Thank you for a successful 2016!


This is a little token of my appreciation for all of the referrals since Pathways Driving Rehab started serving clients!  I am celebrating 3.5 years of business, including servicing over 210 people!  In 2016, Pathways Driving Rehabilitation Services has helped 122 people with a variety of medical conditions return to driving, learn to drive with adaptive equipment, maintain driving safely for as long as possible or to retire from driving.  This is 122% growth from the year before!

Please visit my website to watch a video with client testimonials and a video of me in action. This is a great place to direct clients and family members as they are considering using my services.

Each year I have doubled my business.  I would not be able to help people without your referrals.  Together we have made a difference in our communities!! Thank you for helping my business be a huge success!  I am very grateful for all of the support I have had along the way.  I am also grateful to share one of the most beautiful views I have ever experienced!  May you have a year filled with adventure and making a difference in people’s lives!


Heather Shields, OTR/L, CDRS,
owner of Pathways Driving Rehab

It is Senior Driver Safety Awareness Week!


I’d like share some of the common resources I use.  I hope you will share them with your co-workers, clients and family members. 

Driving is a difficult subject for healthcare professionals, family members and community members. Or, should I say, the possibility of not driving.

I have learned a lot since working with seniors and their family members.  This week I will be sharing with you some of my lessons.  I would like to share a nice email I got from a family member today.  She has allowed me to share this.


I wanted to take a minute to Thank You for your services with my mom.  My mom is in that part of her life where driving probably shouldn’t be happening.  It has taken several months of seeing her primary doctor and a neurologist to get to the point where we were introduced to you. I think my mom knew there was an issue with her memory but wasn’t totally convinced she shouldn’t be driving. She knew that even though this was a cost to her, she needed to know for sure.  We learned so much from your evaluation you did at her home with her family and I now understand more of what is going on with my mom.  I know it wasn’t easy for my mom to make the decision to stop driving but I do believe it was in her best interest and I think now she can move on to enjoy her life without this stress over her.

Thank you again for your kind and caring matter in how you handled my mom.


I would love to help make it easier for you to discuss driving with your clients and loved ones.  Please share your struggles and successes by responding in the blog comments.  I would love to answer any questions you may have.

Here are some of the helpful resources I use.  They are put out by AOTA .  My goal is to help make your job easier with this difficult topic.

Heather Shields, OTR/L, CDRS, owner of Pathways Driving Rehab Services
phone 207-530-0307
fax 207-512-1044 

I had a stroke and I’m ready to drive

I have been an Occupational Therapist since 1997.  My first job was at River Ridge, a brain injury center, in Kennebunk, Maine.  This is where my love for the brain developed.  Did you know that our brains control everything that we physically do, smell, see, hear, say, think, perceive the world and help us experience the world? Each area of the brain has a job to do. When someone has a stroke, often there was a bleed onto an area of the brain. This is almost like putting acid on our skin, it eats away at the brain and diminishes the productivity of that little section.  Sometimes the bleed is severe and a large area is affected.  Other times it is a small area and the affects are subtle.  To learn more about the technical and more specific types of strokes, their causes and results, go to the American Stroke Association or the National Stroke Association.

In all cases, the brain has the potential to re-route neuronal pathways, and that’s the magic of being and Occupational Therapist.  We help facilitate new pathways to grow.

This makes me so happy when I see people making improvements during their recovery.  We don’t appreciate what we have until it goes missing one day, or for several months, which is what happens as people recover from a stroke.  People have the ability to heal from a stroke for years.  It is fascinating!  I once had a young man in his early 50’s who had a stroke 5 years prior.  For 4 years, one of his arms was non useable.  He started to regain some function and he wanted to build on it.  He came to me for outpatient therapy and by the end, he was able to ride his bike around the Back Bay Boulevard in Portland, Maine.  His motivation, willingness to learn and work on exercises at home helped him regain use of his arm.  He even gained function in his hand so that he could grasp the hand brake.

When people have strokes, it is devastating.  For most, their ultimate goal is to return to driving.  Most people don’t realize how complicated driving is.  Driving is one of the highest level tasks we do all day.  Driving uses all of our brain.  It takes adequate vision, depth perception, the ability to quickly process information both visually and cognitively, good attention and ability to quickly shift our focus from one thing to the other.  Physical strength getting in and out of the car, being able to control and coordinate the foot and ankle(or both with standard transmission), ability to grasp and hold the steering wheel, reach for the windshield wipers or change the radio station, change the gear shifter or manage the emergency brake, reaching for the seatbelt.  Timing and coordination with the steering wheel as we enter into traffic or dodge a dangerous situation.  The ability to plan ahead, plan our route while remembering what the final destination is and why we are going there.  Physical ability and flexibility as we turn to check our blind spot before changing lanes or looking behind us when we back up in a busy parking lot.  Memory to remember the list of items we are getting at the grocery store, which kid has to be picked up where and when they need to be somewhere.  Concentration to stay focused in the moment while ignoring unimportant information.

Many people take driving for granted.  It is just something that they have done without much thought for many years.  They feel like driving will be natural when they get back into the car.  For some it does and for some it does not, especially when they have had a stroke.

These are some of the major concerns following a stroke.  Remember, these areas can improve with time and rehabilitation, but not overnight. If you or someone you know has had a stroke and is ready to get back to driving, starting with a comprehensive driving evaluation can be so valuable.  There are simple adaptations that can make a major difference.  If someone can only use one arm, they may benefit from a spinner knob to turn the steering wheel.  Or they may need a blinker on the right side, if the left arm is not working.  Driving rehabilitation is my specialty and Neuro Rehab is my passion.  I have 19 years of experience helping people recover from strokes and other neurological conditions.  Please reach out or share this information with someone you know who may benefit.  I look forward to helping you and your loved ones get back to driving!

Visit Pathways Rehab Services website for more information

Call 207-530-0307 for a free phone consultation to see if this is the right time to drive.

I was interviewed by Derek Volk, author of “Chasing The Rabbit, A Dad’s Life Raising A Son On The Spectrum.”

Screenshot 2016-03-29 08.20.02

I was curious to learn more about teaching teenagers with special needs how to drive.  I learned about Derek Volk from a client, then I attended one of Derek’s talks at the Topsham Public Library on January 21, 2016.  He has been touring the country promoting his book.  I had a chance to speak with him and pick his brain following his talk.  He was kind enough to invite me onto his show to help increase people’s awareness about driving rehabilitation and how my unique approach with young adults is so valuable.

Please listen to the interview and share it with people.  We talk about the range of services I provide

To listen to the interview, click here. 


When we notice changes in our loved ones, it is important to be honest and communicate in a caring way


Last week I wrote about signs that it’s time to reevaluate driving .  This week I am giving tools to communicate in a caring and honest way.

Here are some of my recommendations:

1. If there is a medical condition causing the problems, place the focus on the condition.  It makes it less personal.  It truly is the affect of the medical condition that causes limitations with driving.  Be honest and point out specific examples of how you have witnessed the medical condition causing problems in your loved one’s daily routine.

2. Relate how your concerns with the medical condition relate to skills needed for driving.  An example: “Dad, you know how you have had several falls in the past year?  You have been falling because you do not have good sensation in your feet anymore.  That is a common side affect from advanced diabetes.  I am concerned that you use your right foot to drive and it is your right foot that you have poor sensation.”

Or, “Mom, I have noticed that you have trouble paying attention when I come visit.  You have been asking me the same questions over and over.  Each time I answered your question and showed you how to do it.  I even wrote it down for you.  I am concerned that you are not able to pay attention like you used to.  It is important for you to pay attention when you are driving, especially in parking lots, near schools and in traffic.”

3. Try to stay positive about the concerns and give your loved one the benefit of the doubt.   Be a passenger in the car while your loved one drives to familiar places.  Take notes about how they did and review it after.  Things to pay attention to are maintaining speed, staying centered in the lane, making complete stops at stop signs, attention and reaction with left and right hand turns, ability to handle traffic.  Review your observations at the end of the drive.  This can open a conversation about why you have concerns.

4. It may be time for a formal driving assessment with Pathways Rehabilitation Services. This takes away the family dynamic and gives a professional opinion.

5.  Acknowledge that this is a difficult conversation but important because you love them and want them to stay safe.

Click here to learn more about helpful resources available to make difficult conversations easier.

Signs That It’s Time to Reevaluate Driving


I often receive calls from concerned family members regarding their loved one’s safety with driving.  It is such a difficult subject because driving represents freedom and independence.  It is often people’s last sense of control and purpose.  It is so important to stay connected to the people and places we love.  In our society, driving is the easiest way to get from point A to point B.  It is not always the safest way, especially as we age.  When we age, our processing of information slows down.  Our ability to see or hear and respond slows down.  Our ability to quickly shift from one thing to another slows down.  Our physical abilities also slow down.  It is the combination of those affects that make it potentially unsafe for someone to drive.  When there has been a cognitive decline, that is the time to be concerned.  There is no magic age when it becomes concerning for someone to retire from driving.  I have worked with a person in their early 60’s who had dementia and lost their way to the grocery store.  I have worked with men in their 90’s who were very confident, alert, physically active and responsive with their driving.  It is truly related to how someone’s condition and cognition have changed that prompts concerns.

Here are some warning signs family members, friends and neighbors may notice that would be an indicator that driving may not be safe: 

1. Management at home declines.  A person has had a shift in their ability to take care of their home.  The laundry is not done like it used to be.  There are dirty dishes in the sink and on the counter, when they used to be placed in the dishwasher.  A person is overwhelmed with tasks around the house that used to be mundane.

2. Financial management needs some overseeing.  When a person is making poor financial decisions, forgetting to pay the bills, writing little notes to themselves to pay bills and forgetting where they put the notes.  Those are signs of cognitive decline.

3. Self care: When a person wears the same clothes day in and day out, or does not remember to take a shower.  They become resistant when someone suggests to change their clothes or take a shower.

4. Decline in proper nutrition: When someone is loosing weight.  When the food is outdated in the fridge.  When a person needs reminders to eat.  I recently had a client who is living alone at home with dementia.  Her daughter works and brings over food each week.  She placed the food in containers and put labels on them.  When she came to check on her mother, the food was untouched in the fridge. One month prior, the mother had been cooking and eating properly.  These are all signs of cognitive decline.

5. Emotional changes: It is common for people with cognitive changes to be anxious or easily frustrated.  I observe people becoming very easily irritated and angry, which has not been their nature in the past.  When there are cognitive changes, people lose control and this feels very scary.

6. Memory and attention changes: Memory loss, declining ability to concentrate, getting easily distracted, difficulty following conversation and organizing daily tasks affect safety with driving.  Driving is a very complex task, requiring a high level of attention to many different stimuli at once.

When a loved one has any of these changes, it may be time to reevaluate driving.

If this sounds familiar and you want to discuss your concerns contact us today. 



Senior Driving Awareness Week: Driving Safer, Longer

This week is AOTA’s Older Driver Safety Awareness Week, December 7–11, 2015, which aims to promote understanding of the importance of mobility and transportation to ensure older adults remain active in the community—shopping, working or volunteering—with the confidence that transportation will not be the barrier to strand them at home.


Did you know that age is not the only reason to retire from driving?  Some states are requiring people at a certain age to take a road test.  Studies show that it is a combination of affects that limit someone’s safety with driving.  Naturally, aging does come with medical affects, such as conditions of the eyes: glaucoma, macular degeneration, complications from diabetes.  Aging may cause conditions of the spine, such as arthritis, making it difficult to turn the neck, a necessary skill for driving.  Aging may cause decreased reaction time due to slower reflexes or slower cognitive processing.

I am proud to be the creator of Pathways Rehabilitation Services, a unique driving school focusing on helping older drivers and people with medical conditions. My goal is to help people drive safer and longer.  I have been fortunate to have worked with many older drivers and their family members.  Through my comprehensive evaluation and personalized driving training, clients and their family members are able to be at peace with my recommendations. 

If you know any aging drivers who may need to revisit or refresh their driving skills, contact us today!