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Driving Miss Daisy

20 June 2024 - Dr Catherine Eltringham

The Emotional Impact of Driving Cessation

The decision to stop driving can be a deeply personal and emotional experience for many. It can represent a series of losses and significant life changes. Patients may feel a loss of independence and identity, especially if they have been the primary driver in their household or have a long history of driving. Open communication about what driving means to the patient and early planning for retirement from driving can help mitigate these feelings.

Community Mobility and Wellbeing

Community mobility is vital for the wellbeing and quality of life for people living with dementia. It facilitates their connection to local communities, enabling participation in social activities. For many, driving is the primary means of transportation, representing not just mobility, but freedom, control, and identity. GPs understand the profound impact that stopping driving can have on patients. As the patient's trusted GP, you can provide early support to enhance and enable a smooth transition.

Strategies for Preparing for Change

GPs can support patients by encouraging them to modify their driving habits gradually. This can include driving less frequently, using alternative transportation methods, and allowing another household member to take over more driving responsibilities. Practising alternative transportation options such as public transport, taxis, or ride-sharing services while still driving can also ease the transition.

Balancing Safety and Independence

Finding a balance between maintaining a patient's independence and ensuring their safety is crucial. By discussing the cognitive, sensory and physical functions affected by dementia, GPs can support patients to understand the potential impact on driving.  Ideally this education should be extended to patients and their families and include information on the signs that driving may be becoming unsafe, such as increased stress while driving, reliance on passengers for navigation, and frequent near-misses or accidents.

Legal Responsibilities and Medical Assessments

Patients with dementia must notify their local transport and licensing authority about their condition. This will typically lead to a medical fitness to drive assessment by their GP. Understanding the legal implications of not reporting a diagnosis, such as loss of insurance coverage or potential fines, is essential for patients. It is important for GPs to understand the assessment process, which may include cognitive tests and on-road evaluations, so that they can support their patients through the process. 

Supporting the Adjustment Process

The adjustment to stopping driving can be challenging. It's important for GPs to help patients feel comfortable with the decision by involving them in the process and ensuring they feel fairly assessed. Providing both practical and emotional support during this time is crucial. This might include helping patients find alternative ways to stay connected to their community and continue participating in valued activities.

The Role of Family Members

Family members play a significant role in supporting patients through the driving cessation process. They should start conversations about the meaning of driving early, help monitor safe driving, and assist in finding alternative transportation options. Keeping lines of communication open and involving a trusted third party if conversations become emotionally charged can also be beneficial.

Conclusion

Driving cessation due to dementia is a complex issue that requires careful management and support. By providing a safe, respectful environment for discussions and emphasising the patient’s dignity and agency in decision-making, GPs can help patients adjust to this significant life change. Practical and emotional support, coupled with early planning and open communication, can greatly improve the transition for patients and their families.

Related courses

For further information, join our Dementia and Driving webinar, brought to you by Dementia Training Australia. This session is designed to equip Australian healthcare professionals with critical insights into the complexities of driving assessments for individuals living with dementia. 

Dr Catherine Eltringham
Dr Catherine Eltringham

Catherine is a GP in Geelong, Victoria. She has been involved in a wide variety of Medical Education opportunities, these include GP training, lecturing in Medicine at Deakin University, and providing clinical consultancy for the Deakin Indigenous Health team. Over recent years Catherine has moved into planning and facilitating the professional development of Medical Educators and GP Supervisors as well as learning (like everyone else) to do all of this online. Catherine strives to ensure her education events are engaging and innovative, with a dose of appropriate fun. 

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