Carers supporting mobility transitions for drivers with cognitive decline: Road safety issues

Cognitive impairments can influence an individual’s ability to drive safely. If deficits are due to a progressive disease like dementia, driving cessation is inevitable. Carers1 may express concern about and attempt to modify driving behaviours. Given the ageing population and reliance of older Australians on the private car for transport licensing authorities, health practitioners and the community in general will encounter increasing numbers of older people for whom community mobility may be associated with mobility challenges and increased road safety risks. This study gathered information from carers about their experiences of supporting drivers with chronic health conditions. A cross-sectional design was chosen to give a profile of the experiences of carers within one time span (three years of a driving transition period). Forty participants (carers) completed questionnaires. Most participants rated driver health status as either fair or poor for physical health (n=27), psychosocial health (n=25) and cognitive health (n=29). Events triggering carer concerns frequently included patterns of unsafe driving behaviours including being easily distracted, misjudging distances, driving too fast for conditions and difficulty with lane keeping (n=26). Participants applied practical strategies and sought professional assistance, with varying degrees of success. Carers play a significant role in identifying at-risk drivers, managing mobility transitions and optimising their road safety. A safe system approach requires (a) working with stakeholders to support both carers and drivers (b) community and health professional education to increase awareness of driving skill changes associated with chronic health conditions, and (c) promotion of assessment and licensing options.