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Development of a decision-making tool for reporting drivers with mild dementia and mild cognitive impairment to transportation administrators

Published online by Cambridge University Press:  22 March 2017

Duncan H. Cameron ,
Carla Zucchero Sarracini ,
Linda Rozmovits ,
Gary Naglie ,
Nathan Herrmann ,
Frank Molnar ,
John Jordan ,
Anna Byszewski ,
David Tang-Wai  and
Jamie Dow
...Show all authors
Duncan H. Cameron
Affiliation:
McMaster University, Hamilton, Ontario, Canada
Carla Zucchero Sarracini
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Linda Rozmovits
Affiliation:
Private practice, Toronto, Ontario, Canada
Gary Naglie
Affiliation:
Baycrest Health Sciences, Toronto, Ontario, Canada
Nathan Herrmann
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Frank Molnar
Affiliation:
The Ottawa Hospital, Ottawa, Ontario, Canada
John Jordan
Affiliation:
Western University, London, Ontario, Canada
Anna Byszewski
Affiliation:
The Ottawa Hospital, Ottawa, Ontario, Canada
David Tang-Wai
Affiliation:
University Health Network, Toronto, Ontario, Canada
Jamie Dow
Affiliation:
Société de l'assurance automobile du Québec, Québec, Québec, Canada
Christopher Frank
Affiliation:
Providence Care, Kingston, Ontario, Canada
Blair Henry
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Nicholas Pimlott
Affiliation:
Women's College Hospital, Toronto, Ontario, Canada
Dallas Seitz
Affiliation:
Providence Care, Kingston, Ontario, Canada
Brenda Vrkljan
Affiliation:
McMaster University, Hamilton, Ontario, Canada
Rebecca Taylor
Affiliation:
Baycrest Health Sciences, Toronto, Ontario, Canada
Mario Masellis
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Mark J. Rapoport*
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
*
Correspondence should be addressed to: Mark J. Rapoport, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada. Phone: (416) 480-4085; Fax: (416) 480-5318. Email: [email protected].
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Abstract

Background:

Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators.

Methods:

A multi-faceted, computerized decision support tool was developed, using a systematic literature and guideline review, expert opinion from an earlier Delphi study, as well as qualitative interviews and focus groups with physicians, caregivers of former drivers with dementia, and transportation administrators. The tool integrates inputs from the physician-user about the patient's clinical and driving history as well as cognitive findings, and it produces a recommendation for reporting to transportation administrators. This recommendation is translated into a customized reporting form for the transportation authority, if applicable, and additional resources are provided for the patient and caregiver.

Conclusions:

An innovative approach was needed to develop the DD-DT. The literature and guideline review confirmed the algorithm derived from the earlier Delphi study, and barriers identified in the qualitative research were incorporated into the design of the tool.

Keywords

dementiamild cognitive impairmentautomobile drivingdecision makingcomputer-assisted
Type
Protocol-only paper
Information
International Psychogeriatrics , Volume 29 , Issue 9 , September 2017 , pp. 1551 - 1563
Copyright
Copyright © International Psychogeriatric Association 2017 

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