Checks needed for driving and dementia
The continuing issue of elderly car drivers in early stages of dementia and the question of public safety is being regularly examined by the Australian and New Zealand Society for Geriatric Medicine and has resulted in the recommendation of a number of future strategies to improve the difficult problems.
In a position paper published in the Australasian Journal on Ageing, the society states that there should be regular reviews at least every six months to ensure safe driving capacity by people who have retained a driving licence in early dementia, with special attention given to behaviour, insight, and cognitive progression.
The future recommended strategies include education and training programs for GPs to encourage early and accurate dementia assessment and diagnosis, the use of new assessment tools including a sound screening cognitive test capable of checking on-road driving performance, and further development of the practically useful publication, Austroads Guidelines.
The society wants the provision of an independent arbitration panel to remove the “difficult and punitive task of licence cancellation from the GP or specialist doctor whose primary role is patient support”.
Community education programs should be developed on the dangers of dementia driving, and there needed to be improved transport options for non-licenced older people including a taxi subsidy for dementia sufferers as well as those with a physical disability.
Public safety more important than personal choice for safe seniors driving
Public safety should win against personal choice especially when it comes to elderly seniors who shouldn’t drive, states an editorial in the Canadian Medical Association Journal (CMAJ).
“Just as planning for job retirement is the social norm, we should be planning for driving retirement by creating programs to help seniors drive safely as long as possible and when they can’t, to help them get around,” states Dr Noni MacDonald, section editor and Dr Paul Hebert, editor-in-chief, CMAJ.
In many industrialised countries physicians are often required to assess when a person’s condition is severe enough to impair their driving. However, this is difficult as doctors do not have objective assessment tools to help them.
“Development and validation of a simple, widely applicable screening assessment tool is sorely needed,” write the authors.
Municipalities, health care authorities, community groups, charities and all levels of government can develop solutions for driving retirees. These can include tax or financial incentives for car pooling, a reverse graduated license, urban planning for seniors’ needs and subsidized shuttle services to help seniors run errands and get back home safely.
The authors conclude that without such programs, seniors will prematurely find themselves in nursing homes at significant personal costs and public expense, unless solutions to the driving dilemma are found.
