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Catherine Andrew Occupational Therapist, University of Wollongong

Mapping a road to driving retirement with the driver who has a diagnosis of dementia: Enhancing acceptance of the difficult decisions . Catherine Andrew Occupational Therapist, University of Wollongong Associate Professor Victoria Traynor School of Nursing, Midwifery and Indigenous Health

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Catherine Andrew Occupational Therapist, University of Wollongong

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  1. Mapping a road to driving retirement with the driver who has a diagnosis of dementia: Enhancing acceptance of the difficult decisions. Catherine AndrewOccupational Therapist, University of Wollongong Associate Professor Victoria TraynorSchool of Nursing, Midwifery and Indigenous Health Pro-Vice-Chancellor (Health) Professor Don IversonVice Chancellor’s Unit University of Wollongong

  2. Background

  3. Review of the Literature

  4. Theoretical Framework: Ottawa Decision Support Framework O'Conner and Jacobsen, 2007

  5. Research Aims and Objectives Aim: This study sought to identify decisional support needs to inform strategies for enhancing acceptance of driving retirement for drivers with dementia. Objectives: • Review existing educational literature • Identify the type of evidence drivers consider objective

  6. Method: A qualitative study

  7. Findings: Five Themes Mapping a road to driving retirement

  8. 1. Whose opinion will I accept as trustworthy? The relationship is a very important factor (Int2, P13, p. 12)

  9. 2. Real on road experiences are most convincing. I think the clues might be when you’re driving (Int1, P004, p. 5)

  10. 3. Let's discuss this before my judgement is compromised If you see the signs …say to me, ‘You’re not safe to drive’.… (Int1, P005, p. 4)

  11. 4. Would knowing my alternatives influence my decision ? ….it would be more of a psychological loss than a real loss of ability to go places… (Int1, P001, p. 2)

  12. Would knowing my alternatives • increase acceptance ? • Perceived barriers are less tangible and potential solutions are not considered. acceptable Yes No • Explore self efficacy theory • (Bandura 1986) • Perceived barriers are explicit and can be resolved with practical solutions • I have always been a good driver…. • I love to drive…. • I don’t like buses…. • I need to be independent… yes Maybe No

  13. Implications for practice • Risks identified • Early discussion • Objective evidence • Choose to be assessed or retire • Accept Cancellation or Challenge decision • Retirement or cancellation • These Findings have implications for those health practitioners providing support to people with dementia making decisions about driving retirement. Implications for OT practice • Risks identified • Early discussion • Objective evidence • Choose to be assessed or retire • Accept Cancellation or Challenge decision • Retirement or cancellation

  14. Where to from here? • These findings have implications for health practitioners • This study contributes important empirical knowledge informed by consumers and potential consumers. • Further quantitative research is underway (Carmody et al., 2012)

  15. Conclusion Retirement from driving can be enhanced for people with dementia by including: • views of trusted sources • feedback from real on road experiences • early discussion • identification of suitable alternatives • relevant, concise and informative resources

  16. References • Bandura, A 1986, Social foundations of thought and action : A social cognitive theory Englewood Cliffs, New Jersey, Prentice-Hall. • Carmody, J, Traynor, V & Iverson, D 2012, ‘Dementia and driving: An approach for general practice’, Australian Family Physician, vol. 41, no.4, pp. 230-3. • O'Conner AM & Jacobsen MJ 2007, ‘Decisional conflict: supporting people experiencing uncertainty about options affecting their health’, Ottawa Health Research Institute, Ottawa (available at http://decisionaid.ohri.ca/odsf.htm, accessed August 2008) • O'Conner, A, Jacobsen, M & Stacey, D 2002, ‘An evidence-based approach to managing women's decisional conflict’, Journal of Obstetric, Gyneologic & Neonatal Nursing, vol. 31, no.5, pp. 570-581.

  17. Acknowledgement of visual images • http://images.smh.com.au/2012/06/26/3407005/ipad-art-wide-cbd2-420x0.jpg • http://rac.com.au/Travel/~/media/Travel/TravelVarious/Jan11_IDPLandingPage.ashx • http://resources0.news.com.au/images/2012/08/03/1226442/458136-old-man-driving-a-car.jpg • http://www.alphacarhire.com.au/images/articles/driver-liscence.jpg • http://rac.com.au/Motoring/Driving-centre/Driving-courses/Defensive-driving/~/media/Motoring/driving_centre/Banner_Driving_Enhancement.ashx • http://www.umtri.umich.edu/content/FP_Winter_driver.jpg

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