Dec 14, 2018

New Guidelines For Driving With Dementia

This may come as a shock to some people, but dementia is not actually a specific disease or illness.

Dementia is an ‘umbrella’ term that describes a series of symptoms associated with a decline in memory, or a deterioration in thinking skills that can reduce a person’s ability to perform everyday activities.

And one of these activities can be driving.

There are a number of different types of dementia but the five most common types are Alzheimer’s, Vascular dementia, Lewy body dementia, Frontotemporal and Young-Onset dementia.

Each of these variances come with their own set of symptoms and an individual can actually be living with multiple types of dementia at one time, this can make determining rules and regulations regarding safety extremely hard to pinpoint fairly.

Having the ability to drive plays an integral role in the wellbeing of capable elderly Australians. For most people, driving is the hallmark of independence, so prematurely removing someone’s legal right to drive will also have a significant negative effect on their self worth and dignity.

Elderly Australians are more prone to the mental health issues brought upon by loneliness and isolation, than any other age group. Inhibiting their ability to drive can also enhance these hardships.

Recently, researchers from the University of Newcastle, UK,  teamed up with a number of external partners, researchers and carers to create a set of guidelines for clinicians that deal with complications surrounding driving with dementia or mild cognitive impairment.

These guidelines outline changes in driving safety that may indicate that driving is starting to become unsafe.

Visuospatial judgement

– Changes to the proximity of the car the individual is driving to stationary vehicles or when overtaking

– Unable to hold a steady course in a defined lane

– Difficulty in following subtle changes in the course of the road

 

Response to hazards

– Repeated failure to respond in busy environments such as junctions or crossings

 

Reduction in attention

– Seeming ‘overwhelmed’ in everyday driving situations

 

Decision making

– Decline in ability to make independent decisions when driving

– Verbal prompt required by passenger

– Over-correction or erratic correction to changes in road direction or the environment

 

Errors in sequencing

– Failing to release the handbrake

– Failing to check for hazards before moving off

– Trouble changing gears or missed gear changes

 

Heightened passenger vigilance

– Passengers becoming more aware of changes in driving ability when travelling in the car

– A change from being a passive traveller to providing prompts or cue

 

With driving playing such a crucial role in a person’s ability to remain independent, simply having the conversation regarding someone’s ability to drive can be difficult.

Dr John-Paul Taylor, Senior Lecturer at Newcastle University who lead the the group that developed the guidelines, acknowledged both the sensitivities and responsibilities involved in these types of conversations.

“This can be a difficult conversation for anyone to have, whether you’re a family member or doctor, because losing the ability to drive can have a significant impact on someone’s independence and wellbeing. However, someone who is no longer safe to drive can be a source of concern for families and loved ones, and may also put the driver and others at risk.”

The weight of responsibility involved with driving is something that rarely comes to mind for most people. But the reality is that a vehicle can be a very deadly weapon when things go wrong, and this can pose a massive risk to the driver and everyone else.

Coming to terms with the fact that you-yourself may actually be a risk, is where part of the problem lies. The majority of drivers see themselves as ‘good drivers,’ and people are very reluctant to admit fault.

There are a number of stigmas attached to people living with dementia and the majority of the time, their capabilities are being undersold rather than overstated.

Being diagnosed with dementia is definitely not a clear-cut indication of being unfit to drive, but it should be treated as a starting point for the person and their loved ones to make themselves aware of the signs of driving decline.

Dr Paul Donaghy, Academic Clinical Lecturer at Newcastle University, clarified that these guidelines were created to ensure that a person living with dementia can be independant safely, not to take away their rights because of their diagnosis.

“This isn’t about taking away the independence of people diagnosed with dementia, it’s about clarifying the situation for clinicians through a clinical framework which works with people with mild cognitive impairment or dementia to support their independence and maintain their safety,”he said.

It is vital that elderly people who are capable of driving safely are allowed to do so, regardless of a diagnosis of dementia, but it’s also extremely important that they, or those around them, be mindful of any deterioration in their ability to drive.

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