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The stages of driving cessation for people with dementia: needs and challenges

Published online by Cambridge University Press:  02 September 2013

Jacki Liddle*
Affiliation:
UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
Sally Bennett
Affiliation:
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
Shelley Allen
Affiliation:
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
David C. Lie
Affiliation:
Metro South Older Persons Mental Health Services, Brisbane, Queensland, Australia, and Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Queensland, Australia
Bradene Standen
Affiliation:
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
Nancy A. Pachana
Affiliation:
School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
*
Correspondence should be addressed to: Dr Jacki Liddle, Postdoctoral Research Fellow, UQ Centre for Clinical Research, The University of Queensland, Herston 4029, Queensland, Australia. Phone: +61-7-3346-5583; Fax: +61-7-3346-5509. Email: j.liddle@uq.edu.au.

Abstract

Background:

The impact of dementia on safe driving is well recognized and is generally accepted that all people with dementia are likely to need to cease driving at some stage in the disease process. Both driving and driving cessation can have poor outcomes for people with dementia and their caregivers in terms of health, safety, community access, and well-being. Although approaches to facilitate better outcomes from driving cessation are being developed, the processes of driving cessation for people with dementia are still not fully understood.

Methods:

Within a descriptive phenomenological framework, semi-structured interviews were undertaken with key stakeholders, including retired drivers with dementia, family members, and health professionals.

Results:

Findings from four retired drivers with dementia, 11 caregivers, and 15 health professionals characterized driving cessation for people with dementia as a process with three stages and associated challenges and needs. The early stage involved worried waiting, balancing safety with impending losses, and the challenge of knowing when to stop. The crisis stage involved risky driving or difficult transportation, acute adjustment to cessation and life without driving, and relationship conflict. The post-cessation stage was described as a long journey with ongoing battles and adjustments as well as decreased life space, and was affected by the disease progression and the exhaustion of caregiver.

Conclusions:

The concept of stages of driving cessation for people with dementia could be used to develop new approaches or adapt existing approaches to driving cessation. Interventions would need to be individualized, optimally timed, and address grief, explore realistic alternative community access, and simultaneously maintain key relationships and provide caregiver support.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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