? When I
direct you, please look straight ahead,
and turn the wheel one full turn in the
direction I ask you to. Do you
understand the directions?
OK, now, turn your steering wheel to
the right for one full turn. Good, now
turn your steering wheel back to center
… Now turn your steering wheel to the
left for one full turn. Good, now you
can return it to center again.
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Technician Manual
difficulties with reaching the wheel,
inadequate hand grasping of the wheel
rim, a lack of smoothness in the
movements throughout the turn of the
wheel, or shaking or tremor in the
hands or arms.
If the Technician observes any
difficulties, circle “No,” under item 11
and the occupational therapist or driver
rehabilitation specialist will take a look
at this task at the Check-Out Station.
Please turn the engine off now.
Safety Hint: Confirm that the steering
wheel has been moved back to center
so the front wheels will not be turned
when the driver begins to leave the
space.
At this point, the Technician should look back over the Checklist to make sure
that all items were marked and to add any comments (write legibly, as the driver
keeps a copy of the checklist) that might be helpful at the Check-Out. Circle any
red flag issues so that the occupational therapist can easily see what areas of
concern may need to be addressed at the Check-Out.
The Technician will then hand the clipboard with the Checklist to the driver.
Direct the driver to turn on the engine and proceed slowly to the Check-Out
Station.
SECTION7: CHECK-OUT STATION
The purpose of the Check-Out Station is for occupational therapists to complete
the CarFit Checklist and make any recommendations as needed.
The Role of Occupational Therapists
Occupational therapists have a major role in CarFit and are uniquely qualified to
assist at the CarFit Check-Out Station. Occupational therapists undergo
specialized health care training to help people with various conditions or
disabilities gain or retain independence in performing the activities and tasks of
daily living that are important to them. Community mobility, which for many
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Technician Manual
people means driving their own car, is considered an instrumental activity of daily
living. For this reason, most occupational therapists address community mobility
in some capacity, and some occupational therapists specialize in driver
rehabilitation. Their work centers on helping people become or remain
independent and safe in driving or community mobility for as long as possible.
Driver rehabilitation specialists also know about adaptive driving equipment and
other aids, such as special mirrors and pedal extenders. The occupational therapist
or driver rehabilitation specialist will be able to assist with the CarFit Check-Out
and offer very general suggestions that address areas of concern identified by the
CarFit Technician or by the participant.
Occupational therapists or driver rehabilitation specialists will:
• Complete Item #12, the Vehicle Walk-Around, on the Checklist.
Occupational therapists are more thoroughly trained to notice seemingly
small nuances in gate or balance that may greatly impact safe driving;
• Review the checklist for specific flagged areas of concern and make
recommendations or demonstrate needed “gadgets” as appropriate;
• Discusses community resources provided in the goodie bag;
• Separate the checklist, providing the driver with the top white copy and
collecting the yellow copy & clipboard. Place the copy of the Checklist and
Participant Data Sheet in a box for safe keeping until event has ended.
(Note: A volunteer may assist with paper assembly and filing.)
• Direct driver to the CarFit exit.
NOTE: A CarFit event may be conducted without any occupational
therapists or driver rehabilitation specialists present. In this case, a
Check-Out volunteer hands out goodie bags that include a list of local
occupational therapists and Driving Rehabilitation Programs. The
Technician should strongly recommend that the driver visit an
occupational therapist or driver rehabilitation specialist, especially to
address any flagged issues.
ITEM 12: VEHICLE WALK-AROUND
(Note: This is the last item to be completed on the Checklist)
Objective: To observe whether the driver has any difficulties with getting out of
the vehicle and walking around it, and to begin a conversation about any dents
and scratches.
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Key Points: The Occupational Therapist or Technician is first looking for any
concerns with the driver’s walking, balance, and ability to get in and out of the car.
The Occupational Therapist or Technician should not jump to conclusions,
because many older persons walk slowly or use a cane or walker and are still able
to drive safely. Second, the OT or Technician is looking for any dents, scratches,
or other damage or imperfections such as a cracked windshield and making the
driver aware of them. The OT or Technician can ask how the damage occurred
without making accusations. If the driver does not want to share this information,
don’t press the issue.
(Note: The driver may decline to do the walk-around. This is his/her choice.)
What To Say
What To Do
The occupational therapist/ driving
rehabilitation specialist should review
any flags noted throughout the checklist
prior to beginning the walk around.
Flagged concerns, strategies and devices
should be reviewed as appropriate
throughout the check-out phase.
Observe carefully as the driver moves
his or her legs out of the car and stands
up. Did any part of this task seem
difficult? Did the driver grimace as if
some part of the movement was
painful? Did it take the driver several
extra seconds to get into a standing
position? Did he or she have to pull up
using the door or seat for assistance?
We are now going to take a few minutes
and get out of the vehicle. Will this be a
problem for you? Do you have any
difficulties getting in and out of your
car?
Walk beside the driver around the
vehicle. Be ready to provide a steady
hand if needed. Note if the driver
carries a cane or walker or has artificial
legs. Did the driver have any problems
with balance?
I would now like you to walk with me
around your car. Is walking difficult for
you? Do you have any problems with
balance or dizziness?
Note any problems or difficulties the
driver has with any of these tasks. Some
simple adaptive devices are available to
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Technician Manual
assist with these tasks, and sometimes
learning a different way of performing
the task can reduce or eliminate the
difficulty. For example, someone with
low back pain can actually aggravate
their pain by the way they turn their legs
and trunk when getting out of a car.
Just knowing this and learning a better
way to move the body as a unit may
decrease the person’s pain and improve
their mobility.
If the driver could not get out of the
vehicle and walk around it, make a note
of that on the Checklist.
What To Do
As the OT or Technician walks around
the vehicle, notice any dents or
scratches. The OT or Technician must
be careful here, in order to not make
the driver become defensive. The OT
or Technician can point out the
imperfections as a way of finding out if
the driver was aware of them. The
driver may offer information about how
the dent or scratch occurred, or if the
OT or Technician feels comfortable,
he/she may ask about the damage.
What To Say
Examples of dialogue for this part:
Note whether the headlights, taillights,
side mirrors, rear and front windshields
A lot of the brightness from the
headlights is lost when the lights are
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I notice here there is a bad scratch on
your bumper. Do you know how that
happened?
I notice your back wheel is missing its
hubcap. What happened to it?
Did you know that your rear window
[or rear taillight] has a crack in it? I
would highly recommend that you get
that fixed as soon as possible, as it can
be dangerous to have such a large crack
in your window [or a water leakage may
short your light out]. In many instances,
insurance companies will pay for the
entire cost of replacing the window.
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Technician Manual
are dirty. Have an assistant use Windex dirty, so it’s a good practice to routinely
and paper towel to clean dirty windows, wash them at each fill-up at the gas
station.
mirrors and lights. If they are, say:
Ask driver to sit back in car and fasten
seat belt.
Review the Checklist to ensure you’ve
completed all items. Address any red
flag issues with the appropriate advice
and/or gadget demonstration.
Review the items in the goodie bag and
relevant assistive devices not already
reviewed during the walk around.
Thank the driver for attending the
event.
Thank you for your interest in safety
and for taking the time today to
participate in our CarFit event. Please
drive slowly to the exit.
Safety Hint: If a driver appears too at risk to drive away from the event,
the Event Coordinator and/or the occupational therapist should initiate a
conversation that offers the following:
• To call a friend or family member and ask that they drive the
participant home; ask the driver take a seat in the waiting area;
• Water, food, and rest until the person called arrives;
• A ride (law enforcement may assist with this) or a cab voucher; or
• To drive the person home.
NOTE: Remember this concern is regarding driving away from the
event and is in no way related to making a recommendation about their
long-term ability to drive. Occupational therapists or Technicians
should make the recommendation for the participant to seek
professional advice from their physician.
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