When working with a client with dementia and caregivers, remember that the conversation about driving retirement is most likely more for the benefit of the family, as opposed to the person with dementia. The person with dementia will most likely not be able to abide by driving retirement independently and will require the support from family to establish environmental safeguards and new habits or strategies.
Here are a few guidelines to use when working with families before, during and after driving retirement:
- Remember that some older drivers will not respond to a constructive conversation about driving retirement. The We Need to Talk program offers the following advice: You may have to consider disabling the car, filing down the keys, or taking away the car. Some older drivers, however, find ways to work around these actions, such as calling a mechanic and having a disabled car repaired.
Strategies, such as not renewing a driver’s license, or canceling registration or insurance may be ineffective. Drivers may continue to drive without a driver’s license, car registration or insurance coverage. As a DRS, you can support caregivers in identifying strategies and removing the temptation to drive.
- Educate caregivers on concerns with wandering. Providing activities and wander-safe environments can be a key to helping the person with dementia stay engaged and to stay safe. Suggest a referral to the local Alzheimer’s Association or senior resource center for options for support services for dementia care and day programs.
- Have a clear understanding of the client’s driving and community mobility habits. Understanding client needs for community mobility, especially to participate in desired or necessary activities, will help you to best advise the family of transportation options. We must work with the family to create a plan to continue these habits and to prevent isolation and risk of depression.
- Work with caregivers to provide both planned and spontaneous outings. Trips out should not just be about getting things done but should continue to foster enjoyment of participating in the community.
- Determine the best options for supervised transportation. It is not appropriate to teach a new mode of transportation to clients with dementia, or to allow them to participate in community mobility independently. Be prepared to discuss this need with family, as well as options for transportation that are better suited to individuals with dementia, such as door-to-door transportation or an escort service.
As with other conversations regarding driving retirement, be prepared to provide your client and family with resources and options to support community mobility needs. Provide the full scope of occupational therapy services to facilitate participation in other desired occupations to provide health and wellness.