Driving, dementia and Australian physicians: primum non nocere?

Abstract

Older Australians are increasingly reliant on automobiles as their sole form of transport. As our population is ageing and the prevalence of dementia is increasing, it is anticipated that the number of drivers with dementia will rise over time. Much of the literature relating to driving and dementia focuses on safety rather than mobility. The objective of this paper is to highlight several topical ethical issues that pertain to Australian drivers with dementia. It is recommended that future research, policy and practice should centre on the crucial mobility and transport needs of our senior citizens.

Development and pilot testing of a decision aid for drivers with dementia

“…Discussion with individuals with dementia about driving retirement often represents a challenging clinical encounter for health professionals [24,27]. A Pyrrhic victory may ensue whereby individuals with dementia are instructed to cease driving yet they neither heed their clinician’s advice nor return for medical review.…”

“…There is a need for a comprehensive and inclusive approach to older drivers with cognitive impairment [24,27,33,62]. This study describes an intervention which contributes towards the achievement of an important goal: enhancing patients’ quality of life while simultaneously maintaining personal and public safety [62].…”

“…Firstly, relevant literature addressing driving and dementia was reviewed [24,27,32]. The attitudes of drivers aged over 55 towards existing driving and dementia resources were also sought.…”

“…The subject of driving and dementia raises a range of important ethical and medico-legal issues [15,16,22-24]. In essence, there is a need to balance road safety with the transport requirements of our ageing population [5,25-28].…”

On‐road driving assessment in dementia

“…Carmody and colleagues 1 have written a balanced and logical approach to driving in dementia. I endorse their view that a blanket restriction on driving simply because of diagnosis of dementia is unwarranted until overwhelming evidence from road crashes supports this conclusion.…”