Driving a motor vehicle is one of the most valued and complex tasks of activities of daily living. The task of driving involves perception, good judgment, adequate response times and reasonable physical capacity. A range of medical conditions, as well as certain treatments, may impair any of these factors. Impairment may affect driving ability adversely, possibly resulting in a crash causing injury or death.
As the population ages in Australia and indeed around the world, problems associated with elderly drivers with dementia will rise. The issue that confronts the medical profession and allied health professionals is what determines the ability or inability to drive in persons with mild-moderate dementia, and who should make this decision.
Over the last decade this has become a contentious topic with many studies conducted, and literature appeared in numerous journals. Should doctors make the decision about fitness to drive? What would they base their decision on -MMSE results, neuropsychological tests, reports from carers or relatives? Unfortunately, it is those with mild-moderate cognitive impairments that are generally the most challenging with respect to clinical decision-making.
In Australia the "gold standard" to determine driving capacity in clients with mild-moderate dementia is a standardized occupational therapy driving assessment conducted by a specially trained and accredited Occupational Therapist Driving Assessor, involving an off-road assessment and an on-road driving test. This process involves the analysis of the driving task and the individual's ability to safely complete the task of driving.
This paper will discuss previous literature and studies reported on the topic. The occupational therapy driving assessment in Australia will be presented in detail, along with two case studies.
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