How to Make Your Car More Accessible for Aging, Injury, Disability, or Pregnancy

If you plan to modify your vehicle’s braking, steering, or acceleration, or if you’re looking to purchase a wheelchair-accessible vehicle, talk with a professional, says Susie Touchinsky, an occupational therapist and CDRS. Installing items such as pedal extenders (which attach to the accelerator and brake) or hand controls and spinner knobs for steering on your own could be dangerous. In many states, drivers who use these devices may need to have a restriction added to their licenses as well. 

“If you’re changing how your car starts, stops, or steers, that’s really when you need to work with a specialist to make sure you get the right equipment,” Touchinsky says. 

Even if you aren’t making major changes, a CDRS can keep you from wasting money on modifications that aren’t right for you. “I have people who will shop on the internet, then they get connected with me, and what they think they want is not what they end up with,” Touchinsky says.

If that sounds like the kind of assistance you or a loved one needs, check the American Occupational Therapy Association’s list of driving rehabilitation providers to find one near you. A consultation usually lasts about 3 hours and can be done at a medical facility or at the driver’s home, according to Touchinsky.

Modifications that don’t change how a car drives can be installed without professional help or state approval. But you’ll still want to at least consult with a healthcare provider to make sure those modifications are the best for your needs. For example, your primary care provider, the occupational therapist who’s helping you with an existing condition, or your OB/GYN if you’re pregnant may be able to help. These consultations might be covered by insurance.

Here are some examples of simple modifications that can improve accessibility:

Seat belt grabber (shown below, $8-$10): If you have difficulty reaching across or behind you, this simple and inexpensive add-on will make it easier to pull a shoulder belt across your body.

Cushion for an ostomy bag, port, implanted medical device, or surgical wound ($12 to $100): Drivers or passengers who have an implanted port, ostomy bag, implanted medical device such as a pacemaker, or surgical wound, might find that seat belts are uncomfortable. As a result, they might not buckle up, which puts their lives in danger in a crash, says Elin Schold-Davis, an occupational therapist and CDRS who coordinates the American Occupational Therapy Association’s older driver initiative. Various cushions and shields are available that can make the belt more comfortable.

Some of these modifications may add a small safety risk. For example, a seat cushion can help if you can’t easily see over the steering wheel, which can happen as your body ages. It can also add comfort if your back hurts on long trips. But a cushion might also make it more likely for an occupant to slide under the lap belt in a crash, which could cause ankle injuries. “There’s a trade-off,” Schold-Davis says. “But if you can see over the dash, you may feel that’s worth it.” She says anyone using a cushion should make sure their seat belt is buckled low and tight across their hips and talk with a doctor or an occupational therapist before adding one to determine whether the trade-off is worth it. 

Check your car’s owner’s manual to see whether there are any restrictions specific to your vehicle, Stockburger says. “Some owner’s manuals caution against things like pillows and cushions, as they can interfere with airbag deployment,” she says. In some cases, a seat cover could get in the way of an airbag. In others, a cushion may confuse the vehicle’s sensors that determine whether an airbag should or shouldn’t go off.

Touchinsky says that in her experience, many modern built-in advanced driver assistance systems can help drivers with mobility problems. For example, for people who have difficulty turning their heads, blind spot warning (BSW) and backup cameras can make it easier to see around a vehicle. 

And if you’re in the market for a new vehicle, Stockburger says to look for ones that have seat heights and door openings that make entering and exiting easier. “Both very low and high vehicles can be difficult,” she says. “Power seat adjustments, including lumbar support, and steering wheels that can tilt and telescope can also make tailoring your driving position easier.”

You might also be able to optimize the car you already own without making any modifications. Older drivers can take advantage of CarFit, the free nationwide educational program developed with AAA, AARP, and the American Occupational Therapy Association. It’s designed to help older drivers find comfortable and safe seating positions. During a 20-minute consultation, trained professionals will guide you through 12 steps to sitting more safely and comfortably.

“The program itself is geared for 55-plus, but we don’t turn anybody away,” Kovar says. “Somebody may bring in their mother or grandmother, and we’ll go ahead and help them, too. If a husband and wife both drive a car, we’ll adjust it for both of them.” 

One of the most important changes is making sure the seat belts are adjusted properly so that they don’t cut across the neck or sit too high on the abdomen, which is uncomfortable and could increase the risk of injury. Kovar also helps people adjust their mirrors. And if a car has a memory button for its power seats, she’ll program it so that drivers don’t lose their new seating position.

If there’s no CarFit event near you, the CarFit website can help you set up your own vehicle. “They have some fantastic videos if you’re unable to attend an event,” Kovar says, although she recommends in-person instruction. You can also attend a live virtual event.

If you’re caring for someone who needs assistance getting into and out of a vehicle, Schold-Davis recommends reaching out to an occupational therapist to find ways to avoid injuring yourself. 

Solutions include inexpensive transfer sheets that help passengers slide into a car seat and costly power lifts that bring a passenger up into a vehicle at the push of a button. In some cases, it may make more sense to hire a medical transport service than to modify an existing vehicle.

Even though some of these adaptations may be expensive, Schold-Davis says they’re worth it if they protect the health of a caregiver and the person they’re caring for. “We wear out our caregivers,” she says. “People’s health is worth something; their bodies are worth something.”

If you plan to install adaptive equipment such as hand controls or purchase a converted vehicle such as a wheelchair van, you’ll want to consult with a CDRS first. This equipment isn’t usually covered by insurance and can be expensive. Wheelchair-accessible minivans can cost tens of thousands of dollars more than an unmodified model, for example. 

Some drivers try to make bigger modifications without the help of a professional. But by hooking up pedal extenders or hand controls on their own, they put themselves and other road users at risk, according to Schold-Davis. “I think somehow people think they need to figure it out themselves, and they’re admitting defeat if they’re getting a consult from somebody,” she says.