Determining Fitness to Drive for Drivers with Dementia: A Medical Practitioner Perspective

Bennett, Joanne; Chekaluk, Eugene; Batchelor, Jennifer · 2019 · Crossref

DOI: 10.33492/jacrs-d-18-00276

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Summary

This study investigates the perspectives and practices of medical practitioners in Australia regarding the determination of driving fitness for patients with dementia. As the prevalence of dementia increases, ensuring road safety for this population is critical, yet current guidelines lack specific, validated tools for in-office assessments. The research aimed to identify gaps in practitioner confidence, the methods used for assessment, and the perceived utility of existing guidelines, specifically examining general practitioners, geriatricians, neurologists, neuropsychologists, and occupational therapists. The researchers conducted a cross-sectional survey distributed to 400 practitioners in New South Wales between August and November 2016. Of the 42 respondents (a 10.5% response rate), the majority were experienced practitioners with over 20 years in their field. The questionnaire covered professional practice, awareness of patient driving habits, assessment procedures, reactions to driving cessation discussions, and opinions on current Austroads guidelines. Data were analyzed using descriptive statistics and thematic analysis. Results indicated that practitioners largely rely on self-report and informant interviews rather than objective testing. Although 67% of practitioners identified cognitive function as the most important factor for safe driving, only 25% employed cognitive assessments, and there was little consistency in the specific tests used. General practitioners spent an average of 22 minutes on assessments, while other specialists spent significantly more time. Despite 87% of practitioners being aware of existing guidelines, only 43% found them very informative, with many citing them as vague or lacking specific instructions. Consequently, 87% of practitioners believed they had missed cases of unsafe driving, and 85% supported the need for a more objective assessment tool. Furthermore, 78% reported never receiving professional development on this topic, though 98% expressed a desire for such training. The study concludes that there is a significant disconnect between what practitioners believe determines safe driving and the methods they actually employ. The reliance on subjective self-reporting and the lack of standardized, objective tools contribute to practitioner discomfort and potential safety risks. The findings highlight an urgent need for improved guidelines that include specific, validated cognitive tests with clear cut-off scores, as well as mandatory professional development to help practitioners manage difficult conversations and make accurate fitness-to-drive determinations.

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Topics

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• fitness to drive assessment
• cognitive impairment
• mci dementia driving
• medical conditions