scholarly journals Implementation and evaluation of a driving cessation intervention to improve community mobility and wellbeing outcomes for people living with dementia: study protocol of the ‘CarFreeMe’ for people with dementia program

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Theresa Scott ◽  
Jacki Liddle ◽  
Geoffrey Mitchell ◽  
Elizabeth Beattie ◽  
Nancy Pachana
2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 673-673
Author(s):  
Isabel Margot-Cattin ◽  
Sophie Gaber ◽  
Nicolas Kuhne ◽  
Camilla Malinowski ◽  
Louise Nygard

Abstract For older adults to “age in place”, they need to keep engaged and mobile in their communities, whatever their health condition. The impact of age and cognitive decline on community mobility is a growing problem in Europe and worldwide. Engaging in occupations outside home implies being able to get to those places where activities are performed. Yet little is known regarding the types of places visited, maintained or abandoned for older adults with/without dementia. This study addresses community mobility needs through the places people visit, maintain or abandon. People with and without dementia, aged 55+, were interviewed using the Participation in ACTivities and Places OUTside the Home (ACT-OUT) questionnaire across Switzerland (n=70), Sweden (n=69) and the UK (n=128). Results show that people with dementia experience a higher rate of abandonment for more places than regular older adults. Insights about driving cessation and access to travel passes will be presented.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 289-289
Author(s):  
Theresa Scott ◽  
Jacki Liddle ◽  
Elizabeth Beattie ◽  
Louise Gustafsson ◽  
Geoffrey Mitchell ◽  
...  

Abstract Community mobility is an important social determinant of health. For people living with dementia, the forfeiture of a driving licence can signal a loss of independence, limiting access to activities outside of the home. Loss of community connectivity and social participation has a substantial impact on quality of life and may lead to depression and more rapid cognitive decline. This study is focused on a driving cessation intervention that helps people with dementia identify personal goals that are framed around community mobility and adjusting to life without driving. Health professionals work with participants to translate these into specific, practical and achievable outcomes by program end. Participants may nominate more than one goal. This study reports on goal setting and achievement. Using a modified version of the Canadian Occupational Performance Measure it examines pre- to post-intervention achievement of, and satisfaction with, identified goals for 17 participants living with dementia aged 63-93 (M=75.24, 76% male) from regional and metropolitan Australia. Thematic analysis of clinical interviews and field notes highlighted the range of desired goals, and the challenges posed and problem-solving strategies used in setting realistic, non-driving goals. Significant positive improvements were found across a total of 29 goals for (i) performance t(28) = -10.01, p < .000, and (ii) satisfaction, t(28) = -10.32, p < .000. The implications for practice are that supportive goal-setting of personally relevant objectives and valued activities following driving cessation may be effective in lessening some of the negative effects of giving up driving for people with dementia.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
B. de Boer ◽  
J.P.H. Hamers ◽  
H.C. Beerens ◽  
S.M.G. Zwakhalen ◽  
F.E.S. Tan ◽  
...  

2018 ◽  
Vol 8 (1) ◽  
pp. 190-198 ◽  
Author(s):  
Latha Velayudhan ◽  
Sarah Baillon ◽  
Gabriela Urbaskova ◽  
Laura  McCulloch ◽  
Samuel  Tromans ◽  
...  

Background: Although driving by persons with dementia is an important public health concern, little is known about driving cessation in younger people with dementia. We aimed to determine the prevalence and factors affecting driving cessation in individuals with and without dementia aged under 65 years attending a memory clinic in a European setting. Methods: Subjects were consecutive patients assessed at a specialist memory service at a university teaching hospital between 2000 and 2010. The data collected included demographic, clinical, standardized cognitive assessments as well as information on driving. Dementia diagnosis was made using ICD-10 criteria. Results: Of the 225 people who were or had been drivers, 32/79 (41%) with young-onset dementia (YOD) stopped driving compared to 25/146 (17%) patients who had cognitive impairment due to other causes. Women were more likely to cease driving and voluntarily than men (p < 0.001). Diagnosis of YOD was associated with driving cessation (1.193, 95% CI 0.570–1.815, p ≤ 0.001), and was mediated by impairment in praxis with the highest indirect mediation effect (0.754, 95% CI 0.183–1.401, p = 0.009). Conclusions: YOD diagnosis, female gender, and impairment in praxis have a higher probability for driving cessation in those under 65 years of age with cognitive impairment.


2020 ◽  
Vol 60 (7) ◽  
pp. 1261-1272
Author(s):  
Elaine Stasiulis ◽  
Mark J Rapoport ◽  
Brintha Sivajohan ◽  
Gary Naglie

Abstract Background and Objectives Despite the well-recognized difficulty that persons with dementia and family carers experience in the decision making and transition to nondriving, there are few interventions and resources to support them. As part of our ongoing research to develop a driving cessation toolkit that addresses this gap, we sought to examine the context-specific factors relevant to its effective implementation in settings that support older adults with dementia. Research Design and Methods A qualitative descriptive approach was used to explore the perspectives of Alzheimer Society (AS) staff in their work of supporting people with dementia and family carers within the context of driving cessation. Individual in-depth interviews were conducted with 15 AS staff members in 4 Canadian provinces. Data were examined using interpretative thematic analysis. Results The study results revealed an overarching paradox that despite the importance of driving cessation in people with dementia, it continues to be largely avoided at the individual and system levels. This is explored via the themes of (a) paradox of importance and avoidance identified in AS settings; (b) lack of awareness and understanding about dementia and driving among people with dementia and family carers; (c) distress and avoidance rooted in ongoing system issues; and (d) moving driving cessation to the “front burner.” Discussion and Implications Viewed through the emerging social health paradigm, which focuses on the social and emotional consequences of dementia, our results highlight the urgent need to mobilize our communities, medical education systems, and transportation authorities to finally resolve the dementia and driving cessation paradox.


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