Determining fitness to drive for drivers with dementia: A medical practitioner perspective

Currently in Australia medical fitness to drive decisions for people with dementia are largely conducted by front line medical practitioners. Little is known about the processes that these practitioners use to make these decisions, and how current guidelines assist in making determinations about driving capacity. A short survey was completed by 42 practitioners. The results of the survey supported previous findings that practitioners do not feel comfortable with making the decision regarding fitness to drive for people with dementia. Practitioners relied largely on self-report or informant information regarding current driving practices. Although practitioners reported that the level of cognitive functioning was the most important factor in determining safe driving, only 25% of practitioners employed cognitive assessments. Whilst the vast majority of practitioners were aware of the fitness to drive guidelines, over half did not find them to be sufficient in enabling determinations of driving capacity. Due to this, almost all practitioners reported that they believe they have missed cases of unsafe driving in this population with over 85% endorsing the need for a more objective tool. Significantly, over threequarters of practitioners reported that they have never received training on how to make fitness to drive decisions. Given that the current driver licensing system for people with dementia depends on medical fitness to drive reviews, the lack of confidence by practitioners regarding making fitness to drive decisions can have a detrimental impact on both the safety of the individual drivers, but also the community as a whole.