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Dementia and the process of stopping driving

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How is the decision about driving cessation made when a driver has dementia? How voluntary is the decision to stop driving? What roles do the family members and the family physician play? These are among the issues a new SFI project, supported by TrygFonden, is set to shed light upon.

Approximately 85,000 people in Denmark suffer from dementia, and it is expected that this figure will increase as the population ages. Dementia is an age-associated illness that to a high degree influences various everyday activities.

Driving is among these activities, as most people with dementia eventually need to stop driving. Given that the proportion of licensed drivers is much higher in the cohorts soon reaching old age than in the previous cohorts, an increasing number of drivers can be expected to face the decision to stop driving due to dementia or similar cognitive deficits in the near future.

Factors in driving cessation

Only little is known about the process and the decision to stop driving in dementia. While driving cessation in general has shown to be a gradual and voluntary process, previous literature indicates that in connection with dementia, the process may be more complex. The process may be abrupt, not voluntary, and family members and physicians are more likely to play a part in this process. However, little systematic knowledge exists on the process itself.

The project carried out by SFI will examine driving cessation in dementia through family members’ and physicians’ perspectives. The project consists of three parts. First, a survey conducted among family members; second, a survey conducted among physicians; and third, qualitative interviews conducted among the family members.

Survey questions

The survey among family members will both describe the process of driving cessation in general and investigate the factors that are related to a problematic or non-problematic process. The research questions the study addresses include the following:

  • What facilitates the process, and how gradual is driving cessation?
  • What factors make the decision easier /harder to make?
  • What is the role of family members in the process?
  • What challenges do the family members face, both before, under and after driving cessation?

The survey among physicians will investigate the physicians’ experiences in connection with patients suffering from dementia who are advised to stop driving. In Denmark, the physicians carry out the age-related medical screenings that are required to renew the driving license, and consequently they are likely to have an important role in the process of driving cessation. The research questions this part of the study addresses include the following:

  • How do the physicians view their role in the process?
  • Do the physicians feel they have the relevant tools and other means to assess driving fitness?

Interview questions

The qualitative interviews among the family members will investigate the process of driving cessation in dementia in more in-depth. The research questions this part of the study will address include:

  • How does everyday life change post driving cessation?
  • Are there possible conflicts of interest for family members in the process (e.g., being dependent on the transportation provided by the demented driver vs. being worried about their safety)?
  • What are the dynamics between the driver and the family members in the process? Is there a change post cessation?
  • The results of the project are expected to shed light on what characterizes the process of driving cessation in dementia and which problems the family members and the physicians experience during it. Further, the results are expected to help formulate ways in which persons with dementia as well as their family members and the health professionals involved could be supported in the process of giving up driving.

The project is being carried out between February 2014 and December 2015.

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