Refining a Driving Retirement Program for Persons With Dementia and Their Care Partners: A Mixed Methods Evaluation of CarFreeMe™-Dementia

Abstract

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.

CarFreeMe™-Dementia: Potential Benefits of a Driving Retirement Intervention Supporting Persons With Dementia and Their Families

“…This intervention was adapted for people living with dementia, CarFreeMe™-Dementia (CFM™-D), filling a gap in existing interventions by including both the person with dementia and their care partner(s) in planning and decision-making throughout each phase of the driving retirement process ( Scott et al, 2020b ). The CFM™-D intervention provides person-centered, flexible, and individually tailored education and social support, with a goal of improving outcomes such as community mobility, personal well-being, and driving retirement preparedness ( Peterson et al, 2023 ; Scott et al, 2019 ; 2020b ). The present study describes Phase II of a two-phase study evaluating the CFM™-D intervention modified for a U.S. audience.…”

“…The present study describes Phase II of a two-phase study evaluating the CFM™-D intervention modified for a U.S. audience. A primarily qualitative analysis of 16 care partner/retiring driver dyads’ experiences in Phase I showed acceptability and feasibility of the CFM™-D intervention and identified initial themes for mechanisms of benefit ( Peterson et al, 2023 ).…”

“…Participants were offered a companion workbook (digital or hardcopy) with module content and related resources for them to follow along in the sessions and reference later. Based on Phase I feedback ( Peterson et al, 2023 ), changes to the CFM™-D for Phase II included highlighting a range of alternatives to driving and removal of duplicate content. See Table 1 for a more detailed outline of intervention module details and further information in Liddle et al (2007 , 2013 ); Peterson et al (2023) ; Scott et al (2019) ; and Scott et al (2020b) .…”

“…The Phase II study was adequately powered to detect changes in these measures to demonstrate preliminary efficacy as well as empirically delineate contextual mechanisms of benefit. Given the importance of social support ( Holden & Pusey, 2021 ; Liddle et al, 2023 ) and different driving retirement stage challenges ( Liddle et al, 2013 ; Peterson et al, 2023 ), we hypothesized that dyad status and whether the person with dementia was preparing for or adjusting to driving retirement would have significant effects on intervention receipt, well-being, and driving retirement preparedness.…”

Understanding barriers to evidence-based support for driving cessation

“…2023). Evidence supports the effectiveness of interactive driving cessation programs with individual goal achievement in increasing community mobility (Liddle et al, 2014;Peterson et al, 2023;Scott et al, 2020); however, there is limited access to these programs in the community. For the past 17 years, we have been systematically working with health professionals, older adults with and without dementia, and their key support people to understand effective methods to provide support in driving cessation and the barriers to widespread implementation of a driving cessation support programs in practice (Liddle et al, 2023).…”