News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search

 


Driving and Memory loss

Liam Butler interviews Dr John Carmody and Dr Petra Hoggarth about driving and Memory loss.

26 March 2014

Liam Butler

Dr John Carmody is a Senior Staff Specialist Neurologist at Wollongong Hospital, NSW, Australia. He is Head of the Neurology Department, Clinical Theme Leader for Neuroscience and Mental Health at the Illawarra Health and Medical Research Institute, and is a member of the local Human Research Ethics Committee. In terms of clinical research, Dr Carmody is nearing completion of his PhD studies at the University of Wollongong. This work involves the development and testing of a new decision aid booklet which has been designed specifically for drivers with dementia. It is hoped that this booklet will assist people with dementia plan for retirement from driving in Australia and New Zealand. It is anticipated that the booklet will be made available free-of-charge from mid-2014.

John why did you decide to research Driving and Memory Loss?

I found it hard to know what to say to my patients and harder still to know what to say to carers when addressing the issue of memory loss in the hospital setting. The existing guides were not user-friendly.

John many people who have memory loss have no formal diagnosis, how can they stay safe on the roads?

A greater awareness of memory loss and dementia in our community would go a long way in addressing this issue. An important starting point is arranging an appointment to see your GP.

John what is the best way for families or care givers to address a person's driving if they think it is risky?

There are a variety of measures which could be considered. I would favour contacting their GP, local dementia carer group, Alzheimers Australia 1800 100 500 or Alzheimers NZ 0800 004 001 for advice. At times, families are afraid to raise the issue with the driver. It may be best to let the doctor be the ‘bad guy/girl'.

John, what level of memory loss is it ok to drive? And how does someone know if they are safe to drive?

Some people with early/mild dementia are safe to drive. As dementia is gradually progressive, it is very difficult to accurately determine when someone has become unsafe to drive. Early discussion and planning are important strategies. Retirement from driving is easier when planned rather than forced. Review by a GP or specialist every 6 months is wise.

Dr Petra Hoggarth, what is your experience in this field?

I'm a clinical psychologist and did a PhD investigating factors that predict driving ability in healthy older adults and adults with mild cognitive impairment and Alzheimer's dementia. I currently work at Psychiatric Service for the Elderly at the Canterbury DHB. I work in a day hospital and the geriatric psychiatric inpatient ward where I do therapy for mental disorder. I have an interest in the diagnosis of dementia and do the odd neuropsychological assessment when a complicated case arises (such as a younger-age person, or when a rarer form of dementia is suspected). I've written two published articles specifically for NZ GPs about how to detect unsafe driving in their older patients with a focus on the detection of cognitive impairment:

http://nzbri.org/research/publications/papers/0722.pdf 2013 paper in the NZ Medical Journal

http://nzbri.org/research/publications/papers/0549.pdf 2011 paper in the Australasian Journal on Ageing

It can be a challenge for a General Practitioner to act to stop a person driving. Yet, it is their responsibility. What advice do you have for them?

In regards to the effect of cognitive impairment on driving, once the necessary steps of diagnosis are completed New Zealand GPs have the option of referring for a specialist on-road driving assessment (which for most of NZ is paid for privately by the patient). If the patient fails this the assessor will generally have the hard task of breaking the news. If the decision is made without a specialist assessment then breaking the news can be a hard task. My advice is to remember that driving is a privilege, not a right, and that failing to discuss the issue leaves the patient at a much higher risk of a crash and resultant injury or death than in a non-cognitively impaired older driver. Then there are passengers and other road users to think of also. GPs only need to advise the NZ Transport Agency of the decision if they are concerned that the patient will continue driving against advice. My second piece of advice is to start talking about driving cessation as soon as a dementia diagnosis is given. All drivers with dementia will need to stop driving at some point, and so being clear about this at the beginning and encouraging the patient to think of alternative methods of transportation when that time comes is important. It would be best to involve family in this discussion also.

Dr John Carmody

The responsibility for issuing and revoking driver licences in Australia lies with the local Driver Licensing Authority (DLA). In the Northern Territory and South Australia, health practitioners are obliged to report all unsafe drivers to their DLA. However, in other states and territories, there is no such obligation. A valuable resource for Australian GPs (and all health professionals) is the Austroads Fitness to Drive Guidelines 2012.

When should I stop Driving ?

© Scoop Media

 
 
 
 
 
Culture Headlines | Health Headlines | Education Headlines

 

Theatre: Ralph McCubbin Howell Wins 2014 Bruce Mason Award

The Bruce Mason Playwriting Award was presented to Ralph McCubbin Howell at the Playmarket Accolades in Wellington on 23 November 2014. More>>

ALSO:

One Good Tern: Fairy Tern Crowned NZ Seabird Of The Year

The fairy tern and the Fiji petrel traded the lead in the poll several times. But a late surge saw it come out on top with 1882 votes. The Fiji petrel won 1801 votes, and 563 people voted for the little blue penguin. More>>

Music Awards: Lorde Reigns Supreme

Following a hugely successful year locally and internationally, Lorde has done it again taking out no less than six Tuis at the 49th annual Vodafone New Zealand Music Awards. More>>

ALSO:

EPMU: Fourth Pike River Anniversary

Representatives of the Engineering, Printing and Manufacturing Union are proud to stand with the Pike River families to mark four years since 29 men lost their lives. More>>

ALSO:

'Kindara': Unusual Ginger Coloured Kiwi Chick Released To Taupo Creche

A cute little kiwi chick with an unusual ginger tinge to its feathers has just been released to Wairakei Golf & Sanctuary Kiwi Creche in Taupo after hatching at Rainbow Springs' Kiwi Encounter. More>>

Werewolf: The Complicatist : Bob Dylan Himself, And By Others

Bob Dylan is about to release a six CD version of the entire Basement Tapes sessions he recorded with the Band 40 years ago. To mark the occasion, I’ve rustled together some favourite cover versions of Dylan songs, and a few lesser-known tracks by the great man. More>>

ALSO:

Werewolf: Gone Girl : The Trouble With Amy

Philip Matthews: Three words to describe the David Fincher film Gone Girl: cynical, topical and ridiculous. Ridiculous isn’t a negative. More>>

ALSO:

11/11: Armistice Day Peace Vigils

On Armistice Day 2014, the second in the series of peace vigils that will take place three times each year during the World War One centenary will be held in Hokianga, Whangarei, Auckland, Tauranga, Otaki, Lower Hutt, Wellington and Takaka. More>>

ALSO:

Get More From Scoop

 
 

LATEST HEADLINES

 
 
 
 
Health
Search Scoop  
 
 
Powered by Vodafone
NZ independent news