Research Papers

A driving cessation decision-making and coping framework and toolkit for people with dementia

Version 1
Date added June 26, 2017
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Category 2017 CARSP XXVII Toronto
Tags Research and Evaluation, Session 3C
Author/Auteur Gary Naglie
Stream/Volet Research and Evaluation

Slidedeck Presentation Only (no paper submitted)



Drivers with dementia and their families inevitably face the need to make decisions about driving retirement. For many, driving retirement marks a transition to increased reliance on others for transportation and social support, and can result in negative outcomes for health and well-being. Existing driving cessation programs for older adults typically neglect the unique challenges experienced by drivers with dementia. This research aims to address gaps in support for driving cessation in dementia through an investigation of the challenges faced and corresponding strategies used by persons with dementia and their caregivers regarding driving. We conducted a range of knowledge creation and synthesis activities to inform the development of an evidence-informed framework to organize driving cessation interventions. These activities include reviews on: driving cessation in individuals with dementia and older adults; sex differences in driving cessation in dementia; psychotherapeutic interventions for older adults with cognitive impairment; intervention approaches to major life transitions in older adulthood; and alternative transportation options for individuals with dementia. We also conducted a qualitative study to explore the perspectives of key stakeholders (healthcare professionals, representatives from relevant organizations, caregivers and ex-drivers with dementia) on strategies to support decision-making and the transition to non-driving. We completed a meta-synthesis across all sources of evidence to identify the important elements for inclusion in an intervention to support drivers with dementia and their caregivers make decisions about driving, and adjust once they have stopped driving. Tools and resources that address driving retirement were also collected, reviewed and organized according to the thematic areas of the framework. Based on the results from the meta-synthesis, we have developed a framework to organize interventions according to different content areas (e.g., education and awareness, advanced planning, emotional support and community access) along the continuum of driving cessation stages. The framework and toolkit for driving cessation interventions represent content areas that depict the various needs of drivers and former drivers with dementia, as well as those of their caregivers, along with corresponding tools and resources to address these. We identified the need to balance practical, problem-based approaches with those that address the emotional and meaning-oriented effects of driving cessation in the context of dementia. Our driving cessation intervention will provide an approach that integrates and addresses a range of practical and emotional needs specific to persons with dementia and their caregivers. The driving cessation and dementia decision-making and coping framework and toolkit offers approaches that can be individualized along with supportive tools and resources, which will increase the accessibility of available resources and improve quality of life by facilitating social inclusion. The framework and toolkit have the potential for widespread impact on the safety and quality of life of individuals with dementia and their caregivers as they transition to life after driving cessation. Next steps include the evaluation of the toolkit and framework in local community settings to maximize its acceptability, effectiveness and scalability.

Gary Naglie