Living with dementia and adjusting to life without driving
Scott, T.L, Liddle, J., Pachana, N., Mitchel, G., Chapman, J., Gustafsson, L.
Background: When the time comes, adjusting to life without driving can be a major life change associated with a decline in physical and mental well-being, and a potential increase in isolation for people living with dementia. We developed an education and support program that uses effective, research-based, client-centered methods to maintain community engagement and well-being. Telehealth could potentially deliver support to older people who are simultaneously coping with driving cessation and finding alternative means of transport to access the community for health care.
Methods: A mixed methods feasibility study was conducted, with clinical measures (individual goal setting, travel, self-efficacy, depression, anxiety and well-being), and documented experiences of health professionals and clients. Adults 65+ years received the intervention in their own homes, via telehealth, using a combination of a telerehabilitation clinic-based health professional - expert in the driving cessation intervention - interacting via eHAB software and a tablet in the person's home, and a local health professional - expert in the local area - supporting practical community access. Experiences of health professionals and clients pre- to post-intervention were explored using a case study design.
Results: Five older adults (74-86 years) and three health professionals participated. Older adults felt comfortable with telehealth technology and were able to build a rapport and communicate with health professionals via the telehealth medium. All older adults demonstrated increased satisfaction and performance in at least one goal. They reported increased confidence in getting out and about in the community after stopping driving.
Conclusions: Individualized telehealth approaches may increase access to timely support for older people with dementia who are retiring from driving. The findings provide preliminary evidence for telehealth delivery of the intervention and suggest areas for improvement and further research.