North Dakota woman helps aging or disabled drivers decide if they should still get behind the wheel
An occupational therapist by training, Joy Tandberg of Dak-Minn Driving and Home Evaluations, LLC, works with people whose driving has been affected by factors like age, injury or progressive disease and helps determine if they can still safely get behind the wheel.
BUXTON, N.D. — Peggy Beuchler knows her way around a car.
The Minot 70-something has been driving since she was a 14-year-old farm kid. After she got married, she decided to join her husband, David, in his favorite hobby: drag racing. Beuchler drove a souped-up 1972 Dodge Dart, accelerating to 80-plus miles per hour within seconds in efforts to beat other drivers on a drag strip.
But in 2021, Beuchler suffered a stroke. She had to relearn how to drive by tooling a golf cart around the family farm. Although her license hadn’t been revoked, she didn’t feel safe driving on the highway.
The inability to drive “was devastating, to say the least,” she says.
Then her physical therapist connected her to Joy Tandberg of Dak-Minn Driving and Home Evaluations, LLC. Tandberg is one of just several Driving Rehabilitation Specialists in the state. Tandberg works with people whose driving has been affected by factors like age, injury or progressive disease and determines if they can still safely get behind the wheel.
At Beuchler’s home, Tandberg gave her an extensive cognitive assessment — evaluating factors like reaction time and short-term memory — to gauge whether she had the faculties required to operate a motor vehicle.
Later, with the green-light from her neurologist, Beuchler got back in the driver's seat so Tandberg could assess her road skills first-hand. They spent hours practicing together so Beuchler could relearn how to use a left-foot gas pedal and brake pedal to accommodate for her weakened right side.
On July 27, Beuchler took her driver’s test in Minot. She passed, “in flying colors, they told me,” Beuchler says. "I have my freedom back and can go where I want when I want. I don’t have to depend on my husband to drive me.”
Beuchler continues to drive with left-side pedals and a post on her steering wheel, which makes turning easier. She credits her regained independence to Tandberg.
“She was great,” Beuchler says. “She was so patient. I asked, aren’t you afraid to ride with me and she said no, I have my (instructor’s) brake over here so I can stop the car if I need to. Her personality was so bubbly and she made me feel at ease.”
Beuchler says she would recommend a Driving Rehabilitation Specialist like Tandberg to anyone whose driving skills may have been affected by aging or a health condition. “Go the proper route,” she says. “Find a person like Joy, who has the schooling and the training for it. I wanted to be safe, not only for myself, but I was concerned for the other drivers out there.”
Stories like Beuchler’s are the most rewarding part of the job for Tandberg. In some cases, she can suggest adaptive tools such as cross-over turn signals, hand controls, spinner knobs on the steering wheel and panoramic rearview mirrors to help people drive better. In some cases, she can train people with mental techniques to help them sharpen their road skills.
Or she may find the person is doing just fine, thank you — like the time she evaluated a 92-year-old man who drove nearly perfectly.
But the difficult part of her job is telling people who have driven everywhere their whole lives that they can no longer safely operate a motor vehicle.
“What’s very hard is when I have to say to somebody, ‘You are not safe to even drive down to have coffee with the boys in the morning,’” Tandberg says. “I have cried with many, many patients when I’ve had to give them that kind of information. Those are the times that it’s really hard.”
She's found the driver’s license is one of the most difficult privileges to surrender. The ability to drive is key to maintaining self-sufficiency and independence — especially in a rural state in which the nearest grocery store might be 20 miles away.
Yet it is sometimes the only way to ensure an impaired driver isn’t endangering themselves or others every time they hit the road.
“People do see me as that lady who is going to take their driver’s license away,” Tandberg says. “What they don’t realize is that as an occupational therapist, my goal is to help them maintain independence and participate in activities and stay healthy. I truly want people to be able to get to church or go out to coffee with the boys, as long as they’re going to be safe. If there’s a question of safety, then, yes, I do need to step in and say this isn’t where we need to be right now.”
And sometimes the danger of allowing someone to drive becomes crystal clear, especially when a client heads the wrong way down a one-way street, drives up on a sidewalk or makes an alarmingly close left-hand turn before oncoming traffic on a state highway. Then Tandberg is pretty grateful for her passenger-side brake.
“Luckily, my angels have always caught up with me,” says Tandberg, an affable woman with a healthy sense of humor. “We haven’t had any accidents.”
To drive or not to drive? That is the question
An occupational therapist for 38 years, Tandberg says she knows first-hand how difficult it can be when long-time drivers have to give up the keys.
While living in Colorado, Tandberg was caring for her elderly mom and helping her determine if she could still drive.
Tandberg's siblings all had different views on the subject. “Just like with every family, we had seven kids and one mom and eight differing opinions," she says.
Then her mother got in a minor accident, which made the decision for them. Everyone, mom included, thought it best to retire her license.
Nearly four years ago, Tandberg moved to North Dakota to work with Altru in Grand Forks. Through the encouragement of a mentor who did driver’s rehabilitation work, she decided to launch a similar business here.
Since then, Tandberg has stayed busy, sometimes driving from her home near Buxton to as far away as Bismarck or Minot to work with clients. As the only mobile Driving Rehabilitation Specialist in the state, she's learned that many clients get less anxious about taking a driving evaluation if they can do it in the community where they live and drive vs. traveling to a larger city.
More often than not, Tandberg is contacted directly by family members or the healthcare provider of the potential client. The state can only restrict or revoke a license if the person’s physician signs off on it, so their healthcare provider is part of the process.
People who are sent to her for evaluation may be aging, experiencing diseases like Parkinson's or multiple sclerosis, recovering from stroke or traumatic brain injuries or living with conditions that affect mobility, such as paralysis or loss of a limb.
Tandberg’s role is to conduct a comprehensive clinical evaluation first, in which she looks at cognitive skills. By the end of this portion, Tandberg usually can anticipate whether it's safe to move onto the next step: operating a vehicle for the driving evaluation.
The evaluation process is thorough because driving is so complex, even though most of us are so accustomed to it that we don’t realize it. It requires use of all the senses as well as multiple executive-function skills such as focus, reaction time, multi-tasking, problem-solving and short-term-memory.
From that point, Tandberg will send her recommendations — varying from full driving privileges to driving with adaptations like hand controls, restrictions like daytime driving only or complete revocation of the license — to their doctor for their signature.
The family's role
Tandberg has found her recommendations sometimes add clout to a family’s or doctor’s recommendations to the client.
One gentleman came to her after his doctor and family couldn't make him stop driving. He had Parkinson's disease and some cognitive changes and they were concerned he could no longer drive safely.
As they progressed through the cognitive portion of the test, she realized it wouldn't be safe for him to proceed to the driving portion.
He wasn’t pleased to hear that. But Tandberg sat down with him and broke down how he did on each piece of the evaluation and explained how each skill tested related directly to his ability to drive.
At the end of her explanation, the man said, “That’s the best money I’ve ever spent. Nobody has told me why they don’t want me to drive. They just said I couldn’t drive.”
If possible, Tandberg requests that a family member be present for the clinical evaluation, so they can provide additional information or witness first-hand how a parent is functioning.
She tells of one case in which a daughter sat in on her dad's cognitive test. When Tandberg asked why they were concerned, the daughter said, “I think he’s a great driver. It’s my sister who started all this.”
As they proceeded with the tests, Tandberg observed the daughter quietly getting up several times to walk away and discreetly wipe away tears. Afterward, when Tandberg concluded that the gentleman couldn’t proceed to the driving portion, the daughter told Tandberg: “I had absolutely no idea it was this bad.”
Driving restrictions or revocation can be a “very touchy subject” to bring up with drivers and loved ones because we have an independent Midwestern spirit that doesn’t want to admit loss of function or ask for help, she says. Families may also resist news that dad can’t drive because it places an extra burden on them to figure out how he can get to the doctor or attend church.
So another part of Tandberg’s job is to help clients and their families brainstorm solutions: Could they take turns driving her to the grocery store? Could they work with a social worker or local senior group to learn more about transportation options?
"Every county in North Dakota has a transportation service, which seniors can use for a really minimal fee,” she says. “It might be that you have to plan your schedule around when they make the trips. The point is there are options.”
She also reminds families that getting out to do activities and interacting with others is essential to any human’s well-being. “You can’t forget that the (retired driver) wants to hang out at the lake too, or they want to drive and look at the crops or go to the Dairy Queen and have a parfait. As the kids or nieces and nephews, we owe it to them to try to help them have a good quality of life.”
The cost of Tandberg's comprehensive evaluation, which can take up to three hours, is $400, while training with adaptive equipment is $140 per hour. Most insurance companies typically will not cover it, Tandberg says.
Although Tandberg's work has its challenges, it also has its victories — especially when she can help someone find a way to hit the road again. “When I can help people regain independence, I can’t explain the feeling that I have,” she says.
Learn more about Dak-Minn by calling (701) 330-4445 or go to www.dakmindriving.com.
Fargo has only Certified Driving Rehabilitation Specialist in state
Fargo is fortunate to have the only Certified Driving Rehabilitation Specialist in the state. Lia Dobrinz helped set up the driving rehabilitation at Meritcare, now Sanford, 25 years ago.
Dobrinz has seen Sanford's program grow progressively busier with the aging of Baby Boomers. The good news is that Boomers are more likely to be proactive in retaining their driving skills. "They took the AAA and AARP classes so they can keep their privileges and try to retain their skills for as long as they can," she says. "It's inspiring."
Like Tandberg, Dobrinz finds her work is a blend of rewarding moments like helping someone with disabilities realize they can drive again and the hardship of informing some people they should probably hand over the keys.
In the latter circumstance, she will sometimes discuss with them how they've had a spotless driving record up until that point, so it would be a shame to spoil it by inadvertently causing an injury or serious accident.
"At the end of the day, it's helping to keep the road safe. That really is our goal: safety and independence," she says. "I would rather have someone be upset with me and keep them alive and healthy."
Dobrinz recommends several free resources that can help people talk to their loved ones about whether or not they should continue driving. They include:
- "We Need to Talk," by the AARP
- "At the Crossroads. Family Conversations about Alzeheimer's Disease, Dementia & Driving," by The Hartford :
To contact the Sanford Driver Rehabilitation Program, call (701) 234-5799.