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Driving and Dementia in Older Adults: Implementation and Evaluation of a Continuing Education Project

Correspondence: Address correspondence to Thomas M. Meuser, PhD, Director of Education, Alzheimer's Disease Research Center, Washington University School of Medicine, 4488 Forest Park Avenue, Suite 130, St. Louis, MO 63108. E-mail: meusert{at}abraxas.wustl.edu

Purpose: We aimed to develop and evaluate a multimedia workshop curriculum to educate physicians and other health professionals about (a) driving-related assessment in older adults with dementia, and (b) strategies to encourage driving retirement for impaired individuals.Design and Methods: A curriculum developed by the Older Drivers Project of the American Medical Association was expanded for presentation by a multidisciplinary team. One pilot and seven test workshops were offered. A program evaluation method—testing knowledge, confidence, attitudes, and practice behaviors—was employed at four points in time: T1 (Time 1; pretest focusing on the previous 12 months), T2 (Time 2; same-day post-test), T3 (Time 3; post-test at 3 months), and T4 (Time 4; post-test at 12 months). Results: At T1, participants (N = 147) expressed high agreement that an assessment of driving ability is an important issue in clinical dementia care, but they reported low knowledge of assessment strategies, resources, and state reporting requirements. Modest gains in knowledge and confidence were demonstrated at both T3 (n = 93) and T4 (n = 63). In addition, the frequency of driving-related practice behaviors (i.e., incorporation of driving-related questions into clinical evaluation, chart documentation, reporting of impaired drivers) had increased significantly by T3 and T4. Implications: The results indicate that a focused workshop curriculum, with practical and immediate applications to care, can motivate measurable changes in clinical practice. Once they are informed, health professionals can address issues of driving ability in older patients with dementia and, with the support of available resources, encourage impaired individuals to retire from driving for the safety of everyone on the road.

Key Words: Alzheimer's disease • Cessation • Dementia • Driving • Safety • Retirement

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