If you're worried about your parent's driving, a driving evaluation for seniors gets you a professional's answer, and that answer isn't always to stop driving. A driver rehabilitation specialist, often an occupational therapist with extra training, checks vision, thinking and physical abilities and may also test your parent in a car and on the road. Depending on what they find, the specialist can recommend training, equipment, new routes or limits such as daylight-only driving that let some older drivers keep going safely.

In This Guide

Who Does a Driving Evaluation for Seniors?

The professional you're looking for is a driver rehabilitation specialist, sometimes shortened to DRS. According to NHTSA, the specialist is often an occupational therapist, and can give an in-depth evaluation of a person's driving and work out whether and how a particular condition, such as Parkinson's, stroke or diabetes, is affecting it.

The evaluation isn't only a pass-or-fail exam. NHTSA says the specialist may offer training to improve the person's driving safety, and may suggest installing specialized equipment in the vehicle to keep the person driving safely longer, along with training on how to use it. That's an important difference from what many families picture. A driver rehabilitation specialist is trying to find out what's getting in the way of safe driving and whether something can be done about it.

The National Institute on Aging (NIA) puts the options a little more broadly, suggesting a driver have their skills checked by a driving rehabilitation specialist, an occupational therapist or another trained professional.

What Happens During a Driving Evaluation

The clearest federal description of the evaluation itself comes from a clinician-education handout published by the Department of Veterans Affairs. It's written for VA clinicians as an educational resource rather than a statement of VA policy, but it describes the general practice well.

According to that handout, driver rehabilitation specialists evaluate three kinds of abilities that support driving:

  • Sensory abilities: vision and proprioception
  • Cognitive abilities: the thinking skills driving draws on
  • Motor abilities: the movement skills that support driving

The handout adds that specialists may also provide assessment or training in the vehicle and on the road. Whether a particular program includes an on-road portion, and what it looks like, is something to ask when you call.

What Can Come Out of It

This is the part that tends to ease a parent's fear. The VA handout lists a range of recommendations a driver rehabilitation specialist can make, and only one of them is to stop driving:

  • Rehabilitation, when the specialist judges that the lost abilities can be restored
  • Vehicle modifications to make up for physical limits, such as hand controls or a left-foot accelerator
  • Strategies to work around a problem, such as route changes (no left turns, avoiding rush hour)
  • Restrictions that support continued driving, such as daylight driving only or speed limits
  • A recommendation to the primary care provider that the person is unsafe to drive and should retire from driving

So an evaluation can end with a parent still driving under limits such as daylight-only, or with a clear, professional recommendation to retire from driving. Either way, the family has something firmer to stand on than a hunch.

When to Get a Driving Evaluation

The VA handout says clinicians should consider ordering an evaluation whenever the person, family, friends or the clinician have concerns about the person's fitness to drive, and that it's particularly useful when there's disagreement about whether the older driver is safe. If you and your parent see the same drive differently, a neutral professional can settle the question without anyone having to be the villain.

Age alone isn't the trigger. NIA says there's no one recommended age to quit driving, and NHTSA says decisions about someone's ability to drive should never rest on age alone. What matters is how the person is actually driving, which is why riding along with them is worth doing before you book anything. Our guide to when an older adult should stop driving walks through the warning signs to watch for.

If your parent has dementia

A dementia diagnosis is often what pushes a family to act, and an evaluation fits that moment well. NHTSA's 2023 fact sheet on dementia for medical professionals says a diagnosis of dementia is not, on its own, a sufficient reason to withdraw driving privileges; that a significant number of drivers with dementia can drive safely in the early stages; and that the deciding factor is driving ability and how much and what kind of driving the person does. The same sheet notes that office clinicians don't measure driving competence directly but can refer patients to occupational therapists and driving rehabilitation specialists for behind-the-wheel assessments.

The evaluation is a snapshot, though, not a permanent pass. NHTSA says that for someone diagnosed with Alzheimer's or another dementia, the question isn't whether the person will have to stop driving but when. NIA's list of signs that a person with Alzheimer's should stop includes failing a driving test or other driving evaluation, alongside things like new dents or scrapes on the car, multiple near misses, and taking a long time to run a simple errand without being able to explain why. NHTSA's separate list of early warning signs that Alzheimer's is affecting driving includes getting lost in familiar places. Because people with dementia often don't realize they're having driving problems, NIA says family members need to keep watching the person's driving after any evaluation. Our guide to the stages of dementia explains how abilities typically change over time.

Don't wait for an evaluation in an emergency

Some situations can't wait for an appointment. NHTSA says a driver who fails to stop at red lights and stop signs, or to yield as traffic laws require, puts themselves and others at extreme risk, and that calls for immediate action to stop the driver. In that case, keep your parent from driving first and arrange the evaluation afterward if it still makes sense.

Check the medicines, too

Medication changes are worth raising before or alongside an evaluation. NHTSA notes that changes in an older person's medications can make it hard to drive safely, and NIA advises asking a doctor or pharmacist whether any health problem or medicine might make driving unsafe. Don't stop or change a medicine on your own; ask the prescriber. Our guide to managing an aging parent's medications covers how to keep track of what they take.

How to Find a Driver Rehabilitation Specialist

These steps follow the places NHTSA and NIA point families to.

1
Step 1

Search the national directories

NHTSA points to the American Occupational Therapy Association's Older Driver Resource Center, and NIA says the association maintains a national database of driving specialists. NHTSA also points to the Association for Driver Rehabilitation Specialists, which you can reach at 800-290-2344 or through its website.

2
Step 2

Call local hospitals and rehabilitation facilities

NHTSA suggests calling hospitals and rehabilitation facilities in your area to find an occupational therapist who can help with a driving skills assessment.

3
Step 3

Ask your parent's doctor or your state DMV

NIA says you can ask the state's Department of Motor Vehicles or the doctor to recommend someone who can test driving skills.

4
Step 4

Check whether your state keeps a list

Some state agencies point drivers to specialists directly; New Jersey is one example, described below.

A state example: New Jersey

New Jersey shows what state-level help can look like. The New Jersey Motor Vehicle Commission keeps a courtesy list of licensed driver rehabilitation specialists and tells drivers to contact the program directly for pricing. The NJ Division of Disability Services links to that list and also points to the Association for Driver Rehabilitation Specialists' searchable database of certified specialists. Both agencies describe the specialists' services the same way: evaluating a driver's physical and cognitive capabilities, special training and adaptive vehicle equipment for drivers with medical conditions and disabilities, and rehabilitation for people whose illness or injury has affected their driving. If you live in another state, your DMV's medical or older-driver page is a reasonable place to look for something similar.

Questions to ask when you call

Programs differ, so a short phone call before booking saves surprises. Questions worth asking:

  • What does the evaluation cost, and do you bill any insurance?
  • Do you need anything from my parent's doctor before the appointment?
  • Does the evaluation include time in a car or on the road, and whose car is used?
  • Who receives the results and recommendations?
  • If you recommend training or equipment, do you provide it?

What a Driving Evaluation Costs, and Whether Medicare Pays

No federal source sets a price for a driving evaluation, and it would be guesswork to quote one here. NIA's guidance is simply that there may be fees associated with these assessments. The New Jersey Motor Vehicle Commission likewise tells drivers to contact each program for pricing. Plan on asking each program you call.

Medicare coverage is narrower than many families expect. The detailed rules come from local coverage determinations: decisions a Medicare Administrative Contractor makes about what Medicare covers within the jurisdiction it oversees. We reviewed two of them, and they reach the same bottom line: neither covers an assessment done only to decide whether a person should stop driving.

Policy Where it applies What it says about driving assessments
LCD L34049 (CGS Administrators) Kentucky and Ohio Lists driving assessments among services that are non-covered as skilled therapy
LCD L33631 (Wellpoint Federal) Illinois, Minnesota and Wisconsin; Connecticut, New York, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont Covers driving assessments under an occupational therapy plan of care only when driving ability is expected to be restored or improved and the need relates to a specific injury or illness; generalized aging, weakness or debility doesn't qualify, and an assessment solely to disqualify a driver isn't covered

L33631 also says that for patients who meet those criteria, compensatory training in driving techniques may be covered under the occupational therapy benefit. Under LCD L33631, Medicare coverage of a driving assessment depends on a specific injury or illness and a goal of restoring or improving driving; generalized aging alone doesn't qualify.

These are two contractors' policies, not a national rule, and we haven't reviewed the policies for other regions or for Medicare Advantage plans. Before the appointment, ask the program whether it expects Medicare or another insurer to pay, and call your parent's plan if you're unsure. Our guide to how Medicare covers physical, occupational and speech therapy explains the broader therapy benefit.

How It Differs From a DMV Driving Test

A driving evaluation from a specialist is a clinical service a family arranges. A DMV test is the state licensing agency's own process. NIA mentions both, suggesting families consider a driving test or other driving evaluation at the state's department of motor vehicles as one option for a person with Alzheimer's.

A DMV review can also start without the driver choosing it. NHTSA says that in almost every state a family member can report a driver to the DMV in writing. In Utah, for example, a reported driver may have to complete a driver review that includes a written knowledge test, a vision exam and a driving skills test, and afterward may be granted a restricted driving privilege or denied one. Our guide on how to report an unsafe older driver to the DMV covers that route in full. Separately, some states add tests at license renewal once a driver reaches a certain age; see older driver license renewal rules by state.

Talking to Your Parent About Getting Evaluated

How you raise the idea matters as much as the evaluation itself. NHTSA suggests basing the conversation on what you've actually observed, letting the family member or friend your parent listens to best lead it, and using "I" messages, such as "I am concerned about your safety when you are driving," rather than "You're no longer a safe driver." NIA adds that it helps to talk about the person's driving skills rather than their age, and to come back to the subject gradually instead of forcing it in one conversation.

An evaluation can be an easier ask than "please stop driving." Framing it as a way to find out what would help your parent keep driving safely is accurate, given the range of outcomes a specialist can recommend. One practical point: NHTSA notes that health care professionals such as physicians, eye care specialists and pharmacists can't talk with the family about the driver until the driver signs a release form. If you want to hear the results directly, ask about a release when you book.

If the talk doesn't go well, our guide to when an older adult should stop driving has more on making a plan and following through.

Frequently Asked Questions

Does my parent need a doctor's referral for a driving evaluation?

None of the federal sources we rely on here sets a general referral requirement, so ask each program what it needs before you book. What federal guidance does say is that a doctor can help: the VA clinician handout says clinicians should consider ordering an evaluation when anyone has concerns about fitness to drive, and NIA says a doctor can recommend someone who can test driving skills.

Does Medicare cover a driving evaluation for seniors?

Medicare doesn't cover a driving evaluation done only to decide whether someone should stop driving under the two Medicare contractor policies we reviewed, LCD L34049 (Kentucky and Ohio) and LCD L33631 (Illinois, Minnesota, Wisconsin, New York and the six New England states). LCD L33631 covers a driving assessment only under an occupational therapy plan of care aimed at restoring or improving driving after a specific injury or illness. Other regions and Medicare Advantage plans may differ, so when you call a program, ask whether it would bill Medicare as part of an occupational therapy plan of care and whether your parent's situation fits.

What happens if my parent doesn't pass?

A driver rehabilitation specialist makes recommendations rather than handing out a simple pass or fail. Those can range from training, equipment, route changes and restrictions such as daylight-only driving to a recommendation to the primary care provider that the person retire from driving. Whether a doctor or anyone else must tell the DMV about a medical condition is a separate question of state law; our guide on whether doctors have to report dementia to the DMV explains the rules in the states we've verified.

Can someone with dementia still get a driving evaluation?

Yes. A diagnosis doesn't rule one out, and clinicians can refer drivers with dementia for a behind-the-wheel assessment, as described above. The result may not be all-or-nothing, either. NIA says some people with memory loss can drive short distances on local streets during the day but can't drive safely at night or on a freeway, and that in that case the person's driving times and distances should be limited. If your parent's driving changes after the evaluation, ask the specialist or their doctor whether it's time to look again.

Learn More

CaregiverWhen Should an Older Adult Stop Driving? How to Know and What to DoThere's no set age to stop driving. The warning signs it may be time, how to have the conversation, dementia and driving, and how to stay mobile after. CaregiverHow to Report an Unsafe Older Driver to the DMVIn almost every state you can report an unsafe elderly driver to the DMV in writing. What to include, what happens next, and whether your parent will know. CaregiverDo Doctors Have to Report Dementia to the DMV?In some states, yes. California, Oregon and Pennsylvania require doctors to report; Delaware repealed its law. What each law says and what happens next. CaregiverOlder Driver License Renewal Rules by StateLicense renewal rules for older drivers by state: when renewal moves in person, adds a vision test or shortens the license, each row cited to its source. CaregiverGiving Up a Driver's License: How to Surrender It and Keep a Photo IDHow to surrender a driver's license and keep a photo ID (free in some states), plus what to do with the car's plates and the disability parking placard. CaregiverSenior Transportation: How to Get Around When You No Longer DriveSenior transportation options when an older adult stops driving: aging-network rides, ADA paratransit, Medicaid medical rides, and how to pick the right one.

Find personalized help arranging a driving evaluation for your parent at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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