Objectives We adapted the CarFreeMe™-Dementia program created by The University of Queensland for drivers in the United States. CarFreeMe™-Dementia aims to assist drivers living with dementia and their care partners as they plan for or adjust to driving retirement. This semi-structured program focuses on driving retirement education and support. Topics include how dementia affects driving, lifestyle planning, stress management, and alternative transportation options. This study evaluated the feasibility, acceptability, and utility of the CarFreeMe™-Dementia intervention. Methods This pilot phase of the study included 16 care partners and 11 drivers with memory loss who were preparing for or adjusting to driving retirement. Participants completed 4-8 CarFreeMe™-Dementia intervention telehealth sessions. Online surveys (baseline, 1- and 3-month) and post-intervention semi-structured interviews informed evaluation of the intervention program using a mixed methods approach. Results This study established initial support for CarFreeMe™-Dementia in the United States. Participants indicated the program facilitated dialogue around driving retirement and provided guidance on community engagement without driving. Respondents appreciated the program’s emphasis on overall well-being, promoted through lifestyle planning and stress management. They also reported the program offered practical preparation for transitioning to driving retirement. Discussion The CarFreeMe™-Dementia intervention, tailored to an American audience, appears to be a feasible, acceptable, and useful support program for drivers with memory loss (and/or their care partners) who are preparing for or adjusting to driving retirement. Further investigations of the efficacy of the CarFreeMe™-Dementia intervention in the United States, as well as other countries and cultural contexts, are warranted.
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.
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