Graduated 1980 University of Manchester. Trained as General Physician and Geriatrician in Newcastle-upon-Tyne.
MD thesis on Risk factors for Stroke 1993. Came to Waitakere Hospital in 1992 and then to Auckland City Hospital where I practice as a General Physician and Geriatrician. Particular interests in Teaching/Supervision and Error in Medicine. Not a very good driver but a clean licence.
Older Drivers And Dementia
In New Zealand, driving is part of the culture. It enables good social integration and independence. As the numbers of elders increase, so does the number of people with dementia. Dementia impairs the ability to drive safely.
Unlike many driving restrictions due to health issues (such as visual deficits or post-Myocardial infarction) where there are defined rules, driving may be permitted in cases of early dementia, provided that “the medical practitioner is satisfied that there is no significant loss of insight or judgement and an individual does not show signs of disorientation or confusion.” This requires clinical judgment. The removal of driving privileges can have adverse effects on the patient, their families and the therapeutic relationship between doctor and patient.
I will review the data on driving safety in elders, the process of clinical assessment of drivers with cognitive impairment, referral to Occupational Therapy driving assessors, alternatives to driving and communication with patients, relatives and the LTSA.
I will not discuss “routine” age specific driving assessment. Nor will I discuss driving restriction with other medical conditions.